ABSTRACT
<p><b>Objective</b>To compare the level of testosterone between type-2 diabetes mellitus (T2DM) patients and healthy controls and to investigate the status of hypogonadism and the influence of hypopgonadism on the quality of life.</p><p><b>METHODS</b>We collected serum total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), and other clinical data from 166 T2DM patients aged over 30 years and 186 age-matched healthy controls. We investigated the quality of life (QoL) of the two groups of subjects using the questionnaires of Androgen Deficiency in Aging Males (ADAM), Aging Male Symptoms (AMS), 36-Item Short-Form Health Survey (SF-36), and Special Quality of Life for Diabetes Mellitus (DSQL).</p><p><b>RESULTS</b>The level of calculated FT (cFT) was remarkably lower in the T2DM patients than in the healthy controls (P<0.05), but no statistically significant differences were observed between the two groups in the levels of TT, bio-available testosterone (Bio-T), and SHBG. The T2DM males with hypogonadism showed significant differences from those without in age, height, systolic blood pressure, and creatinine (P<0.05). Based on the criteria of cFT <0.3 nmol/L and AMS score ≥27, the incidence rate of hypogonadism was 51.81% in the T2DM patients, 31.58% in the 30－39 yr group, 32.50% in the 40－49 yr group, 50% in the 50－59 yr group, 69.23% in the 60－69 yr group, and 77.27% in the ≥70 yr group, elevated by 77.4% with the increase of 10 years of age (OR = 1.774, P<0.001). The AMS score was significantly correlated with the scores of DSQL (r = 0.557, P<0.001) and SF-36 (r = －0.739, P<0.001) in the T2DM patients.</p><p><b>CONCLUSIONS</b>T2DM patients have lower levels of cFT than healthy men, accompanied with a higher incidence of hypogonadism. Age is a main risk factor of hypogonadism. Severer testosterone deficiency symptoms are associated with lower scores of QoL in T2DM males.</p>
ABSTRACT
Objective To study the mortality and pathogens of candidemia in patients at hospital intensive care unit(ICU).Methods Clinical data of candidemia cases admitted to ICU of the First Affiliated Hospital of Zhejiang University in recent five years were analyzed retrospectively.Chi-square test and logistic regression analysis were used.Results A total of 6034 patients were discharged in the ICU over the 5-year period.and 75 were diagnosed as candidemia.The annual morbidity rates of candidemia from 2002 to 2006 were 0.67%,1.46%,1.21%,1.15% and 1.56%, respectively.36 cases died of the disease,with the mortality as 48%.The annual mortality rates from 2002 to 2006 were 50%,64%,33%,41% and 52%,respectively.In this period,78 positive blood culture samples strains from ICU were identified as Candida,among which Candida albicans, C.glabrata,C.tropicalis,C.parapsilosis and C.lusitaniae accounted for 46.2%,21.7%,17.9%,12.8% and 1.3%, respectively.Average APACHE Ⅱ scores of the patients with candidemia were 17.21±4.38(range:9-27).During the 5-year period,the annual morbidity of candidemia had increased from 0.67%to 1.56% while the ratios of candidemia due to non-albicans Candida species(NAC)increased from 50.0%to 56.5%.When analyzing the C.albicans group and NAC group with single factor and multiple conditional logistic regression method.we found that age(66±14 vs.53±16,P=0.001,OR=1.077,95% CI:1.031-1.124)and hypoproteinemia(61.8% vs.81.6%, P=0.033,OR=0.206,95%CI:0.048-0.880)both showed statistical significance.Conclusion Candidemia cases in ICU increased gradually and causing higher mortality.The number of patients with candidemia caused by NAC increased in recent 5 year.Age was proved to be a risk factor for those candidemia caused by C.albicans.Hypoproteinemia was proved to be risk factors for the candidemia caused by NAC.