不同体重指数男性性激素变化的临床研究  

Changes of sex hormones in males with different body mass indexes

作　　者：许瑞元 周珺[1] 罗晓红[1] Xu Ruiyuan;Zhou Jun;Luo Xiaohong.(Department of Endocrinology, Lanzhou General Hospital of PLA, Lanzhou 730050, Chin)

机构地区：[1]中国人民解放军兰州总医院内分泌科,甘肃兰州730050

出　　处：《临床内科杂志》2018年第6期396-398,共3页Journal of Clinical Internal Medicine

摘　　要：目的探讨不同体重指数（BMI）男性性激素变化情况及其影响因素。方法选取于我院体检中心体检的男性223例，根据BMI将其分为正常BMI组（76例）、超重组（77例）和肥胖组（70例）。测定其血糖、血脂相关指标及硫酸脱氢表雄酮（DHEAS）、性激素结合球蛋白（SHBG）、促卵泡生成素（FSH）、促黄体生成素（LH）、雌激素（E2）、睾酮（T）等性激素水平，并进行比较分析。结果与正常BMI组比较，超重组和肥胖组空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA—IR）及甘油三酯（TG）水平均明显升高，胰岛素敏感指数（ISI）明显降低（P〈0．05），且超重组和肥胖组问HOMA—IR和ISI比较差异有统计学意义（P〈0．05）。肥胖组SHBG水平明显高于正常BMI组（P〈0．05）；正常BMI组、超重组及肥胖组的T水平依次降低，E2／T依次升高（P〈0．05），余性激素指标比较差异均无统计学意义（P〉0．05）。相关性分析结果显示，BMI与E2／T呈正相关（r=0．272，P：0．036），与T和SHBG呈负相关（r=-0．201，P=0．050；r=-0．322，P=0．009）；腰臀比与E2／T呈正相关（r=0．141，P=0．045），与SHBG呈负相关（r=-0．240，P=0．041）。结论不同BMI男性的性激素水平存在差异，在肥胖治疗中可考虑适当补充雄激素。Objective To investigate the changes of sex hormones in males with different body mass indexes（BMI）. Methods A total of 223 male patients checked up in physical examination center were divided into normal BMI group（ 76 cases ）, overweight group（ 77 cases ） and obesity group （70 cases ） according to BMI. Blood glucose, lipid related indicators and sex hormones including dehydroepiandros- terone sulfate （ DHEAS ） , sex hormone binding globulin （ SHBG）, follicle-stimulating hormone （ FSH ） , luteinizing hormone （ LH ）, estrogen （ E2 ） and testosterone （ T ） levels were assayed and compared. Results Compared with normal BMI group, fasting insulin （ FINS ）, HOMA-IR and triglyceride （ TG ） increased in overweight group and obesity group ,while insulin sensitivity index（ISI） decreased significantly （P 〈 O. 05 ）. There were statistical differences in HOMA-IR and ISI between overweight group and obesity group （P 〈0.05 ）. SHBG in obesity group decreased significantly compared to normal BMI group （ P 〈 0. 05）. T level decreased and E2/T ratio increased successively with the rise of BMI （ P 〈 0.05 ）. Correlation analysis showed that BMI was positively correlated with E2/T （ r = 0. 272, P -= 0. 036） and negatively conelated with T and SHBG （ r = - 0. 201, P = 0. 050 and r = - 0. 322, P = 0. 009 ）. The waist- hip ratio was positively correlated with E2/T （r = 0. 141, P = 0. 045 ） , and negatively correlated to SHBG （ r = - 0. 240, P = 0. 041 ）. Conclusion Levels of sex hormones are changed in males with different BMI and appropriate supplementation of androgens can be considered in the anti-obesity treatment.

关 键 词：男性 体重指数 肥胖 性激素 

分 类 号：R587.1[医药卫生—内分泌]