睾酮、脱氢表雄酮与更年期女性胆石症的关联分析

Association analysis of testosterone,dehydroepiandrosterone and cholelithiasis in transitional menopausal women

目的探讨更年过渡期女性睾酮、脱氢表雄酮(DEHA)水平与胆石症的关系。方法纳入美国妇女健康研究数据库40~55岁更年期女性2 127例,根据是否有胆石症分为胆石症组(n=129)和对照组(n=1 998),检测研究对象的血清睾酮、DEHA及其他临床指标。总体均值比较使用Mann-Whitney U检验,logistic回归探讨睾酮、DEHA是否与胆石症具有相关性。结果胆石症组倾向于有更高的睾酮、收缩压、体质指数、腰围、髋围、三酰甘油、C-反应蛋白,和更低的DHEA、性激素结合球蛋白、高密度脂蛋白胆固醇(均P<0.05)。经过充分调整协变量后,睾酮和DEHA水平与胆石症的发生相关,OR(95%CI)分别为1.010(1.005~1.015)和0.994(0.991~0.997)。多因素logistic回归中,睾酮独立于其他因素与胆石症风险呈正相关关系,其OR(95%CI)为1.012(1.007~1.016);DEHA独立于其他因素与胆石症风险呈负相关关系,其OR(95%CI)为0.994(0.991~0.997)。此外,体质指数和促甲状腺激素与胆石症风险呈正相关关系。胆石症风险还受种族/民族的影响。结论在更年过渡期女性中,睾酮与胆石症风险呈正相关关系,DEHA与胆石症风险呈负相关关系。

Objective To investigate the relationship between testosterone,dehydroepiandrosterone(DEHA)and cholelithiasis among women in climacteric transition period.Methods A total of 2 127 women aged 40~55 were included from the Study of Women's Health Across the Nation.Individuals were divided into gallstone group(n=129)and control group(n=1 998).Serum testosterone,DEHA and other clinical indicators were measured.Mann-Whitney U test was used to compare the averages of continuous variables between groups.Logistic regression was used to analyse the associations between testosterone and DEHA and cholelithiasis.Results The gallstone group had higher testosterone,systolic blood pressure,BMI,waist circumference,hip circumference,triglyceride,C-reactive protein,and lower DHEA,sex hormone binding globulin and high density lipoprotein(P<0.05).After fully adjusting the covariates,testosterone and DEHA levels were correlated with gallstone occurrence,OR(95%CI)were 1.010(1.005~1.015)and 0.994(0.991~0.997),respectively.In multivariate logistic regression,testosterone may be independent risk factors for gallstones,OR(95%CI)were 1.012(1.007~1.016).DEHA may be independent protective factors for the end of gallbladder,OR(95%CI)were 0.994(0.991~0.997).Conclusion Testosterone was positively correlated with gallstone risk and DEHA was negatively correlated with gallstone risk in transitional menopausal women.