内源性雄激素及雄激素受体水平与老年男性冠心病的相关性  

Correlation of endogenous androgen and androgen receptor level with coronary artery diseases in elderly males

作　　者：张秀锦[1] 李小鹰[1] 曹甜甜[2] 叶玲[3] 

机构地区：[1]解放军总医院老年心内科,北京100853 [2]贵阳医学院 [3]解放军总医院老年医学研究所,北京100853

出　　处：《中华医学杂志》2011年第14期984-986,共3页National Medical Journal of China

基　　金：全军医学科学技术研究＂十一五＂计划（06G105）

摘　　要：目的 探讨内源性雄激素及雄激素受体（AR）水平与老年男性冠心病的相关性.方法 选择冠状动脉造影证实的老年男性冠心病患者237例,对照组59例.所有患者均检测血清中7种内源性性激素水平,包括游离睾酮（FT）、总睾酮（TT）、雌二醇（E2）、黄体生成素（LH）、卵泡雌激素（FSH）、性激素结合球蛋白（SHBG）及脱氢表雄酮（DHEA）,并用流式细胞术检测外周血淋巴细胞AR水平.结果 冠心病组FT水平低于对照组[（24.1±22.2）×10-9mmol/L比（34.1±31.8）× 10-9mmol/L,P=0.06],其余激素水平差异均无统计学意义（均P＞0.05）.两组AR阳性率也差异无统计学意义（56.3%±24.0%比57.1%±20.8%,P＞0.05）.Logistic回归分析显示FT降低冠心病发病风险（OR=0.98,95%CI0.973～0.997,P=0.0049）.FT与AR阳性率之间呈正相关,而年龄与FT和AR阳性率呈负相关.结论 内源性雄激素水平减低在老年男性人群的冠心病发病中有独立作用.FT和AR水平下降,可能与老年男性冠状动脉粥样硬化加速进展有关.Objective To investigate the correlation of endogenous androgen and androgen receptor （AR） level with coronary artery diseases （CAD） in elderly males and elucidate the potential mechanism of gender difference in the prevalence of CAD. Methods A total of 296 male patients from different centers were divided into the CAD group （ n = 237 ） and the control group （ n = 59 ） according to the results of coronary angiography. Their mean ages were 68.6 ± 6. 8 and 66. 2 ± 6. 5 years old respectively. The serum levels of FT （free testosterone）, TT （total testosterone）, E2 （estradiol）, LH （luteinizing hormone）, FSH （ follicle-stimulating hormone ）, SHBG （ sex hormone-binding globulin ） and DHEA （dehydroepiandrosterone） were measured in all participants. And the androgen receptors of peripheral lymphocytes were assessed by flow cytometry. Results The serum level of FT was lower in the CAD group than that in the control group[（24. 1 ±22. 2） × 10-9 mmol/L vs（ 34. 1 ±31.8） × 10-9 mmol/l, P =0. 06]. But two groups showed no statistic differences in the levels of TT, E2 , LH, FSH, SHBG, DHEA and lymphocyte AR （56. 3% ± 24. 00 vs 57.1% ± 20. 8% ）. As demonstrated by the logistic regression analysis, the level of FT was negatively correlated with the CAD risk （ OR = 0. 98, P = 0. 0049 ） and positively correlated with the peripheral lymphocyte AR level. However age was negatively correlated with the levels of FT and AR. Conclusion The deficiency of endogenous androgen contributes to a high prevalence of CAD in elderly males. The age-related decreases of FT and AR impair the physiological functions of androgen so as to accelerate the progression of coronary atherosclerosis.

关 键 词：冠状动脉疾病 睾酮 受体 雄激素 男性 

分 类 号：R541.4[医药卫生—心血管疾病]