| Objective To investigate the relationship between follicle-stimulating hormone(FSH)and other sex hormone indices with lipid,glucose,uric acid(UA)and body mass index(BMI)levels in men with type 2 diabetes;to describe the independent role of elevated FSH on dyslipidemia in the presence of normal testosterone(T)levels and the associated risk factors affecting hyperlipidemia.Methods Male adult patients with type 2 diabetes who were hospitalized at the Affiliated Hospital of Qingdao University from January 2018 to June 2020 were retrospectively collected.(1)Clinical information collected from patients included:basic characteristics:patient age,disease duration,BMI,comorbidities and complications and related medications,FSH,luteinizing hormone(LH),T,estradiol(E2),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG),glycated hemoglobin(Hb A1c),and UA.(2)FSH and other sex hormone indicators were compared by quartile grouping for lipid,glucose,UA and BMI levels;(3)FSH and other sex hormone indicators were compared by quartile grouping for each index of lipid,glucose,UA and BMI;(4)Spearman correlation analysis was performed for those indexes that were significant in the univariate analysis between sex hormone and glucose,lipid,UA and BMI;(5)Subgroup analysis of the relationship between FSH and lipid was performed for patients with normal T levels;(6)Multifactorial analysis of independent risk factors affecting hyperlipidemia.Results Nine hundred and sixty-three patients with T2DM,with an age range of20-87 years and a mean age of 58.89±12.246 years,were included.(1)Serum T,E2,FSH and LH were grouped in quartiles,from low to high as Q1,Q2,Q3 and Q4 to compare each index of lipids,and the results showed that:(1)When comparing T levels between groups,TC,TG,LDL-C,and non-HDL-C levels were increased and HDL-C levels were decreased in the Q1 group compared to the Q4 group(all P<0.05);(2)No difference in lipid indexes when comparing E2 levels between groups (all P>0.05);(3)When comparing FSH levels between groups,TC,TG,LDL-C and non-HDL-C levels were higher in the Q4 group than in the Q1 group(all P<0.05),and there was no difference in HDL-C levels(P>0.05);(4)When comparing LH levels between groups,TC,TG,LDL-C and non-HDL-C levels were significantly higher in the Q4 group compared with the Q1 group(all P<0.05),and there was no difference in HDL-C levels(P>0.05);(2)The results of comparing T,E2,FSH,and LH levels by median grouping for each indicator of lipids showed that,compared with the low level group:(1)T levels were significantly lower in the high TC,TG,LDL-C and non-HDL-C groups,while T levels were higher in the high HDL-C group(all P<0.05);(2)No difference in E2 levels between the groups(all P>0.05);(3)FSH levels were significantly higher in the high level TC,TG,LDL-C and non-HDL-C groups(all P<0.05),while there was no difference between HDL-C groups(P>0.05);(4)LH levels were significantly higher in the high level TC,TG,LDL-C and non-HDL-C groups(all P<0.05),while there was no difference between HDL-C groups(P>0.05);(3)Serum T,E2,FSH,and LH were grouped into four quartiles,Q1,Q2,Q3,and Q4,respectively,from low to high,and the results showed that:(1)There was no difference in FBG and Hb A1c levels between groups when comparing T levels(all P>0.05),UA levels were higher in the Q4 group than in the Q1 group(P<0.05),and BMI levels were higher in the Q1 and Q2 groups than in the Q3 and Q4 groups,respectively(all P<0.05);(2)E2,FSH,and LH levels were compared between groups,and there were no significant differences in FBG,Hb A1c,UA,and BMI levels between groups(all P>0.05).(4)FBG,Hb A1c,UA and BMI were grouped to compare FSH and other sex hormone indexes,and the results showed that:(1)When FBG was grouped at 6.1 mmol/L,the T level in the attainment group was higher than that in the non-attainment group(P<0.05),while FSH,LH and E2 levels did not differ between the two groups(all P>0.05);(2)When Hb A1c was grouped at 7%,the T levels were higher than those of the non-compliant group(P<0.05),while FSH,LH and E2 levels were not different between the two groups(all P>0.05);(3)Grouping UA at 420 mmol/L,T and FSH levels in the HUA group were lower than those in the UA normal group(all P<0.05),while LH and E2 levels were not different between the two groups(all P>0.05);(4)BMI levels were divided into three groups:18.5-23.9kg/m~2in the normal group,24.0-27.9 kg/m~2in the overweight group,and≥28.0kg/m~2in the obese group,and T levels in the BMI normal group were higher than those in the overweight group than in the obese group(all P<0.05),while FSH,LH and E2 levels did not differ between the three groups with different BMIs(all P>0.05).(5)The results of subgroup analysis showed that:(1)Among 788 patients with normal T levels,FSH was divided into Q1,Q2,Q3 and Q4 according to quartiles from lowest to highest.Q2,Q3 and Q4 groups were compared,and TC,TG,LDL-C and non-HDL-C levels were higher in the Q4 group than in the Q1 group(all P<0.05),while HDL-C levels were not statistically different between the groups(P>0.05).Further 395 patients with T levels in the upper quartile of 788 patients were selected for comparison,and this relationship still held(all P<0.05);(2)Among 384patients(48.73%)with normal T levels and aged 20-60 years,FSH,TC,TG,LDL-C and non-HDL-C levels were higher in the 40-60 years group than in the 20-40 years group(all P<0.05),while there was no difference in T and HDL-C levels between the two groups(P>0.05);(6)Comparing the lipid indices by grouping FBG and Hb A1c,the results showed that:(1)When FBG was grouped with a cut-off of 6.1mmol/L,TG levels in the FBG non-compliant group were higher than those in the FBG compliant group(P<0.05),while TC,LDL-C,HDL-C and non-HDL-C levels were not different between the two groups(all P>0.05);(2)Hb A1c was grouped at7%,and TC,TG,LDL-C,HDL-C and non-HDL-C levels were higher in the Hb A1c non-compliant group than in the Hb A1c compliant group(all P<0.05);(7)Blood lipid indicators were grouped according to median to compare FBG,Hb A1c,UA and BMI The results showed that:compared with the low level group,(1)FBG levels were higher in the high TC group(P<0.05),while Hb A1c,UA and BMI levels were not different between the two groups(all P>0.05);(2)FBG and BMI levels were higher in the high TG group(all P<0.05),while Hb A1c and UA levels were not different between the two groups(all P>0.05);(3)FBG levels in the high non-HDL-C group had elevated FBG and BMI levels(all P<0.05),and Hb A1c and UA levels did not differ between the two groups(all P>0.05);(4)FBG,Hb A1c,UA and BMI levels did not differ between LDL-C and HDL-C groups(all P>0.05);(8)Spearman Correlation analysis showed that(1)T and TC,TG,LDL-C and non-HDL-C were weakly negatively correlated(r=-0.193,-0.198,-0.138,-0.236;all P<0.05),and weakly positively correlated with HDL-C(r=0.159;P<0.05);(2)FSH was weakly positively correlated with TC,TG,LDL-C and non-HDL-C(r=0.354,0.336,0.312,0.362;all P<0.05)and no correlation with HDL-C levels(P>0.05);(3)LH showed a weak positive correlation with TC,TG,LDL-C and non-HDL-C levels(r=0.189,0.215,0.181,0.207;all P<0.05)and no correlation with HDL-C levels(P>0.05);(4)FSH was very weakly negatively correlated with UA(r=-0.086;P<0.05);(5)T was weakly negatively correlated with both UA and BMI(r=-0.175,-0.234;both P<0.05);(10)In logistic multifactorial analysis,(1)High FSH and low T levels were independent risk factors for high TC,high TG,high LDL-C and non-HDL-C blood disorders;(2)Age≥60 years was an independent risk factor for high TG blood disorders;(3)Hb A1c≥7%was an independent risk factor for high LDL-C and high non-HDL-C blood disorders;(4)BMI≥24 kg/m~2was an independent risk factor for high TG and low HDL-C blood disorders.Conclusion(1)Both high serum FSH levels and low T levels in men with T2DM were influential factors in the elevation of TC,TG,LDL-C,and non-HDL-C,and this effect of FSH was independent and preceded the change in T levels;(2)FSH was very weakly negatively correlated with UA,and there was no correlation between FBG,Hb A1c,and BMI levels;(3)T was weakly negatively correlated with UA and BMI levels,and there was no correlation between FBG and Hb A1c levels;(4)High FSH and low T levels were independent risk factors for high TC,high TG,high LDL-C,and non-HDL-C hemorrhage;(5)Age≥60 years was an independent risk factor for high TG hemorrhage,Hb A1c≥7%was high LDL-C,high non-HDL-C hemorrhage,and BMI≥24 kg/m~2was an independent risk factor for high TG and low HDL-C hemorrhage independent risk factors. |
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