男性Graves病患者唾液睾酮及血清性激素水平的变化

CHANGES OF SALIVARY TESTOSTERONE AND SERUM SEX HORMONES IN MEN WITH GRAVES DISEASE

本文观察了20例男性Graves病患者抗甲状腺药物治疗前后的唾液睾酮及血清中几种性激素水平的变化,并与年龄、性别相配对的20例健康者进行了比较分析。患者治疗前唾液睾酮水平明显低于正常,治疗后显著上升,与血T_3、T_4的变化呈负相关;治疗前血总睾酮、雌二醇、LH及FSH显著高于正常,治疗2个月后除雌二醇外均随T_3、T_4的下降而下降。本文结果支持唾液睾酮不受SHBG的影响,提示Graves病患者游离睾酮减低。

The levels of salivary testosterone (ST), serum total testosterone (TT), LH, FSH and estradiol (E,) were measured with RIA in 20 men aged 21 to 47 years, with Graves' disease (GD) before and during treatment with thioureas. The results were compared with those of 20 sex-and age-matched healthy subjects. Prior to treatment, the level of ST in 20 patients (156.7±10.7pmol/L, Xr±SE) was significantly lower than that in normal males (245.8±23.8), but the levels of serum TT (49.5±4.1nmol/L), LH (29.6±3.4IU / L) and FSH (16.3±1.8IU / L) were above normal (TT 20.8±1.4, LH 15.6±1.4, FSH 9.0±1.3). With decrease of serum T, and T4 during treatment, ST gradually increased while TT, LH and FSH declined. When the patients were treated for 2 months, ST (203.5±15.6), TT (23.7±2.1) and LH (18.3 ±1.9) became comparable to controls. The levels of E2, while not significantly changed before (201.6±27.2pmol / L) and during treatment (206.8±30.8), all were higher than those in controls (119.5±12.2). There was a significant correlation between the levels of LH and those of T3 and T, (r= -0.270 and -0.267 respectively) as well, but no significant correlation between LH and ST levels(r= -0.106). The results suggested that free testosterone reflected by ST was reduced in men with GD and the concentration of ST was not influenced by SHBG.