2022 年第 8 期 第 17 卷

2型糖尿病患者勃起功能障碍与葡萄糖在目标范围内时间的关系

Relationship between erectile dysfunction and time in range in patients with type 2 diabetes mellitus

作者：迟海燕杨亚超宋明强

英文作者：Chi Haiyan Yang Yachao Song Mingqiang

单位：山东大学附属威海市立医院内分泌科，威海264200

英文单位：Department of Endocrinology Weihai Municipal Hospital Shandong University Weihai 264200 China

关键词：2型糖尿病；勃起功能障碍；目标范围内时间

英文关键词：Type2diabetesmellitus;Erectiledysfunction;Timeinrange

• 摘要：

• 目的 探讨2型糖尿病（T2DM）患者勃起功能障碍(ED)与葡萄糖在目标范围内时间（TIR）的关系。方法 选取2020年1—12月山东大学附属威海市立医院门诊就诊的349例男性T2DM患者，根据国际勃起功能指数问卷（IIEF-5）评分分为非ED组（＞22分）和ED组（≤21分）。所有患者佩戴瞬感扫描式葡萄糖监测系统，记录第2~13天的TIR、低于目标范围时间（TBR）和高于目标范围时间（TAR）。分析TIR、TBR、TAR与T2DM患者发生ED的相关性。结果 349例T2DM患者中，ED组198例，非ED组151例。ED组患者年龄、糖尿病病程、总胆固醇、低密度脂蛋白胆固醇（LDL-C）、空腹血糖及糖化血红蛋白水平均明显高于/长于非ED组，IIEF-5评分明显低于非ED组［（11.5±3.2）分比（24.6±2.1）分］（均P＜0.05）。ED组TIR明显低于非ED组［（49±15）%比（69±20）%］，TBR、TAR均明显高于非ED组［（26±6）%比（17±4）%、（19±5）%比（13±3）%］（均P＜0.001）。Pearson相关性分析结果显示，IIEF-5评分与糖尿病病程、HbA1c、TBR及TAR呈负相关，与TIR呈正相关（均P＜0.05）。多元线性回归分析结果显示，校正年龄、糖尿病病程、HbA1c后，TIR、TBR及TAR与IIEF-5评分仍明显相关（均P＜0.05）。结论 TIR、TBR、TAR与T2DM患者发生ED相关，为减少ED的发生，临床医师制定降糖方案时应注意减小葡萄糖波动幅度。

• Objective To investigate the relationship between erectile dysfunction (ED) and time in range (TIR) in patients with type 2 diabetes mellitus. Methods Total 349 outpatients with T2DM admitted to Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University from January to December 2020 were enrolled. According to the international questionnaire on erectile function (IIEF-5) score, patients were divided into non ED group (>22) and ED group (≤21). All the patients were scanned with Transient Scanning Glucose Monitoring System to record value of TIR, time below the target range (TBR) and time above the target range (TAR) during the 2nd-13th day. The relationship between TIR, TBR, TAR and ED in patients with T2DM was analyzed. Results Among 349 patients, there were 198 cases in ED group and 151 cases in non ED group. The age, course of diabetes mellitus, total cholesterol, low-density lipoprotein cholesterol (LDL-C), fasting blood glucose and glycosylated hemoglobin levels in ED group were higher/longer than those in non ED group, and IIEF-5 score in ED group was lower than that in non ED group ［（11.5±3.2） vs （24.6±2.1）］(all P<0.05). TIR in ED group was lower than that in non ED group ［（49±15）% vs （69±20）%］, and TBR and TAR in ED group were higher than those in non ED group ［（26±6）% vs （17±4）%, （19±5）% vs （13±3）%］(all P<0.001). Pearson correlation analysis showed that IIEF-5 score was negatively correlated with course of diabetes mellitus, glycosylated hemoglobin, TBR and TAR, and positively correlated with TIR (all P<0.05). Multivariate linear regression analysis indicated that TIR, TBR and TAR were significantly associated with IIEF-5 score after adjusting for age, course of diabetes mellitus and glycosylated hemoglobin (all P＜0.05). Conclusions  ED in patients with T2DM is closely correlated to TIR, TBR and TAR. Clinicians should pay attention to reduce the glycose fluctuations when formulating hypoglycemic plan.