中老年男性性激素与血脂水平的相关性研究

Relationship between sex hormone levels and serum lipid profile in middle aged and elderly men

目的探讨我同中老年男性性激素与血脂代谢的相关性。方法收集2013年1月—2014年12月常规体检的40岁以上男性644例,年龄40~82岁。测定其血清性激素水平,包括卵泡刺激素（FSH）、黄体生成索（LH）、雌二醇（E_2）、总睾酮（TT）、性激素结合球蛋白（SHBG）、游离睾酮（FT）,以及血脂水平,包括高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固酵（LDL-C）、总胆同醇（TC）以及三酰甘油（TG）。并分析性激素各项指标与血脂指标之间的相关性。结果随着年龄的增加,FSH,LH及SHBG水平逐渐上升（P〈0.01）,FT逐渐降低（P〈0.01）。51~60岁组,61~70岁组TT、HDL-C水平明显高于40~50岁组及〉70岁组人群（P〈0.01）。TG水平随年龄增加呈大致降低趋势（P〈0.01）。相关性分析发现,各项激素与血脂水平呈现普遍的相关性,校正年龄和BMI后,FSH、SHBG与HDL-C仍呈正相关（r=0.08、0.18,P〈0.01或P〈0.05）,LH、SHBG与TC仍呈负相关（r=-0.08、-0.08,P〈0.01）。TT、SHBG与TG仍呈显著负相关（r=-0.16、-0.20,P〈0.05）。多元线性回归分析发现,FSH、SHBG与HDL-C均呈正相关（β=0.010,P=0.001;β=0.004,P=0.02）,LH与HDL-C呈负相关（β=-0.020,P=0.001）,TT与TG呈负相关（β=-0.080,P=0.01）。结论在中老年男性中,低浓度的FSH和SHBG,以及高浓度的LH有增加血脂异常（低HDL-C血症）的风险,而低TT也有增加血脂异常（高TG血症）的风险。

Objective To investigate the correlation between male sex hormones and blood lipid metabolism in middle age and elderly men. Methods From 2013 January to 2014 December, to collect routine examination men aged 40 and over 644 cases, aged 40-82 years old. Determination of the serum levels of sex hormones, follicle stimulating hormone （ FSH）, lu- teinizing hormone （LH） and estradiol （E2 ）, total testosterone （TF）, sex hormone binding globulin （SHBG）, free testoster- one （FT）, and lipid levels, including high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C） , total cholesterol （TC） and triglycerine （TG）. And the correlation between the indexes of sex hormones and the in- dexes of blood lipids was analyzed. Results Along with the increase of age, FSH, LH and SHBG increased gradually （ P 〈 0.01 ）, FT decreased gradually （ P 〈 0.01 ）. The age group of 51 -60, 61 -70, TT and HDL-C was significantly higher than 40-50 years group and 〉 70 years group （ P 〈 0.01 ）. The level of TG decreases with the increase of age （ P 〈 0.01 ）. Correlation analysis showed that serum hormone and lipid levels in the present universal relevance, after adjustment for age and body mass index （BMI） , FSH and SHBG and HDL-C still showed significant positive correlation （ r =0.08, r = 0.18, P 〈 0.01 orP 〈0.05）, LH and SHBG and TC is still showing a significantly negative correlation （ r = -0.08, r = -0.08, P 〈 0.01）. TF, SHBG and TG still showed a significant negative correlation （ r = -0. 16, r = -0.20, P 〈 0.05）. Multiple linear regression analysis showed that, FSH and SHBG and HDL-C were significantly positive correlation （ 15 = 0.010, P = 0. 001 ; 15 = O. 004, P = 0.02）, luteinizing hormone （LI-I） and HDL-C significantly negative correlated （ 15 = - 0. 020, P = 0.001 ）, TF and TG significantly negative correlated （ β = - 0. 080, P = 0.01 ）. Conclusion In middle-aged and elderly men, low concentrations of FSH and SHBG; and high concentrations of LH have risk of increased dyslipidemia （low HDL-C） , and low TT also increase the risk of dyslipidemia （high TG）.