Objective: To evaluate the effects of Testosterone Undecanoate Pills (TUP) on insulin resistance (IR) in type-2 diabetes men with hypogonadism.
Methods: We randomly divided 82 type-2 diabetes patients with hypogonadism into a treatment (n = 42) and a control group (n = 40), both maintaining their glucose- and lipid-reducing therapies, while the former treated orally with TUP in addition. After 6 months of medication, we compared the body mass index (BMI), waist circumference (WC), blood glucose level, HbA1c, lipid profile, IR index obtained by homeostatic model assessment (HOMA-IR), insulin sensitivity index (ISI), sex hormone levels, and sexual function scores between the two groups of patients.
Results: Compared with the baseline, the patients in the treatment group showed significant decreases after medication in BMI (［26.71 ± 2.39］ vs ［25.15 ± 2.28］ kg/m2, P <0.05), WC (［89.96 ± 9.13］ vs ［85.03 ± 9.58］ cm, P <0.05), HbA1C (［7.73 ± 1.31］ vs ［7.01 ± 1.25］ %, P <0.05), and triglyeride (［1.97 ± 0.83］ vs ［1.41 ± 0.69］ mmol/L, P <0.05), a markedly elevated level of total testosterone (［7.16 ± 2.21］ vs ［14.22 ± 2.63］ nmol/L, P <0.05), and remarkable improvement in HOMA-IR (3.76 ± 1.18 vs 2.55 ± 1.03, P <0.05), ISI (96 ± 51 vs 138 ± 53, P <0.05) and total scores of the Aging Males' Symptoms (P <0.05). But no significant changes were observed in the scores of the International Index of Erectile Function (IIEF) after treatment (13.28 ± 6.38 vs 14.95 ± 6.08, P >0.05).
Conclusions: TUP can significantly improve insulin resistance in type-2 diabetes men with hypogonadism.
目的: 探讨睾酮替代治疗对糖尿病合并迟发性性腺功能减退患者胰岛素抵抗的作用及其临床疗效。方法： 82例糖尿病合并迟发性性腺功能减退患者随机分为睾酮治疗组（n=42）和对照组 (n=40)，两组患者均维持原有降糖、调脂治疗方案，治疗组在此基础上予十一酸睾酮胶丸口服，共治疗6个月，观察两组治疗前后体重指数、腰围、血糖、血脂谱、胰岛素敏感性、生殖激素以及中老年男性症状问卷（AMS）评估的相关症状评分及IIEF-5评分变化。结果： 与治疗前相比，治疗组干预后体重指数(26.71±2.39 vs 25.15±2.28, P<0.05)、腰围(cm)（89.96±9.13 vs 85.03±9.58，P<0.05）、糖化血红蛋白(%)（7.73±1.31 vs 7.01±1.25，P<0.05）、甘油三酯(mmol/L)（1.97±0.83 vs 1.41±0.69，P<0.05）显著下降，总睾酮(μmol/L)（7.16±2.21 vs 14.22±2.63，P<0.05）显著升高， 稳态模型评估的胰岛素抵抗指数（3.76±1.18 vs 2.55±1.03，P<0.05）和胰岛素敏感指数（96±51 vs 138±53，P<0.05）显著改善，AMS心理和躯体评分显著改善（P<0.05），但IIEF-5评分（13.28±6.38 vs 14.95±6.08，P>0.05）改善不明显。结论： 睾酮替代治疗可以改善糖尿病合并迟发性性腺功能减退患者胰岛素抵抗并具有确切临床疗效。.