目的探讨初发2型糖尿病患者勃起功能障碍与血清同型半胱氨酸水平的关系,并分析影响勃起功能的其他因素。方法收集30例初发2型糖尿病合并勃起功能障碍患者[根据国际勃起功能指数(IIEF-5)评分判定],同时收集33例初发2型糖尿病未合并勃起功能障碍患者为对照组,并设正常对照组30例。用特定蛋白分析仪免疫散射比浊法测定血清总同型半胱氨酸,并测定血糖、HbA1C、胰岛素、血脂、尿酸、性激素等指标。结果糖尿病勃起功能障碍组血清总同型半胱氨酸水平[(12.9±1.2)μmol/L]明显高于糖尿病非勃起功能障碍组[(9.9±1.6)μmol/L,P〈0.05]及正常对照组[(7.2±1.1)μmol/L,P〈0.01];初发2型糖尿病患者IIEF-5评分与总同型半胱氨酸、年龄、吸烟、体重指数、HbA1C、空腹血糖负相关(相关系数分别为-0.574、-0.413、-0.231、-0.242、-0.274、-0.371,P〈0.05或P〈0.01),与高密度脂蛋白胆固醇呈正相关(相关系数为0.275,P=0.013)。结论糖尿病勃起功能障碍是一个多环节、多病因参与的结果,同型半胱氨酸可能是糖尿病性勃起功能障碍一个新的危险因素。
Objective To detect the relationship between serum homocysteine (Hcy) level and erectile dysfunction in type 2 diabetic patients, and to investigate the factors which influence the erectile function. Methods Thirty type 2 diabetic patients with erectile dysfunction were recruited as the first group in the study. 32 type 2 diabetic patients without erectile dysfunction were included as the second group. 30 healthy subjects served as control. Serum total Hcy was measured by protein-specific immune analyzer nephelometry in all subjects. Fasting and postprandial plasma glucose, HbA1C, fasting insulin, blood lipids, uric acid, sex hormones, and other biochemical indicators were measured in all participants. Results The serum total Hcy level in the group with erectile dysfunction [ (12.9±1.2)μmol/L] was significantly higher than that in both of the group without erectile dysfunction [ ( 9.9± 1.6 )μmol/L, P〈 0.05 ] and the control group [ ( 7.2±1.1 ) μmol/L, P〈 0.011- International index of erectile function (IIEF) -5 score in patients with type 2 diabetes was negatively correlated with serum levels of total Hcy, age, smoking history, body mass index, HbAt c, and fasting plasma glucose (r were -0. 574, -0. 413, -0. 231, -0. 242, -0. 274, -0. 371, respectively, P〈0.05 or P〈0.01 ) , and significantly positive correlation existed between IIEF-5 scores and high-density lipoprotein-cholesterol ( r = 0. 275, P = 0. 013 ). Conclusions Erectile dysfunction in diabetic patients is a consequence caused by multi-factors with a complicated mechanism. Hey seems to be a possible risk factor in diabetic patients with erectile dysfunction.