中老年男性体检人群生殖激素水平的动态变化及相关因素分析

Dynamic changes of reproductive hormone levels and related factors in old and middle-aged men in health examination

目的:调查中老年男性体检人群生殖激素水平的动态变化及与年龄、血脂的关系。方法:2011年1月至2014年12月40岁以上正常健康体检男性4 333例,年龄40~85岁,70岁以下者按5年间隔分组,70岁以上者为1组,共分为7组。测定血清睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、孕酮(P)、催乳素(PRL)和总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),并计算睾酮分泌指数(TSI=T/LH)。结果:7个年龄组的LH、FSH、E2和TSI水平有显著性差异(P均<0.05)。≥70岁组的LH、FSH和E2水平显著高于其他6个年龄组(P均<0.05),而TSI水平显著低于其他6组(P均<0.05)。2014年40~44岁组、45~49岁组及50~54岁组的T、E2和TSI水平均显著低于其他3个年份的相应年龄组(P均<0.05);2014年55~59岁组的T和TSI水平显著低于其他3个年份(P均<0.05)。LH、FSH和E2与年龄呈正相关,P、PRL和TSI与年龄呈负相关;T与TC、TG、LDL-C呈负相关,与HDL-C呈正相关。40~85岁男性LH、FSH和E2的平均年增长率分别为1.9%、2.7%和0.5%,TSI平均年下降率为2.0%。结论:40岁以上男性LH、FSH和E2随年龄增长而升高,TSI逐渐减低;40~59岁男性T和TSI 4年间有下降趋势,40~54岁男性E2 4年间有下降趋势;低水平T与血脂异常有着密切关系。

Objective： To investigate the dynamic changes of serum reproductive hormone levels in old and middle-aged males in health examination and their correlation with age and lipid profile. Methods： This study included 4 333 men in health examination from January 2011 to December 2014. The men were aged from 40 to 85 years old and divided into seven five-year-span age groups.We determined the levels of serum testosterone（ T）,luteinizing hormone（ LH）,follicle-stimulating hormone（ FSH）,estradiol（ E2）,progesterone（ P）,prolactin（ PRL）,total cholesterol（ TC）,triglyceride（ TG）,low-density lipoprotein cholesterol（ LDL-C）,high-density lipoprotein cholesterol（ HDL-C）,and the testosterone secretion index（ TSI = T / LH）. We analyzed the obtained data using SPSS Pram,Kruskal-Wallis H test,Mann-Whitney U test,exponential regression,and Spearman correlation analysis. Results：Statistically significant differences were found in LH,FSH,E2 and TSI among the seven age groups（ P〈0. 05）. The levels of serum LH,FSH and E2 were significantly higher（ P〈0. 05） while TSI remarkably lower（ P〈0. 05） in the ≥70 yr group than in the other six groups. The serum T and E2 levels and TSI were markedly lower in the 40- 44,45- 49 and 50- 54 yr groups in 2014 than in the other three years（ P〈0. 05）,and so were the levels of serum T and TSI in the 55- 59 yr group（ P〈0. 05）. The levels of serum LH,FSH and E2 were correlated positively while those of P,PRL and TSI negatively with age. The serum T level was correlated positively with HDL-C but negatively with TC,TG and LDL-C. The levels of serum LH,FSH and E2 showed a yearly average increase of 1. 9%,2. 7% and 0. 5%,respectively,while TSI an annual mean decline of 2. 0% in the 40- 85 yr group. Conclusion： LH,FSH and E2 were increased while TSI decreased with age in the 40 years old males. T and TSI were reduced in the 40- 59 years old men from2011 to 2014,and so was E2 in the 40- 54 yr group. Low-level testosterone is closely related to dyslipidemia.