评估透皮睾酮替代疗法对 2 型糖尿病男性血糖控制的影响

IF 0.7 Q4 ENDOCRINOLOGY & METABOLISM
Diabetes Mellitus Pub Date : 2024-05-06 DOI:10.14341/dm13131
R. Rozhivanov, M. O. Chernova, V. A. Ioutsi, G. Mel’nichenko, M. V. Shestakova, E. R. Rozhivanova, E. Andreeva, N. Mokrysheva
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引用次数: 0

摘要

背景:评估雄激素替代疗法对血糖控制的影响非常重要。目的:评估经皮睾酮疗法对患有性腺功能减退症和 T2DM 的男性血糖控制的影响。材料与方法:这项前瞻性比较研究包括 300 名 55[49;61] 岁的男性:同时接受降糖疗法 (GLT) 和经皮睾酮的男性;以及仅接受 GLT 的患者。观察期为 1 年。对患者进行病史、雄激素缺乏症状问卷调查,并测量总睾酮和糖化血红蛋白。结果发现:在研究开始后的 6 个月和 12 个月内,接受雄激素替代疗法和 GLT 联合治疗的患者,其总睾酮水平明显更高,雄激素缺乏症状的严重程度也更轻。在评估研究参数的变化幅度时发现,接受睾酮替代疗法(TRT)的患者糖化血红蛋白水平的下降在统计学上更为明显(平均差异为 0.3%)。在 29 名(20.4% (95% ДИ 13.8-27.0) )仅接受 GLT 治疗的男性患者中,性腺功能减退症已被消除。在 TRT 组的 3 名患者中,观察到总血 PSA 水平出现病理性升高,因此停止了 TRT。在使用 TRT 和未纠正性腺功能减退症的男性中,分别有 8% 和 1.3% 的人检测到血红蛋白升高超过参考值(>172 克/升),P=0,011:结论:与单独使用 GLT 相比,透皮 TRT 和 GLT 的组合对血糖控制有积极作用,表现为糖化血红蛋白的降低幅度更大。睾酮水平的正常化会导致雄激素缺乏症状的减轻,生活质量也会随之提高。在少数病例中,仅使用 GLT 可消除性腺功能减退症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of the effect of testosterone replacement therapy with a transdermal testosterone on glycemic control in men with type 2 diabetes mellitus
BACKGROUND: It is important to evaluate the effect of androgen replacement therapy on glycemic control.AIMS: Assessment of the effect of transdermal testosterone therapy on glycemic control in men with hypogonadism and T2DM.MATERIALS AND METHODS: The prospective, comparative study included 300 men aged 55[49;61] years: men receiving both glucose-lowering therapy (GLT) and transdermal testosterone; and patients receiving only GLT. Observation period 1 year. A medical history, a questionnaire for symptoms of androgen deficiency, and measurement of total testosterone and glycated hemoglobin were carried out. Groups were compared using nonparametric methods.RESULTS: Patients receiving androgen replacement therapy in combination with GLT at both 6 and 12 months from the moment of inclusion in the study, they had a statistically significantly higher level of total testosterone and less severity of symptoms of androgen deficiency. When assessing the magnitude of changes in the studied parameters, it was found that patients receiving testosterone replacement therapy (TRT) were characterized by a statistically significantly more pronounced decrease in the level of glycated hemoglobin (average difference 0,3%). In 29 (20,4% (95% ДИ 13,8–27,0)) men who received only GLT, hypogonadism was eliminated. In 3 patients from the TRT group, a pathological increase in the level of total blood PSA was observed, and therefore TRT was discontinued. An increase in hemoglobin above the reference value (>172 g/l) was detected in 8% and 1,3% of men on TRT and without correction of hypogonadism, respectively, p=0,011.CONCLUSIONS: The combination of transdermal TRT and GLT has a positive effect on glycemic control, which is manifested by a decrease in glycated hemoglobin to a greater extent than when using GLT alone. Normalization of testosterone levels leads to a decrease in the symptoms of androgen deficiency, which is accompanied by an improvement in quality of life. Elimination of hypogonadism only with GLT is possible in a small number of cases.
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来源期刊
Diabetes Mellitus
Diabetes Mellitus ENDOCRINOLOGY & METABOLISM-
CiteScore
1.90
自引率
40.00%
发文量
61
审稿时长
7 weeks
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