Klinefelter综合征患者糖代谢分析
目的评价Klinfelter综合征（KS）患者糖代谢特点，同时探讨KS患者易发生糖代谢紊乱的可能病因。方法回顾性分析1990年以来在解放军总医院就诊的28例KS患者（包括9例合并糖尿病患者）的一般情况、病史资料和实验室检查结果[性腺激素水平、血脂水平、口服75 g口服葡萄糖耐量试验（OGTT）血糖和胰岛素水平]等临床资料。同时选择18例单纯糖尿病患者与9例合并糖尿病的KS患者按照年龄、体质指数（BMI）、病史进行配对。统计学方法采用完全独立样本t检验及配对样本t检验。结果（1）KS人群中糖尿病发生率为32.1%（9/28），染色体核型为47，XXY的患者糖尿病发生率为30.7%（8/26），染...
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| Published in | 中华糖尿病杂志 Vol. 9; no. 3; pp. 195 - 199 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Chinese |
| Published |
解放军总医院内分泌科,北京,100853
2017
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1674-5809 |
| DOI | 10.3760/cma.j.issn.1674?5809.2017.03.011 |
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| Abstract | 目的评价Klinfelter综合征（KS）患者糖代谢特点，同时探讨KS患者易发生糖代谢紊乱的可能病因。方法回顾性分析1990年以来在解放军总医院就诊的28例KS患者（包括9例合并糖尿病患者）的一般情况、病史资料和实验室检查结果[性腺激素水平、血脂水平、口服75 g口服葡萄糖耐量试验（OGTT）血糖和胰岛素水平]等临床资料。同时选择18例单纯糖尿病患者与9例合并糖尿病的KS患者按照年龄、体质指数（BMI）、病史进行配对。统计学方法采用完全独立样本t检验及配对样本t检验。结果（1）KS人群中糖尿病发生率为32.1%（9/28），染色体核型为47，XXY的患者糖尿病发生率为30.7%（8/26），染色体核型为48，XXYY患者糖尿病发生率为50%（1/2）；（2）合并糖尿病的KS患者与单纯KS患者相比，年龄大、睾酮水平低[分别为（28±8）比（22±4）岁，（2.0±1.3）比（5.4±4.3）nmol/L，t=3.044、-2.249；均P〈0.05]，虽然两组基础胰岛素水平和胰岛素分泌曲线下面积未见显著差异，但合并糖尿病的KS患者胰岛素抵抗指数较单纯KS患者明显增大（6.5±3.4比1.2±2.1，t=3.234，P〈0.05）；（3）KS合并糖尿病患者与单纯糖尿病患者相比，虽然75 g OGTT试验血糖和胰岛素水平一致，但身材更高、体重更重、低密度脂蛋白胆固醇水平更低[分别为（178±12）比（170±6）cm，（91±23）比（80±14）kg，（2.1±0.9）比（2.8±0.5）mmol/L，t=0.750、3.866、-2.681；P〈0.05]；（4）合并糖尿病的KS患者与单纯KS患者及单纯糖尿病患者相比，雌激素/雄激素比值（E/T）高，差异具有统计学意义（t=2.302、2.748；均P〈0.05）。结论（1）KS患者糖尿病发生率明显升高；（2）KS患者易发生糖代谢异常的病因可能包括年龄、睾酮水平低和卵泡刺激素水平高、高E/T值、胰岛素抵抗和X染色体数目异常等。 |
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| AbstractList | 目的 评价Klinfelter综合征(KS)患者糖代谢特点,同时探讨KS患者易发生糖代谢紊乱的可能病因.方法 回顾性分析1990年以来在解放军总医院就诊的28例KS患者(包括9例合并糖尿病患者)的一般情况、病史资料和实验室检查结果[性腺激素水平、血脂水平、口服75 g口服葡萄糖耐量试验(OGTT)血糖和胰岛素水平]等临床资料.同时选择18例单纯糖尿病患者与9例合并糖尿病的KS患者按照年龄、体质指数(BMI)、病史进行配对.统计学方法采用完全独立样本t检验及配对样本t检验.结果 (1)KS人群中糖尿病发生率为32.1%(9/28),染色体核型为47,XXY的患者糖尿病发生率为30.7%(8/26),染色体核型为48,XXYY患者糖尿病发生率为50%(1/2);(2)合并糖尿病的KS患者与单纯KS患者相比,年龄大、睾酮水平低[分别为(28±8)比(22±4)岁,(2.0±1.3)比(5.4±4.3)nmol/L,t=3.044、-2.249;均P<0.05],虽然两组基础胰岛素水平和胰岛素分泌曲线下面积未见显著差异,但合并糖尿病的KS患者胰岛素抵抗指数较单纯KS患者明显增大(6.5±3.4比1.2±2.1,t=3.234,P<0.05);(3)KS合并糖尿病患者与单纯糖尿病患者相比,虽然75 g OGTT试验血糖和胰岛素水平一致,但身材更高、体重更重、低密度脂蛋白胆固醇水平更低[分别为(178±12)比(170±6)cm,(91±23)比(80±14)kg,(2.1±0.9)比(2.8±0.5)mmol/L,t=0.750、3.866、-2.681;P<0.05];(4)合并糖尿病的KS患者与单纯KS患者及单纯糖尿病患者相比,雌激素/雄激素比值(E/T)高,差异具有统计学意义(t=2.302、2.748;均P<0.05).结论 (1)KS患者糖尿病发生率明显升高;(2)KS患者易发生糖代谢异常的病因可能包括年龄、睾酮水平低和卵泡刺激素水平高、高E/T值、胰岛素抵抗和X染色体数目异常等. 目的评价Klinfelter综合征（KS）患者糖代谢特点，同时探讨KS患者易发生糖代谢紊乱的可能病因。方法回顾性分析1990年以来在解放军总医院就诊的28例KS患者（包括9例合并糖尿病患者）的一般情况、病史资料和实验室检查结果[性腺激素水平、血脂水平、口服75 g口服葡萄糖耐量试验（OGTT）血糖和胰岛素水平]等临床资料。同时选择18例单纯糖尿病患者与9例合并糖尿病的KS患者按照年龄、体质指数（BMI）、病史进行配对。统计学方法采用完全独立样本t检验及配对样本t检验。结果（1）KS人群中糖尿病发生率为32.1%（9/28），染色体核型为47，XXY的患者糖尿病发生率为30.7%（8/26），染色体核型为48，XXYY患者糖尿病发生率为50%（1/2）；（2）合并糖尿病的KS患者与单纯KS患者相比，年龄大、睾酮水平低[分别为（28±8）比（22±4）岁，（2.0±1.3）比（5.4±4.3）nmol/L，t=3.044、-2.249；均P〈0.05]，虽然两组基础胰岛素水平和胰岛素分泌曲线下面积未见显著差异，但合并糖尿病的KS患者胰岛素抵抗指数较单纯KS患者明显增大（6.5±3.4比1.2±2.1，t=3.234，P〈0.05）；（3）KS合并糖尿病患者与单纯糖尿病患者相比，虽然75 g OGTT试验血糖和胰岛素水平一致，但身材更高、体重更重、低密度脂蛋白胆固醇水平更低[分别为（178±12）比（170±6）cm，（91±23）比（80±14）kg，（2.1±0.9）比（2.8±0.5）mmol/L，t=0.750、3.866、-2.681；P〈0.05]；（4）合并糖尿病的KS患者与单纯KS患者及单纯糖尿病患者相比，雌激素/雄激素比值（E/T）高，差异具有统计学意义（t=2.302、2.748；均P〈0.05）。结论（1）KS患者糖尿病发生率明显升高；（2）KS患者易发生糖代谢异常的病因可能包括年龄、睾酮水平低和卵泡刺激素水平高、高E/T值、胰岛素抵抗和X染色体数目异常等。 |
| Abstract_FL | Objective To evaluate the characteristics of glucose metabolism and the possible mechanisms of glucose metabolism disorder in patients with Klinefelter's syndrome (KS). Methods This was a retrospective clinical research. The following data were collected and analyzed:the general condition, gonadotropic and gonadal hormone levels, lipid and glucose profiles, glucose and insulin levels after a 75 g oral glucose tolerance test, and homeostasis model assessment of insulin resistance (HOMA-IR) in 19 patients with KS alone, 9 patients with both KS and DM, 18 DM patients without KS;all were hospitalized in PLA General Hospital since 1990. Independent sample t test was used for comparison betneen two groups. Results (1)The incidence of DM in KS patients was 32.1% (9/28); in patients with 47,XXY karyotype and 48,XXYY karyotype the incidence were 30.7%(8/26) and 50%(1/2), respectively;(2)Compared with simple KS patients, patients with both KS and DM was significantly older, while the testosterone (T) level was significantly lower[(28 ± 8)vs (22 ± 4) year,(2.0 ± 1.3) vs (5.4 ± 4.3) nmol/L,t=3.044,-2.249;all P<0.05];Although they had similiar fasting insulin level and area under the curve of insulin, KS patients complicated with DM presented a much higher insulin resistance index(6.5 ± 3.4 vs 1.2 ± 2.1,t=3.234,P<0.05);(3)KS patients complicated with DM were much higher and heavier than simple DM patients[(178±12)vs(170±6) cm,(91 ± 23)vs(80 ± 14)kg,t=0.750,3.866;P<0.05]. The low-density lipoprotein concentration in patients with both KS and DM were lower than that of the patients with KS alone [(2.13±0.93)vs(2.85±0.50) mmol/L, t=-2.681;P<0.05],but their glucose and insulin levels during an oral glucose load were not different between two groups;(4)The estradiol-to-testosterone ratio of KS patients complicated with DM was significantly higher than that of simple KS patients as well as simple DM patients(t=2.302,2.748;P<0.05). Conclusions (1)KS patients tend to develop late-onset DM;(2)The possible risk factors of glucose metabolism disorder in KS patients are age, testosterone level, insulin resistance, high estradiol-to-testosterone ratio and abnormalities of X chromosome. |
| Author | 彭璐 陈光 窦京涛 李乐乐 韩白玉 臧丽 金楠 谷伟军 杜锦 杨丽娟 巴建明 吕朝晖 陆菊明 母义明 |
| AuthorAffiliation | 解放军总医院内分泌科,北京100853 |
| AuthorAffiliation_xml | – name: 解放军总医院内分泌科,北京,100853 |
| Author_FL | Ba Jianming Dou Jingtao Zang Li Du Jin Peng Lu Han Baiyu Lyu Zhaohui Li Lele Gu Weijun Lu Juming Yang Lijuan Jin Nan Mu Yiming Chen Guang |
| Author_FL_xml | – sequence: 1 fullname: Peng Lu – sequence: 2 fullname: Chen Guang – sequence: 3 fullname: Dou Jingtao – sequence: 4 fullname: Li Lele – sequence: 5 fullname: Han Baiyu – sequence: 6 fullname: Zang Li – sequence: 7 fullname: Jin Nan – sequence: 8 fullname: Gu Weijun – sequence: 9 fullname: Du Jin – sequence: 10 fullname: Yang Lijuan – sequence: 11 fullname: Ba Jianming – sequence: 12 fullname: Lyu Zhaohui – sequence: 13 fullname: Lu Juming – sequence: 14 fullname: Mu Yiming |
| Author_xml | – sequence: 1 fullname: 彭璐 陈光 窦京涛 李乐乐 韩白玉 臧丽 金楠 谷伟军 杜锦 杨丽娟 巴建明 吕朝晖 陆菊明 母义明 |
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| Keywords | X染色体 Testosterone 胰岛素抵抗 Klinefelter综合征 Diabetes mellitus Klinefelter's syndrome Insulin resistance X-chromosome 糖尿病 睾酮 |
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| Notes | Peng Lu,Chen Guang,Dou Jingtao,Li Lele,Han Baiyu,Zang Li,Jin Nan,Gu Weijun,Du Jin,Yang Lijuan,Ba Jianming,Lyu Zhaohui,Lu Juming,Mu Yiming （Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China） ObjectiveTo evaluate the characteristics of glucose metabolism and the possible mechanisms of glucose metabolism disorder in patients with Klinefelter＇s syndrome （KS）.MethodsThis was a retrospective clinical research. The following data were collected and analyzed： the general condition, gonadotropic and gonadal hormone levels, lipid and glucose profiles, glucose and insulin levels after a 75 g oral glucose tolerance test, and homeostasis model assessment of insulin resistance （HOMA-IR） in 19 patients with KS alone, 9 patients with both KS and DM, 18 DM patients without KS; all were hospitalized in PLA General Hospital since 1990. Independent sample t test was used for comparison betneen two groups.Results（1） The incidence of DM in KS patients was 32.1% （9/28）; in patients with 47, XXY karyoty |
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| Snippet | 目的评价Klinfelter综合征（KS）患者糖代谢特点，同时探讨KS患者易发生糖代谢紊乱的可能病因。方法回顾性分析1990年以来在解放军总医院就诊的28例KS患者（包括9例合并糖尿病患者）的一般情况、病史资料和实验室检查结果[性腺激素水平、血脂水平、口服75... 目的 评价Klinfelter综合征(KS)患者糖代谢特点,同时探讨KS患者易发生糖代谢紊乱的可能病因.方法 回顾性分析1990年以来在解放军总医院就诊的28例KS患者(包括9例合并糖尿病患者)的一般情况、病史资料和实验室检查结果[性腺激素水平、血脂水平、口服75... |
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| SubjectTerms | Klinefelter综合征 X染色体 睾酮 糖尿病 胰岛素抵抗 |
| Title | Klinefelter综合征患者糖代谢分析 |
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