| Objectives A large number of clinical epidemiological studies have found that low testosterone level can cause the rise of central obesity,insulin resistance,and promote the occurrence and development of coronary heart disease.Our research group's previous clinical studies have also found that physiological dose testosterone supplementation therapy can improve glucose and lipid metabolism in middle-aged and elderly men diagnosed with low testosterone.The research group further conducted animal experiments on rats,that is,by different concentrations of gradient testosterone intervention on castrated SD rats,and observed that rats with testosterone deficiency would show different degrees of glucose and lipid metabolism disorders,atherosclerosis,etc.Based on the results of our previous study,we aimed to explore the correlation between changes in testosterone levels and abnormal bone metabolism in men with type 2 diabetes mellitus.Methods1.The patients with type 2 diabetes admitted to the endocrinology department of our hospital were aged between 40 and 60 years old.According to detailed medical history,physical examination and bone mineral density of males,the subjects were divided into three groups: type 2 diabetes mellitus group with normal bone metabolism,type 2diabetes mellitus group with decreased bone mass,and type 2 diabetes mellitus group with osteoporosis.There were 40 cases in each group,a total of 120 cases.At the same time,40 healthy subjects who underwent physical examination in our hospital during the same period were selected as the control group,and the medical history of all subjects was collected and recorded.General information of the patients,such as height (m)and weight(kg),was first collected,and body mass index(BMI): weight(kg)/height 2(m2)was calculated.Blood test indexes of the subjects were collected,including sex hormone indexes: peripheral blood serum testosterone(T),serum estrogen(E);Bone metabolism related indicators: osteocalcin(BGP),calcitonin(CT),parathyroid hormone(PTH),n-terminal osteocalcin(n-midocn),total type 1 procollagen n-terminal propeptide(t P1NP),collagen degradation product(-crosslaps).Blood biochemical indexes: fasting blood glucose(FPG),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(ldl-c),high-density lipoprotein cholesterol(hdl-c),alkaline phosphatase(AKP),calcium(Ca),serum magnesium(mg),serum phosphorus(P).2.Results1.The testosterone level of type 2 diabetes mellitus group,type 2 diabetes mellitus group with decreased bone mass,and type 2 diabetes mellitus group with osteoporosis group was lower than that of the control group(p < 0.05),and the decrease of testosterone was more obvious with the aggravation of the abnormal degree of bone metabolism.2.type 2 diabetes mellitus group,type 2 diabetes mellitus combined with bone loss group,type 2 diabetes mellitus combined with osteoporosis group bone metabolism indicators t P1 NP,-crosslaps were higher than the normal group(p < 0.05),and with the aggravation of bone metabolism,t P1 NP increased,-crosslaps decreased.3.There was no significant difference in the indicators of AKP,Ca,Mg and P between the two groups(P > 0.05).CT of type 2 diabetes mellitus group,type 2 diabetes mellitus group with decreased bone mass and type 2 diabetes mellitus group with osteoporosis was significantly lower than that of the control group(p < 0.05),and CT and T/E2 were significantly lower than those of the other three groups(p < 0.05).4.Testosterone is negatively correlated with ldl-c(P<0.05)and positively correlated with hdl-c(P<0.05),but not statistically correlated with TC and TG(P>0.05).Conclusions1.Serum testosterone is one of the indicators reflecting metabolic disorders in male type2 diabetes mellitus.When serum testosterone level drops,insulin resistance index increases and bone formation inhibition increases.2.The testosterone level of the osteoporosis group was significantly lower than that of the other three groups,and the ratio of testosterone to estradiol was also significantly lower than that of the other three groups,suggesting that the occurrence of osteoporosis in men was closely related to the decrease of the secretion of the dominant hormone testosterone.3.Testosterone can regulate blood lipid metabolism: when testosterone level is high,ldl-c decreases while hdl-c increases;on the contrary,ldl-c increases while hdl-c decreases. |
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