不同负荷运动量对血清睾酮,游离睾酮和皮质醇浓度的影响

目的：探讨不同负荷运动量对血清睾酮（Ｔ）、游离睾酮（ＦＴ）和皮质醇（Ｃ）浓度的影响。方法：对１６名摔跤运动员训练当日晨,训练前,训练后即刻,次日晨和再次日晨抽取血液标本。结果：小强度训练变化不明显,中、大强度训练前后血清Ｔ、ＦＴ和Ｃ均有明显变化。结论：血清Ｔ、ＦＴ和Ｃ可作为观察运动量的指标。     

运动负荷时血睾酮、皮质醇及其比值变化

目的探讨利用运动员血睾酮(T)、皮质醇(C)及T/C的动态变化作机能评定可行性的研究.方法进行2级负荷训练,以放免法对T、C进行测定分析.结果(1)T值最高为降低强度训练后值,最小为实验前值;与受试前比,男降低强度训练后值,P＜0.05,女P＜0.01;SD值较大.(2)T/C值最高为降低强度训练后值,最小为实验前值;与受试前比,降低强度训练后值,P＜0.01;SD值较大.(3)C值2级负荷后的数值都有变化P＞0.05.结论T,C,T/C值对负荷反应灵敏,数值变化有随强度变化的趋势,可作为运动员机能评定的指标;由于T、T/C的SD值较大,运用该指标进行机能评定时,需区别对待.     

优秀田径运动员大运动量训练后血液生化指标的变化

目的:观察优秀田径运动员大强度的运动训练前后血清激素、血清酶和全血乳酸、血红蛋白等生化指标变化。方法:实验于2005-04/2005-05在广西师范大学体育学院田径场和实验室完成,选择16名广西师范大学体育学院的中长跑项目男性运动员,平均(20±1)岁,均无器质性病变和遗传病史,且对检测项目知情同意。①采用递增负荷式中长距离的跑项目进行训练,共4周,训练课间的强度以瑞典生理学家Rorg研制的主观心理感觉的等级表来控制,并且在最后1次训练课上采用最大强度的力竭性运动训练。分3次抽取受试对象静脉血,进行实验前受试对象安静时第1次取样,第2次取样在大强度训练运动后即刻进行取样测定,第3次取样安排在完成上述运动训练次日7∶00～8∶00(运动恢复后)进行。②采用放射免疫分析法测定血清睾酮与皮质醇水平,试剂盒由南京建成生物工程研究所提供;采用岛津公司产全自动生化分析仪测定血清肌酸激酶、血尿素、乳酸脱氢酶等血清酶的活性;采用用美国产YSI-23L全自动乳酸分析仪测定全血乳酸水平,采用全自动血球计数仪进行测定血红蛋白水平。结果:纳入受试对象16名均进入结果分析。①血清睾酮、皮质醇的变化:运动后即刻血清睾酮和皮质醇值分别为(4.56±1.84),(0.20±0.03)μg/L,低于安静时[(4.87±0.20),(0.14±0.03)μg/L,P<0.05],血清睾酮与皮质醇的比值低于安静时及运动恢复后[0.47±0.15,0.65±0.17,0.70±0.21,P<0.01]。②血清肌酸激酶、血尿素、乳酸脱氢酶变化:运动恢复后的血清肌酸激酶活性高于安静时及运动后即刻[(6.86±2.21),(5.79±2.10),(5.20±1.77)μkat/L,P<0.01],乳酸脱氢酶活性高于安静时[(5.18±0.97),(4.28±1.15)μkat/L,P<0.05]。血尿素水平高于安静时及运动后即刻[(178.2±38.7),(151.9±25.2),(100.7±13.9)mg/L,P<0.01]。③全血乳酸和血红蛋白的变化:运动后即刻及运动恢复后血清血红蛋白含量低于安静时[(143.1±7.8),(149.5±13.4),(156.6±11.7)g/L,P<0.01],运动后即刻全血乳酸水平高于安静时及运动恢复后[(9.56±2.05),(3.95±0.93),(2.87±0.71)mmol/L,P<0.01]。结论:大运动量的训练后即刻测定睾酮/皮质醇、乳酸脱氢酶、全血乳酸三项指标、训练恢复期测定肌酸激酶、血尿素两项指标能更好的反映运动强度。     

血清PSA与睾酮联合检测对确定PSA水平为2～4 ng/ml的前列腺疾病患者活检临界值的价值

目的 探讨血清游离/总前列腺特异性抗原(f/tPSA)比值、睾酮(T)及游离睾酮(FT)的前列腺穿刺活检(TRUS)临界值,及其对PSA 2～4 ng/ml的前列腺疾病患者进行前列腺TRUS的价值.方法 用放射免疫法(IRMA)和化学发光法(CLIA)分别测定275例血清PSA 2～4 ng/ml的前列腺疾病患者血清中的FT和f/tPSA、T水平,且均以直肠超声引导下TRUS为确诊标准,并用受试者工作特征曲线确定诊断的敏感度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比和95%可信区间.结果 275例患者中检出前列腺癌(Pca)44例,检出率是16%,Pca组血清f/tPSA比值、T和FT水平[分别为0.19±0.02、(9.32±5.21)nmol/L、(27.20±10.23)pmol/L]均明显低于非前列腺癌组[分别为0.24±0.05、(17.01±8.12)nmol/L、(46.71±13.27)pmol/L,P＜0.001].Pca组中f/tPSA、FT和T在ROC曲线下的面积(AUC)分别为0.680、0.713、0.547,f/tPSA和FT联合应用的AUC为0.851.经ROC曲线分析,f/tPSA 0.19和FT 27.20 pmol/L联合应用的活检临界值,敏感度和特异度均可达84%,阳性预测值50%,阴性预测值96%,阳性似然比5.25和阴性似然比0.19.f/tPSA、FT的单侧95%可信区间分别为0.19(0.19和0.20)、27.20(24.61和29.79 pmol/L)pmol/L.结论 在PSA为 2～4 ng/ml的前列腺疾病患者中,血清f/tPSA与FT联合测定,可提示哪些患者需要进行前列腺TRUS,并可提高Pca早期检出率.     

成年男性乙型肝炎患者血清睾酮、雌二醇水平测定及意义

目的了解成年男性乙型肝炎患者不同病变时期及年龄相匹配的血清睾酮、雌二醇水平的变化.方法采用双抗体放射免疫分析法,对30例对照组、106例观察组(急性肝炎28例;慢性肝炎63例,其中轻度12例,中度36例,重度15例;肝炎肝硬化15例)血清睾酮、雌二醇水平进行检测,并应用方差分析进行统计学处理.结果(1)肝硬化组患者血清睾酮水平较对照组、急性肝炎组、慢性肝炎(轻、中、重)组均显著降低(P＜0.01);(2)肝硬化组患者血清雌二醇水平较对照组降低(P＜0.05),而其余各组患者血清睾酮、雌二醇水平变化差异无显著性(P＞0.05).结论成年男性乙型肝炎的肝硬化患者血清睾酮、雌二醇含量均降低,且以睾酮水平降低更明显;急性肝炎和慢性肝炎患者血清睾酮、雌二醇含量无变化.     

快速进入高原环境中对男子柔道运动员运动能力的影响

目的:快速处于高原环境后人体产生一系列的应激,研究该反应对运动员运动能力的影响。方法:观察了7名广东省男子柔道运动员在高原(昆明,1891m)3d进行训练前后的血红蛋白(Hb)、肌酸激酶(CK)、血尿素(BUN)、血乳酸(BLA)、血清睾酮(T)、皮质醇(C)和T/C比值的变化,并与平原训练后指标的变化进行比较。结果:高原训练中,Hb变化不大,而血清CK活性、BUN和BLA显著升高,血清睾酮趋于降低,皮质醇及T/C比值显著升高;在高原进行与平原相同负荷训练时,血清CK活性、BUN、BLA水平明显高于平原;运动员主观感觉高原反应明显,运动能力下降。结论:短期的高原训练未能使机体调节功能产生适应。     

重庆地区表观健康成年人血清睾酮参考区间的建立

目的建立重庆地区表观健康人群血清睾酮的参考区间。方法选取体检健康成年人为研究对象,按性别、年龄分组,检测血清睾酮水平,根据美国临床和实验室标准协会C28-A3文件相关要求,建立血清睾酮的95%参考区间。结果研究纳入体检健康人群共602例,其中男性300例,血清睾酮水平呈正态分布,平均水平为(4.89±1.33)ng/mL;女性302例,血清睾酮水平呈非正态分布,水平中位数(四分位数)为[0.38(0.20~0.57)]ng/mL,二者比较差异有统计学意义(P<0.05)。进一步年龄分组比较血清睾酮测定结果,男性血清睾酮水平在两个年龄亚组间的差异无统计学意义(P>0.05),女性的睾酮水平随年龄增长而降低,20~<50岁年龄组明显高于≥50岁年龄组(P<0.05)。重庆地区表观健康人群血清睾酮的参考区间:男性为2.28~7.50 ng/mL,女性20~<50岁为0.10~1.03 ng/mL,女性≥50岁为0.10~0.70 ng/mL。结论初步建立了重庆地区表观健康人群不同性别的血清睾酮的参考区间,女性人群需根据年龄分组采用不同的参考区间。     

睾酮补充治疗对中老年男性糖脂代谢的影响

目的观察睾酮(T)补充治疗对中老年男性糖脂代谢的影响。方法收集睾酮水平低下的中老年男性对照组(C组)42例,非肥胖治疗组(A组)31例和肥胖治疗组(B组)35例,观察1年,检测治疗前后睾酮及糖脂代谢变化。结果治疗前3组睾酮及代谢指标无明显差异,1年后,A、B组随着睾酮增加,三酰甘油(TG)、空腹胰岛素(FIns)、胰岛素抵抗指数(HOMA-IR)水平降低,高密度脂蛋白胆固醇(HDL)升高,C组实验前后指标无明显差异;B组较A组更早出现TG水平差异,且HOMA-IR较A组下降趋势更明显。结论睾酮补充治疗可改善糖脂代谢,为中老年男性带来心血管方面的获益。     

成都地区健康成人血清游离睾酮和生物可利用睾酮水平调查

目的调查成都地区健康成人血清总睾酮、游离睾酮和生物可利用睾酮的水平,为建立本地区血清睾酮的参考范围提供依据。方法共纳入499例体检健康人群,使用电化学发光免疫分析技术,检测其血清总睾酮和性激素结合蛋白(SHBG)水平,计算血清游离睾酮、生物可利用睾酮水平,分析其与年龄的相关性,计算其95%参考范围。结果男性总睾酮、游离睾酮、生物可利用睾酮与年龄呈均负相关(P<0.05),男性总睾酮随年龄增长下降趋势较缓(r=-0.171),而游离睾酮、生物可利用睾酮随年龄增长呈现明显下降趋势(r=-0.510、-0.571);女性总睾酮、游离睾酮、生物可利用睾酮与年龄均呈负相关(P<0.05),且三者下降趋势一致;男性总睾酮、游离睾酮、生物可利用睾酮的95%参考范围分别为:2.55~9.00ng/mL、41.27~133.42pg/mL、1.04~3.59ng/mL;女性总睾酮、游离睾酮、生物可利用睾酮的95%参考范围分别为:25.00~496.25pg/mL、0.22~6.44pg/mL、5.68~156.80pg/mL。结论男性和女性游离睾酮和生物可利用睾酮均与年龄呈负相关性,临床使用中应充分考虑年龄因素,男性游离睾酮和生物可利用睾酮较总睾酮更敏感。     

十一酸睾酮联合血府逐瘀片治疗中老年男性MS合并ED疗效观察

目的:观察睾酮联合血府逐瘀片治疗中老年男性代谢综合征(MS)合并勃起功能障碍(ED)的临床疗效。方法:选择符合纳入病例标准的86例MS伴ED患者随机分为十一酸睾酮胶丸联合血府逐瘀片研究组(n=45)和十一酸睾酮胶丸组(n=41),6个月后比较组内和组间治疗前后IIEF-5评分、性激素(TT、TSI、FT、E2、E2/TT、SHBG)、糖脂代谢指标(TG、HDL、LDL、FBG、FIns、HOMA-IR)变化情况,以及治疗对血尿常规、PSA、IPPS、肝肾功能的影响作用。结果:治疗后研究组与十一酸睾酮组IIEF-5评分、TT、FT、TSI、SHBG、HDL、血液流变学指标均有不同程度的改善,TG、LDL、FBG、FIns、HOMA-IR、E2、E2/TT不同程度降低(P<0.001或P<0.05),研究组疗效显著优于十一酸睾酮组,差异有极显著性(P<0.001)。结论:睾酮联合血府逐瘀片治疗MS合并ED能明显改善患者雄激素水平,能明显改善血管内皮功能、勃起功能,减轻胰岛素抵抗,未见明显的补充睾酮治疗的副作用,为MS伴ED患者带来新方法。     

Measurement of testosterone and its sub-fractions in Canada

Interest in measuring bioactive testosterone in aging males has increased considerably in the last 5 years in Canada. Emerging andropause clinics have submerged our laboratories with requests for bioavailable testosterone (BAT) testing in replacement or addition to the traditional total testosterone (TT) and direct free testosterone (FT) assays. Beginning with a brief explanation of the bioavailability concept of Pardridge, this review examines the technical characteristics of various approaches currently available to measure TT and its sub-fractions. First, limitations in the measurement of TT, SHBG, and particularly direct (analog) FT assays are extracted from the scientific literature and recent external and internal QC reports. It is concluded that the free direct T assay is useless in the clinical context of andropause. The impact of the observed limitations of TT and SHBG measurements on calculated FT and BAT or BAT obtained by precipitation with ammonium sulfate is then discussed. A comparative evaluation of the advantages and disadvantages of calculated FT or BAT vs. precipitated BAT is presented before concluding that doing a TT as a first line test remains overall the most cost-effective measurement in the diagnosis of hypogonadism in males, and that this sole determination will be sufficient in over 75% of the cases.     

Review of health risks of low testosterone and testosterone administration

Hypogonadism is prevalent in older men and testosteronereplacement therapy(TRT) for older hypogonadal men is a promising therapy. However, a number of important clinical concerns over TRT safety remain unsolved due to a lack of large-scale randomized clinical trials directly comparing the health risks of untreated hypogonadism vs long-term use of TRT. Meta-analyses of clinical trials of TRT as of 2010 have identified three major adverse events resulting from TRT: polycythemia, an increase in prostate-related events, and a slight reduction in serum high-density lipoprotein cholesterol. There are other purported health risks but their incidence can be neither confirmed nor denied based on the small number of subjects that have been studied to date. Furthermore, subsequent literature is equivocal with regard to the safety and utility of TRT and this topic has been subject to contentious debate. Since January 2014, the United States Food and Drug Administration has released two official announcements regarding the safety of TRT and clinical monitoring the risks in TRT users. Additionally, the health risks related to the clinical presentation of low or declining testosterone levels not been resolved in the current literature. Because TRT is prescribed in the context of putative risks resulting from reduced testosterone levels, we reviewed the epidemiology and reported risks of low testosterone levels. We also highlight the current information about TRT utilization, the risks most often claimed to be associated with TRT, and current or emerging alternatives to TRT.     

The evolving role of testosterone in the treatment of erectile dysfunction

Hypogonadism may play a significant role in the pathophysiology of erectile dysfunction (ED). A threshold level of testosterone may be necessary for normal erectile function. Testosterone replacement therapy is indicated in hypogonadal patients and is beneficial in patients with ED and hypogonadism. Monotherapy with testosterone for ED is of limited effectiveness and may be most promising in young patients with hypogonadism and without vascular risk factors for ED. A number of laboratory and human studies have shown the combination of testosterone and other ED treatments, such as phosphodiesterase type 5 (PDE5) inhibitors, to be beneficial in patients with ED and hypogonadism, who fail PDE5 inhibitor therapy alone. There is increasing evidence that combination therapy is effective in treating the symptoms of ED in patients for whom treatment failed with testosterone or PDE5 inhibitors alone. Testosterone replacement therapy has potentially evolved from a monotherapy for ED in cases of low testosterone, to a combination therapy with PDE5 inhibitors. Screening for hypogonadism may be useful in men with ED who fail prior PDE5 inhibitors, especially in populations at risk for hypogonadism such as type 2 diabetes and the metabolic syndrome.     

男性急性冠状动脉综合征患者血清睾酮与血管性假血友病因子改变的关系

目的:观察不同类型男性冠心病患者血清睾酮、游离睾酮与血管性假血友病因子水平改变及互相间相关关系,进一步探讨睾酮与血管性假血友病因子在男性急性冠脉综合征发病中的作用。方法:冠心病患者分为急性心肌梗死组(AMI)、不稳定型心绞痛组(UAP)、稳定型心绞痛组(SAP),每组30例患者,另设健康对照组30例,比较各组间血清睾酮、游离睾酮与血管性假血友病因子水平差异并分析其相关性。结果:AMI组和UA组血清游离睾酮与血管性假血友病因子水平与对照组差异有统计学意义(P<0.01)。结论:血清游离睾酮与血管性假血友病因子水平改变与急性冠脉综合征的发生有关,可作为评价冠状动脉粥样硬化斑块稳定性与病变严重程度的一个参考指标,并为临床预防和治疗急性冠脉综合征开辟了新的途径。     

Comparisons between commercial salivary testosterone enzyme-linked immunosorbent assay kits

Introduction: Measuring testosterone concentrations is of interest both in clinical situations and for research, the latter expanding rapidly during recent years. An increased demand for convenient methods has prompted a number of companies to develop enzyme-linked immunosorbent assay (ELISA) kits to measure testosterone concentrations in saliva. However, the inter-comparability of kits from different manufacturers have yet to be determined.

Aim of study: The aim of this study was to compare commercially available ELISA kits from four different manufacturers (Salimetrics, IBL, DRG and Demeditec).

Methods: Saliva was collected from 50 participants (25 men and 25 women). Each sample was analysed by the four ELISA kits.

Results: The correlations between the ELISA kits from Demeditec, DRG and Salimetrics were moderate to high with r-values >?.77; however, proportional errors between the methods calls for caution. The ELISA kit from IBL malfunctioned and no results from this kit was obtained.

Conclusions: Results from studies using the ELISA kits from Demeditec, DRG and Salimetrics are generally comparable; however, translation using the formulae presented in the current study could increase the accuracy of these comparisons.     

同位素稀释液相色谱串联质谱法测定血清睾酮

目的建立一种用同位素稀释液相色谱串联质谱法(ID-LC/MS/MS)测定血清睾酮的候选参考方法。方法以[16,17,17-d3]睾酮为内标,用重量法准确地与血清混合,用乙酸乙酯-正己烷混合溶剂提取,以羟丙基-β-环糊精水溶液对提取液作净化处理,用液相色谱串联质谱分析,质谱选择离子监测模式检测睾酮与内标的特定碎片离子,用包括法定量。结果血清睾酮测定的批内、批间和总变异系数(CV)的均值(范围)为0.84%(0.22%~2.00%)、1.01%(0.48%~2.37%)和1.37%(0.53%~3.09%)。参考物质ERM DA-345a和NIST SRM 971测定结果与认定值的平均偏差范围为-2.0%~+1.8%。结论用ID-LC/MS/MS建立了血清睾酮的测定方法,方法准确、精密、简便,有望作为血清睾酮测定的参考方法。     

The effect of testosterone replacement on plasma lipids and apolipoproteins

Ten men with Klinefelter's syndrome were studied to assess the effect of testosterone replacement on plasma lipids and apolipoproteins. Measurements taken before the insertion of a testosterone ester implant were compared with those obtained 1 week and 4 weeks later. Mean plasma testosterone, androstenedione, total cholesterol and calculated LDL-cholesterol increased significantly after 1 and 4 weeks. No significant changes were seen in total plasma concentrations of HDL-cholesterol, HDL-cholesterol subfractions 2 and 3 or in apoplipoproteins A-I, A-II or B. A significant correlation was seen between total cholesterol and plasma oestradiol concentrations (Rs = 0.61; P less than 0.001). A significant negative correlation was seen between the concentrations of total testosterone and total triglyceride (Rs = -0.56; P less than 0.005) but not with the other lipid parameters. Testosterone replacement is associated with slight but potentially adverse changes in plasma cholesterol levels.