内源性睾酮对血浆脂质、脂蛋白和载脂蛋白水平的影响

Plasma levels of lipids, lipoproteins and apolipoproteinsaffected by endogenous testosterone

对１０２例冠心病患者及９９名健康人进行了血浆睾酮、雌二醇、空腹血糖（ＢＳ）、总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白－胆固醇（ＨＤＬ－Ｃ）、低密度脂蛋白（ＬＤＬ－Ｃ）、脂蛋白（ａ）［Ｌｐ（ａ）］、载脂蛋白（Ａｐｏ）ＡＩ，ＡｐｏＢ１００测定。观察到血浆睾酮与ＴＧ和Ｌｐ（ａ）呈负相关，而与血浆ＨＤＬ－Ｃ和ＨＤＬ３－Ｃ呈正相关。血浆睾酮水平低下组，其ＴＧ和Ｌｐ（ａ）浓度明显高于血浆睾酮水平正常组；而ＨＤＬ－Ｃ和ＨＤＬ３－Ｃ水平则前者明显低于后者。冠心病组血浆睾酮水平明显低于健康对照组。提示内源性睾酮对体内血脂代谢有良好的调节作用；血浆睾酮水平低下则可引起血脂异常。

Plasma testosterone(T), estrodiol(E), total cholesterol(TC), triglyceride(TG), high density lipoproteincholesteral(HDLC), HDL2-C, HDL3C, lipoprotein(a), apolipoprotein(Apo) AI and B100 were determined in 201 subjects, among them 102 patients with coronary heart disease(CHD) and 99 healthy subjects. It was observed that plasma T level was correlated negatively with TG(r=-0.47, P<0.01) and Lp(a) (r=-0.163, P<0.05), and positively with HDL3C(r=0.328,P<0.01) and Lp(a)(r=-0.163,P<0.05), and positively with HDL3(r=0.328,P<0.01) and HDL3C(r=0.328,P<0.01). Meanwhile, plasma levels of TG (1.47±1.16mmol·L-1) and Lp(a)(25±17.8g·L-1) were significantly higher in the subjects with low plasma T level (<270ng·ml-1) than those in the subjects with normal plasma T level (1.10±0.74mmol·L-1 and 17±15.9g·L-1, respectively), while plasma levels of HDLC (1.31±0.30mmol·L-1) and HDL3C(0.88±0.22mmol·L-1) were significantly lower in the former than in the latter (1.44±0.33mmol·L-1 and 1.02±0.26mmol·L-1, respectively). The results support that low plasma T level may be a risk factor for coronary heart disease, which may relate to the changes of plasma lipoproteins.