老年男性血清性激素水平与代谢综合征的相关性  

Correlation of serum sex hormone levels with metabolic syndrome in elderly men

作　　者：肖海英[1] 卢艳慧[1] 龚燕平[1] 成晓玲[1] 田慧[1] 李春霖[1] 

机构地区：[1]解放军总医院老年内分泌科,北京100853

出　　处：《中华医学杂志》2016年第9期702-706,共5页National Medical Journal of China

摘　　要：目的探讨老年男性血清性激素水平与代谢综合征（MS）及各组分的相互关系。方法采用横断面研究方法，收集2012年5至6月在解放军总医院常规年度体检年龄≥60岁的老年男性1505名，年龄60-96岁，平均年龄（75．4±9．7）岁。测量身高、体重、血压、血糖、血脂及性腺五项[包括血清卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇、睾酮、性激素结合球蛋白（SHBG）]，并计算游离睾酮（FT）、生物可利用睾酮（BT），分析性激素水平与代谢综合征及其各组分的相互关系。结果本研究人群MS患病率为21．7％（326／1505），MS患者SHBG、睾酮、FT、BT水平均低于非MS患者（P〈0．05）。在超重／HE胖、高血糖、高三酰甘油（TG）及低高密度脂蛋白（HDL-C）代谢异常组，SHBG、睾酮、F11、BT水平低于其正常组，差异均有统计学意义（均P〈0．05）。Logistic多因素回归分析显示，SHBG是MS的影响因素之一（OR=0．977，95％CI：0．964-0．989，P〈0．001）；而睾酮、FT、BT均与MS无显著相关性。随着SHBG四分位水平降低，MS患病率显著增加（P〈0．001）；当校正年龄、吸烟、饮酒和其他性激素指标后，最低四分位水平组与最高四分位水平组相比，MS患病风险增加至2。13倍（95％CI：1.125-4.032）。结论SHBG水平降低与老年男性MS的患病率增加相关，而睾酮F11和BT水平与MS患病率未见明显关联，这种机制仍有待进一步研究。Objective To investigate the relationship between sex hormones and metabolic syndrome （MS）, as well as its components in elderly men. Methods 1 505 elderly men （ ≥60 years old, mean age 75. 4±9. 7 years old） who participated in a routine health screening examination in PLA general hospital from May to June in 2012 were enrolled in this cross-sectional study. Serum lipids, glucose and sex hormones were measured along with body height, weight and blood pressure. Free testosterone （FT） and bioavailable testosterone （BT） were calculated. The correlation of serum sex hormones with the presence of MS and its components were analyzed. Results The prevalence of MS was 21.7% （ 326/1 505 ） in this study. Elderly men with MS had lower levels of sex hormone-binding globulin （SHBG）, total testosterone （TT）, FT and BT than those without MS. The levels of SHBG, TT, FT and BT were significantly lower in the overweight/obesity group, hyperglycemia group and dyslipidemia group than those in the respective control groups （ P 〈 0. 05）. Logistic regression analysis showed that the SHBG level was an independent risk factor for MS in elderly men（ OR = 0. 977, 95% CI： 0. 964 - 0. 989, P 〈 0. 001 ）, while the tevels ofTT, FT and BT were not associated with MS. The prevalence of MS gradually increased with decreasing of SHBG values （P 〈 0. 001 ）. When comparing subjects in the lowest and highest quartile of SHBG, the former group demonstrated a 2. 13-fold increase in the odds ratio for MS after adjusting for age, smoking, drinking and other sex hormone indices. Conclusion In elderly men, lower SHBG level, not TT, FT or BT may be an independent predictor for the prevalence of MS, in which the mechanism requires further studies.

关 键 词：代谢综合征X 性腺激素类 性激素结合球蛋白 睾酮 老年男性 

分 类 号：R589[医药卫生—内分泌]