中老年男性血清睾酮与动脉粥样硬化的相关性研究  

Association of serum testosterone with atherosclerosis in middle-aged and elderly men

作　　者：郑晓彬[1] 李芳萍[1] 林刁珠[1] 孙侃[1] 黎锋[1] 李璐婧[2] 吴嘉仪[2] 管小凤[2] 李焱[1] 严励[1] 

机构地区：[1]中山大学孙逸仙纪念医院内分泌科,广东广州510120 [2]中山大学孙逸仙纪念医院超声科,广东广州510120

出　　处：《中华男科学杂志》2015年第6期536-540,共5页National Journal of Andrology

摘　　要：目的 ：探讨中老年男性睾酮水平与动脉粥样硬化之间的相关性。方法：选取2012年10月至2013年3月40~75岁的广州男性居民413例作为研究对象,收集人口学资料、临床资料及身体测量指标,实验室检测性激素、血糖、血脂等指标,彩色多普勒超声诊断仪测定颈动脉内膜中层厚度（CIMT）。结果：以CIMT=0.9 mm作为切点将人群分为颈动脉硬化组与非硬化组,游离睾酮（FT）在两组间的中位数分别为57.41 pmol/L及59.72 pmol/L（P=0.005）,总睾酮（TT）两组间未见差异。Spearman相关分析提示TT、FT与CIMT呈负相关,r分别为-0.126（P=0.011）和-0.188（P〈0.01）。以四分位数点作为切点由低到高将FT分为Q1、Q2、Q3、Q4组,各组颈动脉硬化患病率分别为23.30%、13.46%、17.48%、7.77%（P for trend=0.008）。TT各组颈动脉硬化的患病率分别为17.48%、18.27%、16.50%、9.71%（P for trend=0.116）。多因素Logistic回归分析评估FT各组颈动脉硬化患病优势比（OR）提示,以Q4组作为对照,在校正了年龄、腰围、收缩压、糖基化血红蛋白的影响后,Q1组的患病风险明显增高（OR1=2.491,95%CI：1.01~6.149）。同样在TT的分组中采取Logistic回归分析,以Q4组作为对照,各组患病风险未见明显差异。结论：中国40岁以上男性,血清FT低下可能是动脉粥样硬化的危险因素。Objective： To investigate the association between the level of serum testosterone and atherosclerosis in middle-aged and elderly men. Methods： We conducted a population-based study of 413 males aged 40- 75 years in a community in Guangzhou.We obtained the sociodemographic characteristics,clinical data,physical measurements,and laboratory results of sex hormones,blood glucose,and blood lipid of the subjects. We also measured the carotid intima media thickness（ CIMT） by color Doppler ultrasonography. Results： The subjects were divided into a carotid atherosclerosis（ CAS） group（ CIMT≥0. 9 mm） and a non-CAS group（ CIMT〈 0. 9 mm）. The medians of free testosterone（ FT） were 57. 41 and 59. 72 pmol / L in the CAS and non-CAS groups,respectively（P = 0. 005）,and no significant difference was found between the two groups in total testosterone（TT）. The levels of serum FT and TT were negatively correlated to CIMT,with Spearman’s rank correlation coefficients of- 0. 126（ P = 0. 011） and- 0. 188（ P 〈0. 001）,respectively. The incidence rates of CAS were 23. 30,13. 46,17. 48,and 7. 77% in the Q1,Q2,Q3,and Q4 groups,respectively according to the quartile of FT（ P for trend = 0. 008） and 17. 48,18. 27,16. 50,and 9. 71% respectively according to the quartile of TT（ P for trend = 0. 116）. Based on the quartile of FT and after adjustment for age,waist circumference,systolic blood pressure,and Hb A1 c,the risk of CAS was significantly increased in the Q1 group as compared with Q4（ OR = 2. 491,95% CI 1. 01-6. 149）,but no statistically significant differences were observed according to the quartile of TT. Conclusion： A low serum FT level may be a risk factor of atherosclerosis in Chinese men aged 40 years or older.

关 键 词：睾酮 颈动脉内膜中层厚度 动脉粥样硬化 中老年男性 

分 类 号：R697.22[医药卫生—泌尿科学] R592[医药卫生—外科学]