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目的:比较垂体功能减退症患者(Hypopituitarism,Hypo-Pit)与低促性腺激素性性腺功能减退症(Hypogonadotropic hypogonadism,HH)的糖脂代谢状况。方法:收集从2013年6月至2016年9月在西京医院内分泌代谢科确诊的Hypo-Pit及HH男性患者的临床资料,分别有32例Hypo-Pit患者和43例HH患者纳入本研究,对照组为22例年龄、体质指数(BMI)与研究组相匹配,且无糖尿病等慢性疾病家族史的男性。采集空腹静脉血后测定血脂水平,行3h口服葡萄糖耐量试验(OGTT),测定血糖及胰岛素水平,计算葡萄糖、胰岛素曲线下面积、胰岛素抵抗指数等。3组间计量资料组间的比较应用LSD方差分析检验,非正态分布的数据经自然对数转换(ln)后进行分析。结果:各组间年龄、BMI均无统计学差异(P>0.05);与正常对照组相比,Hypo-Pit患者及HH患者的高密度脂蛋白水平下降(均P<0.05),甘油三酯水平升高(P<0.05);与HH患者相比,Hypo-Pit患者的胆固醇、甘油三酯、低密度脂蛋白升高(P<0.05);与正常对照组相比,HH患者的稳态模型胰岛素抵抗指数及胰岛素敏感指数升高(P<0.05);与对照组比较,Hypo-Pit患者及HH患者OGTT 3h血糖水平升高,差异有统计学意义(均P<0.05);HH患者空腹、2h、3h血清胰岛素水平均明显升高,差异有统计学意义(均P<0.05);与HH组相比,Hypo-pit患者的HOMA-IR水平降低(P<0.05)。结论:Hypo-Pit患者存在糖脂代谢紊乱,且脂代谢紊乱较HH患者更差,而HH患者胰岛素抵抗水平高于Hypo-Pit患者。
Objective: To compare the glucose and lipid metabolism of Hypopituitarism (Hypo-Pit) and hypogonadotropic hypogonadism (HH). Methods: The clinical data of Hypo-Pit and HH male patients diagnosed in Department of Endocrinology and Metabolism of Xijing Hospital from June 2013 to September 2016 were collected. 32 cases of Hypo-Pit and 43 cases of HH were enrolled in this study. The group consisted of 22 males with a family history of age-matched, body mass index (BMI) matched the study group without a family history of chronic disease such as diabetes. Serum lipids were measured after fasting venous blood was collected. OGTT was performed 3 hours later. Blood glucose and insulin levels were measured. Glucose, insulin area under the curve and insulin resistance index were calculated. The comparisons between the three groups of measurement data were performed using the LSD analysis of variance. The non-normal distribution data were analyzed after natural logarithmic conversion (ln). Results: There was no significant difference in age and BMI between the two groups (P> 0.05). Compared with the normal control group, the levels of HDL in Hypo-Pit patients and HH patients were decreased (all P <0.05) (P <0.05). Compared with HH patients, the levels of cholesterol, triglyceride and low density lipoprotein in Hypo-Pit patients increased (P <0.05). Compared with the control group, the steady state (P <0.05). Compared with the control group, the blood glucose level of OGTT 3h increased significantly in Hypo-Pit patients and HH patients (all P <0.05); the fasting (P <0.05). The level of HOMA-IR in Hypo-pit patients was lower than that in HH group (P <0.05). CONCLUSIONS: Hypo-Pit patients have dyslipidemia and dyslipidemia worse than HH patients, whereas patients with HH have higher insulin resistance than Hypo-Pit patients.