糖尿病と男子性腺機能に関する研究

Abstract

The purpose of the study is to clarify the nature of f unctional disturbance of the sexual glands which often accompanied to male patients with diabetes mellitus. Out of 134 patients who were inquirely examined on their sexual functions, 78 patients (58.2%) were found to have impotence. As various endocrine function studies, urinary total 17-KS and its fractions, urinary 17-OHCS, urinary estrogens and their fractions, and urinary gonadotrophin were determ ined. The impressive results in patients with impotence due to diabetes mellitus were marked decreases in III, IV and V fractions of 17-KS and lowered urinary gonadotrophin. A part of patients was performed gonadotrophin test and semi n al vesicle absorption studies as the functional evaluation of the sexual glands. Histological examinations of the testicle obtain e d by biopsy performed in 18 patients showed atrophic pictures in 14 cases (77.8%). The main findings are summarized as 1) peritubular fibrosis 2) disturbance of spermatogenesis and 3) changes of interstitial blood vessels. Ou t of 12 cases, in which analysis of semen was performed, decisions of subfertility and infertility were made in 5 and 2 cases respectively. Concentration of fructose and total reducing substances in the semen was also determined. As the pathogenetic mechanisms of impotence in patient with diabetes mellitus , such theories as a specific status of hypogonadotrophic hypogonadism , occurrence of erectile impotence due to diabetic neuropathy and many other opinions have been elucidated. The author suggests multiglandular endocrine disorder theory in addition to the above theories . After all, it is supposed that the cause of impotence is by no means a single factor in diabetes mellitus which consists of very complicated multi-factors .