中老年男性血清性激素水平与代谢综合征的相关性

Correlation between serum sex hormone levels and metabolic syndrome in middle-aged and elderly men

目的探讨中老年男性血清性激素水平与代谢综合征(metabolic syndrome,MS)的关系。方法用分层整群抽样方法抽取遵义市年龄≥40岁的男性进行问卷调查和体格检查,空腹抽取静脉血检测血清总睾酮(total testosterone,TT)、性激素结合球蛋白(sex hormone-binding globulin,SHBG)、黄体生成素(luteinizing hormone,LH)、甘油三脂(triglyceride,TG)和高密度脂蛋白(high density lipoprotein,HDL),计算游离睾酮(calcuated free testosterone,c FT)、游离睾酮指数(free testosterone index,FTI)和睾酮分泌指数(testosterone secretion index,TSI)。结果获得合格数据437例,MS患病率为18.8%。MS组TT、SHBG和TSI均低于非MS组,FTI高于非MS组(均有P<0.05);TT与体质指数(body mass index,BMI)、TG、HDL、舒张压(diastolic pressure,DBP)呈负相关(均有P<0.05);SHBG与BMI、TG、HDL呈负相关(均有P<0.05),c FT与BMI呈正相关,与收缩压(systolic pressure,SBP)呈负相关(均有P<0.05);FTI与BMI、TG呈正相关(均有P<0.05);TSI与HDL呈正相关,与SBP、DBP呈负相关(均有P<0.05);LH与BMI、TG呈负相关,与SBP呈正相关(均有P<0.05)。随着MS组分数增加,TT、SHBG和TSI逐渐下降,c FT无明显变化,FTI缓慢上升,LH先上升后下降;Logistic回归模型校正年龄、吸烟、饮酒等因素后发现TT、SHBG和TSI<P50患MS的风险分别是≥P50的3.972、2.426和2.534倍(均有P<0.05)。结论中老年男性血清TT、SHBG和TSI水平降低与MS的发生密切相关。

Objective To investigate the relationship between serum sex hormone levels and metabolic syndrome( MS) in middle-aged and elderly men. Methods Adult males aged 40 years and above from Zunyi area were selected by the stratified cluster sampling method and questionnaires and physical examination were conducted. Total testosterone( TT),sex hormone-binding globulin( SHBG),luteinizing hormone( LH),triglyceride( TG) and high density lipoprotein( HDL) were measured by fasting venous blood,calcuated free testosterone( c FT),free testosterone index( FTI) and testosterone secretion index( TSI). Results A total of 437 qualified subjects were included with a MS prevalence rate of18. 8%. The serum levels of TT,SHBG and TSI in the MS group were lower than those in the healthy group,FTI was higher than that in healthy group( all P < 0. 05). TT was negatively correlated with body mass index( BMI),TG,HDL and diastolic pressure( DBP),and SHBG was negatively correlated with BMI,TG and HDL;c FT was positively correlated with BMI,negatively correlated with SBP,FTI was positively correlated with BMI,TSI was positively correlated with HDL,negatively correlated with SBP,LH was negatively correlated with BMI,positively correlated with SBP( all P < 0. 05). While MS scores increased,serum levels of TT,SHBG and TSI levels gradually decreased,in contrast,c FT levels did not change significantly,FTI levels gradually increased and LH levels increased first and then decreased. Logistic regression analysis showed that after adjustment for age,smoking,alcohol consumption and other factors,low TT,SHBG and TSI levels( <50%) respectively resulted in 3. 972,2. 426 and 2. 534 times higher risk of MS( all P < 0. 05). Conclusion The decrease of serum TT,SHBG and TSI levels in middle-aged and elderly men was closely related to the occurrence of MS.