上海某社区肥胖与中老年男性雄激素水平相关性的研究

Research on Association between Obesity and Testosterone in Middle-aged Males in A Community in Shanghai

目的 按“中国成人超重和肥胖症预防控制指南”评估不同程度的肥胖对社区中老年男性雄激素水平低下的影响。方法 2014年6月—2015年5月在上海市某社区抽样选取中老年男性,男性肥胖及超重程度由体重指数（BMI）与腰围（WC）区分,测定血清总睾酮（TT）、促黄体生成素（LH）与性激素结合球蛋白（SHBG）,睾酮补充治疗标准参考国际老年男子研究学会（ISSAM）、澳大利亚内分泌协会指南（ESA）及欧洲泌尿外科协会（EAU）共识以及中华医学会男科学分会指南推荐。结果 共260例40-80岁男性肥胖症者25例（BMI≥28 Kg/cm2或WC≥95 cm）,超重者109例;相比较体重正常范围男性,肥胖及超重者TT水平更低。TT〈8 nmol/l中肥胖症16%、超重者5.5%、而体重正常者仅占1.6%。参考ESA标准,认为肥胖及超重者中有20例,体重正常者中3例可从睾酮补充治疗中受益;按中华医学会标准,肥胖及超重者36例,体重正常者12例。结论 中国中老年男性肥胖率较欧美国家平均水平低,肥胖程度与中老年男性睾酮水平密切相关,BMI及WC可作为预测男性雄激素缺乏指标之一。

OBJECTIVE To evaluate different degrees of obesity on the serum testosterone level of middle-aged males according to ＂Chinese adult overweight and obesity prevention and control guidelines＂. METHODS Males in a community of Shanghai were interviewed by age stratified sampling method from Jun. 2014 to May. 2015, degrees of obesity were distinguished by BMI and WC, the concentration of serum total testosterone （TT）, serum sex hormone binding globulin （SHBG） and luteinizing hormone （LH） were tested. Testosterone supplement therapy standard was reference to ISSAM, ESA, EAU and andrology branch of Chinese medical association guidelines. RESULTS 260 men aged 40-80 years were recruited; 25 men were obese （BMI≥28 Kg/cm^2 or WC≥95 cm） and 109 men were overweight. Obese and overweight men had lower total testosterone （TF） level than normal weight men. TT level 〈 8nmol/1 were recorded in 16% of obese men, 5.5% of overweight men and 1.6% of normal weight men. Applying the ESA guidelines for the diagnosis of age-related AD, 20 obese and overweight men and 3 normal weight men were classified as being eligible for androgen therapy. As for CMAA guidelines, there were 36 obese and overweight men and 12 normal weight men. CONCLUSION Obesity rateof middle-aged men in China was lower than that of developed countries and the degrees of obese were related toed total tes- tosterone levels in elderly men. BMI and WC could be used as predictive indicators of androgen deficiency in males. It needed further study of standardized testosterone supplement therapy in Chinese middle-aged men.