老年男性内源性性激素水平与代谢综合征的关系

Association between endogenous sex hormones and metabolic syndrome in elderly men

目的探讨老年男性性激素水平与代谢综合征（MS）的关系。方法选择60～90岁老年男性400例,分为MS组（137例）和非MS组（263例）。测定血清睾酮、性激素结合球蛋白（SHBG）、雌二醇、硫酸脱氢表雄酮（DHEA-S）水平和血脂、空腹血糖（FBG）、空腹胰岛素水平（FINS）,测量身高、体重、腰围、血压。结果MS组睾酮、SHBG、游离睾酮（FT）水平分别为4.0、37.8和0.21 nmol/L,显著低于非MS组。Logistic回归分析显示：睾酮与MS呈负相关。睾酮增加1 SD,MS的危险度下降58%（OR=0.42）,睾酮与腰围、三酰甘油、FBG呈负相关,睾酮增加1SD,大腰围的危险度下降39%（OR=0.61）,高三酰甘油的危险度下降20%（OR=0.80）,高FBG的危险度下降22%（OR=0.78）。结论老年男性内源性睾酮水平降低,增加了发生MS的危险,睾酮可能在MS的发展过程中起保护作用。

Objective To explore the relationship between sex hormones and metabolic syndrome （MS） in elderly men. Methods Four hundred men aged 60-90 years were divided into two groups： MS（137 subjects） and non-MS （263 subjects） groups. Serum concentrations of testosterone, sex hormone bingding globulin （SHBG）, estradiol（E2）, dehydroepiandrosterone sulfate （DHEA-S）, lipids, fasting glucose, fasting insulin were measured. Body height, weight, waist circumference, blood pressure were assessed. Results Serum concentrations of testosterone,SHBG and FT in MS group were 4.0, 37.8 and 0. 21 nmol/L, respectively, lower than the subjects in non-MS group. Logistic regression analysis showed a negative relationship between testosterone and MS. One standard deviation increase in testosterone level was associated with 58% reduced risk of suffering from MS （OR=0. 42）. Negative relationships were observed between testosterone level and waist circumference, triglycerides and fasting glucose. One standard deviation increase in testosterone level was associated with 39 % reduced risk for having high waist circumference （OR = 0.61）, 200,% reduced risk for having high triglycerides level（OR=0.80）, and 22% reduced risk for having high fasting glucose levels （OR = 0. 78）. Conclusions Low endogenous testosterone level appears to increase the risk for the development of MS in elderly men, testosterone probably plays a protective role in the development of MS.