Sex Hormones and Androgen Receptor：Risk Factors of Coronary Heart Disease in Elderly Men

Objective To investigate the variation of sex hormone and its receptor level in elderly male patients with coronary heart disease （CHD） and to evaluate the correlations between CHD and sex hormone as well as sex hormone receptor. Methods Altogether 139 male CHD patients （CHD group） aged 60-92 years and 400 healthy men （control group） aged 60-90 years were included in this cross sectional study. The plasma concentrations of dehydroepiandrosterone sulfate （DHEAS）,total testosterone （TT）,free testosterone （FT）,estradiol （E2）,sex hormone binding globulin （SHBG）,luteinizing hormone （LH）,and follicle-stimulating hormone （FSH） were measured. The androgen receptor （AR） was tested by flow cytometry. Correlations between CHD and levels of sex hormones and AR were analyzed. Results Compared with the control group,the levels of DHEAS,TT,FT,SHBG,and the fluorescence intensity of AR in the CHD group significantly reduced （P0.05）,while the levels of FSH and E2 significantly increased （P0.01）. Age was negatively correlated with TT （r=-0.28,P=0.00） and FT （r=-0.17,P=0.01）,while it was positively correlated with SHBG （r=0.14,P=0.04） and E2 （r=0.33,P=0.00）. AR fluorescence intensity was negatively correlated with systolic blood pressure （r=-0.12,P=0.01）. Binary logistic regression analysis showed that TT,SHBG,and AR were all negatively correlated with CHD （P0.05）. Conclusions Elderly male patients with CHD are found to have low levels of DHEAS,TT,FT,SHBG,and AR,while high concentrations of E2 and FSH. Low levels of TT and SHBG may be the potential risk factors of CHD in elderly men.     

Anti-Müllerian hormone,antral follicle count and folliclestimulating hormone for predicting the number of oocytes retrieved in IVF/ICSI cycles

Objective To evaluate the efficacy of anti-Müllerian hormone(AMH), antral follicle count(AFC) and follicle-stimulating hormone(FSH) for predicting the number of oocytes retrieved in in-vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)cycles.Methods In this retrospective study, a total of 122 infertile women were divided into two groups: group A, 35 years(n=71); group B, ≥35 years(n=51). AMH and FSH were determined on 2-5 d of the early menstrual cycle. AFC was tested on the second day of the menstrual cycle before the start of stimulation.Results Group B had higher FSH levels compared with group A(8.2±3.5 IU/L vs 6.8±2.4 IU/L, P0.05). However, levels of AMH and AFC in group B were lower than those of group A(AMH: 4.2±3.5 μg/L vs 2.7±2.7 μg/L; AFC: 9.0±3.9 vs 5.4±3.3, P0.05). The number of oocyte retrieved in the two groups was not significantly different(11.5±6.8 vs 9.6±6.9, P0.05). The level of AMH was more strongly correlated with the number of oocytes retrieved than that of AFC or FSH level. The strengths of the correlation degrees were AMH level, AFC, and FSH level in turn(r=0.600, 0.511,-0.369).Conclusion AMH would be a useful predictor for ovarian response.     

脂蛋白相关磷脂酶A2与冠状动脉粥样硬化病变程度及斑块稳定性的关系

目的 探讨脂蛋白相关磷脂酶A2(Lp-PLA2)与冠状动脉粥样硬化病变程度及斑块稳定性的关系.方法 对160例可疑冠心病患者行冠状动脉造影,根据冠状动脉造影结果分为冠状动脉造影正常的对照组(34例)和冠心病组(126例),冠心病组根据临床类型分为急性冠状动脉综合征组(86例)和稳定型心绞痛组(40例).以病变支数和Gensini积分评价动脉粥样硬化病变程度,以临床类型评价斑块稳定性.检查所有患者血清Lp-PLA2水平、高敏C-反应蛋白(hs-CRP)等指标,分析Lp-PLA2、hs-CRP等与病变支数、Gensini积分、斑块稳定性的关系.结果 冠心病组Lp-PLA2水平显著高于对照组(P＜0.05),而且随着冠状动脉病变支数的增加和Gensini积分的增加而逐渐升高,在急性冠状动脉综合征组较稳定型心绞痛组升高.Lp-PLA2水平与hs-CRP无明显相关性.结论 冠心病患者血清Lp-PLA2水平与冠状动脉粥样硬化病变程度及斑块稳定性有关. Abstract： Objective To investigate the correlations between serum levels of lipoprotein -associated pospholipase A2 ( Lp - PLA2 ) and the severity and stability of coronary atherosclerosis. Methods Coronary angiography (CAG) was performed in 160 patients who were suspected as having coronary artery disease(CAD). According to the coronary artery chanrges and plaque characters in CAG, all patients were divided into control group( n =34) and CAD group( n = 126). According to the clinical types,the CAD patients were divided into acute coronary syndrome (ACS) group ( n = 86) and stable angina pectoris (SAP) group ( n = 40). The number of diseased coronary branches and Gensini' s score was used for evaluate the severity of atherosclerosis. The clinical types was used for evaluate the stability of plaque. Lp - PLA2 and hs - CRP were measured in all the patients. The correlation between serum LpPLA2 with hs - CRP and the number of diseased coronary branches, Gensini's score, clinical types were analyzed. Results Lp - PLA2 in CAD patients was significantly higher than that in control group ( P＜0.05) and increased with the increasing number of diseased coronary branches and Gensini's score.Lp -PLA2 in ACS group was higher than SAP group. Lp -PLA2 level had no correlated with hs -CRP.Conclusions CAD patients serum Lp - PLA2 level is correlated with the severity of atherosclerosis and the stability of plaque.     

Levels of soluble adhesion molecules in patients with various clinical presentations of coronary atherosclerosis

Background Adhesion molecules play an important role in the development and progression of coronary atherosclerosis. The aim of this study was to compare concentrations of soluble forms of adhesion molecules in patients with different clinical presentations of coronary artery disease （CAD）.Methods One hundred and twenty-eight patients with CAD were divided into three groups; the first group was acute myocardial infarction group （AMI group, n=45）, the second group was unstable angina pectoris group （UAP group, n=48）,the third group was stable angina pectoris group （SAP group, n=35）. We compared them with patients with normal coronary arteries （control group, n=31）. The serum levels of vascular cell adhesion molecule （VCAM-1）, intercellular adhesion molecule-1 （ICAM-1）, E-selectin and P-selectin were measured in all subjects.Results The serum level of VCAM-1 in the AMI group was significantly higher than in the UAP, SAP and control groups （P 〈0.01）. The level in the UAP group was significantly higher than the SAP group and control group （P 〈0.01） and the level in the SAP group was significantly higher than in the control group （P 〈0.01）. The serum ICAM-1 level was significantly elevated in the AMI, UAP and SAP groups as compared to the control group （P 〈0.01）. The levels of serum E-selectin and P-selectin in the AMI and UAP groups were significantly higher than in the SAP and control groups （P〈0.01）.Conclusions Increased levels of VCAM-1 and ICAM-1, E-selectin and P-selectin, as markers of inflammation, showed the importance of inflammatory processes in the development of atherosclerosis and clinical expression of CAD. Soluble ICAM-1, VCAM-1, E-selectin and P-selectin concentrations are useful indicators of the presence of atherosclerosis and the severity of CAD clinical presentation.     

Apparent protective effect of high density lipoprotein against coronary heart disease in the elderly

Background This study was designed to evaluate the relationship between high-density lipoprotein cholesterol (HDL-C) level and acute myocardial infarction (AMI) and coronary heart disease (CHD) death and to explore the protective effect of HDL against CHD in the elderly Chinese.Methods Started from 1986, 1211 retirees (92% males) were enrolled consecutively and studied prospectively. The average starting age was 70±9 years, and that at the end of the study was 80±9 years. During the follow-up study, all the participants received yearly physical examination and blood chemistry survey from 1986-2000. The average duration of the follow up study was 11.2 years. The end point of this study was either attacks of AMI or death due to CHD and other causes. CHD risk factors were screened by logistic regression analysis. According to their HDL-C levels, cases were divided into low (<1.03 mmol/L), medium (or normal, 1.03-1.56 mmol/L) and high (>1.56 mmol/L) level groups, the differences in incidence of AMI and CHD death in each group were analyzed.Results The cumulative attacks of acute coronary syndrome (mostly AMI) were 214 cases, including 89 cases of coronary death and 308 death caused by other diseases during the follow up study. AMI occurrence and CHD death in normal HDL-C group were lower than those in the low HDL-C group by 40% and 53%; and those in the high HDL-C group were lower than in the normal group by 56% and 50%, respectively. Statistical analysis on normal lipid cases （411 cases, total cholesterol<5.17mmol/L, triglyceride<1.69 mmol/L） revealed that the cases at low HDL-C level had similar rates of AMI events and CHD mortality as those of the entire group (including hyperlipidemia); however, AMI attacks and CHD deaths decreased significantly at the normal and high HDL-C levels. The results demonstrated that the protective effect of HDL against coronary artery disease is more prominent in people with low lipid level.Conclusion Low HDL is an important independent risk factor for AMI attacks and CHD death in the elderly; high HDL has significant protective effect against coronary artery disease.     

ApoB/apoA1 is an effective predictor of coronary heart disease risk in overweight and obesity

We investigated the relationship of apoB/apoA1 ratio and coronary heart disease (CHD) in persons who were overweight or obese.The subjects were divided by the body mass indexes (BMI) into the normal weight group (n=397,BMI<24 kg/m 2) and the overweight group (n=400,BMI>24 kg/m 2).Our results showed that the overweight group had higher blood pressure [(130.15±19.01) mmHg vs (123.66±18.70) mmHg] and higher levels of blood sugar [(7.09±2.89) mmol/L vs (6.21±2.59) mmol/L],triglyceride [(1.93±1.19) mmol/L vs (1....     

Effects of Liandou Qingmai Recipe(连豆清脉方) on Endothelin-1,Nitric Oxide,Interleukin-6 and Interleukin-10 Levels in Patients with Coronary Heart Disease

Objective:To observe effects of Liandou Qingmai Recipe(连豆清脉方) on endothelin-1(ET-1),nitric oxide(NO),interleukin-6(IL-6) and IL-10 levels in patients with coronary heart disease.Methods:Total 101 cases with coronary heart disease were randomly divided into a treatment group(n=45) treated by Liandou Qingmai Recipe and a standard treatment group(control group,n=56),with a normal group of 16 health persons set up.Changes of ET-1,NO,IL-6 and IL-10 levels were measured before treatment and after treatment for two weeks.And the data were analyzed by SPSS 16.0 statistic software.Results:Before treatment,the levels of ET-1,IL-6 and IL-10 levels were significantly higher and NO was significantly lower in the patients with coronary heart disease than those in the normal group(90.7±12.7 ng/L vs 41.8±13.5 ng/L,9.17±0.18 ng/L vs 1.10±0.08 ng/L,1.94±0.26 ng/L vs 1.09±0.06 ng/L,and 92.2±17.7 μmol/L vs 124.5±27.2 μmol/L;all P<0.05),with no significant differences in the levels of ET-1,NO,IL-6 and IL-10 between the treatment group and the control group(P>0.05);After treatment,ET-1 and IL-6 significantly decreased in the treatment group and the control group,and NO increased in the treatment group;And IL-6 level was significantly lower and NO level was higher in the treatment group than those in the control group(4.48±1.22 ng/L vs 5.13±1.85 ng/L,117.4±22.3 μmol/L vs 92.4±17.1 μmol/L;both P<0.05);There was a positive correlation between IL-6 and IL-10,and a negative correlation between NO and IL-10(r=0.142,r=-0.152;both P<0.05).Conclusion:Liandou Qingmai Recipe can decline IL-6,IL-10 and ET-1 levels,and raise NO level in patients with coronary heart disease on the basis of standard treatment,so as to inhibit endothelial inflammatory response,improve vascular endothelial function,with stronger anti-AS action;And vascular endothelial lesion is related with inflammatory response.     

Effect of Liandouqingmai Recipe on life quality and vascular endothelial injury in patients with coronary heart disease

OBJECTIVE:To observe the effects of Liandouqingmai Recipe on life quality and vascular endothelial injury in patients with coronary heart disease.METHODS:Capitalized 101 patients with coronary heart disease were randomly divided into a treatment group(n=45) treated with Liandouqingmai Recipe and a standard treatment group(control group,n=56).A normal group of 16 healthy persons was additionally set up.Changes in ET-1 and NO levels were measured and Seatle Angina Questionnaire(SAQ) was adopted in studying life quality before and after treatment for two weeks.The data were analyzed with SPSS 16.0 statistic software.RESULTS:The average level of ET-1 in the normal group was lower and NO higher than that of patients with coronary heart disease.There was no significant difference in the average level of ET-1 and NO and in the scores of SAQ [physical limitation(PL),pngina stability(AS),apngina frequency(AF),treatment satisfaction(TS) and disease perception(DP)] between the two groups before treatment(P>0.05).But after treatment,the scores of SAQ(PL,AS,AF,TS,DP) and NO level were higher than those in the control group,and ET-1 average level in the treatment group was lower than that in the control group.The negative relations between PL and ET-1 and between AF and ET-1 were found in this study.CONCLUSION:Liandouqingmai Recipe can raise scores of SAQ and NO level and decline ET level in patients with coronary heart disease on the basis of convertional standard treatment,thus improving vascular endothelial function and life quality.Life quality is related to vascular endothelial function.     

Study on Differences in Spermatogenic Suppression between Azoospermic and Oligozoospermic Responders Treated with Levonorgestrel Implant Plus Testosterone Undecanoate Injectable in Chinese Men

Objective To investigate possible causes resulting in the differences in the spermatogenesis suppression on individual treated with levonorgestrel (LNG) implants and testosterone undecanoate (TU) injectableMethods Totally 21 Chinese male volunteers were given treatment with LNG implants (four rods, 75 mg/rod) and intramuscular injection of TU (500 mg,bimonthly for 3 times). According to the effects of treatment, they were divided into two groups, namely, azoospermia group (group A) and oligozoospermia group (group O). Then seminal FSH, LH, T and estradiol (E2) were determined by immunoenzymetric assay, while seminal and serum dihydrotachysterol (DHT) and serum sex hormone binding globulin (SHBG) were by radioimmunoassay, and seminal transferrin (Tf) by scatter turbidimetry assay.Results Seminal FSH, LH and serum DHT, SHBG, FTI (T/SHBG ×100) levels were significantly lower in group A than in group O, while higher seminal concentrations ofE2 were observed in azoospermia group.Conclusion The differences i     

Roles of human epicardial adipose tissue in coronary artery atherosclerosis

This study examined the adipocytokine-vascular interactions and link between epicardial adipose tissue and coronary artery atherosclerosis.Thirty-four patients undergoing open heart surgery were chosen randomly, and divided into groupⅠ(non-coronary artery disease group) and group Ⅱ(coronary artery disease group).Blood samples were taken through peripheral vein prior to surgery.Plasma levels of a panel of proteins (adiponectin, IL-10, TNF-α) were detected by using ELISA.Epicardial adipose tissue was taken near the proximal tract of the right coronary artery and subcutaneous adipose was taken from the leg before cardiopulmonary bypassing, adiponectin and CD68+ were detected by using RT-PCR and immunohistochemistry.Our results showed that plasma adiponectin level was significantly lower in the group Ⅱ as compared with group Ⅰ(P<0.05).There were no differences in plasma concentration (IL-10, TNF-α, tatal-chol, HDL-chol, LDL-chol) between group Ⅰ and group Ⅱ.The number of CD68+ cells in epicardial adipose tissue of group Ⅱ was significantly higher than that in subcutaneous adipose tissue.Adiponectin mRNA expression was 6 fold higher in subcutaneous adipose tissue than in epicardial adipose tissue of group Ⅱ (P<0.01).Furthermore, the level of adiponectin mRNA in the epicardial adipose tissue in group Ⅱ was also significantly lower than in group Ⅰ (P<0.05).We are led to conclude that inflammation that occurs locally in epicardial adipose tissue of CAD contributes to the pathogenesis of coronary artery disease.     

综合干预治疗对多囊卵巢综合征患者雄激素浓度的影响

目的 评估多囊卵巢综合征（polycystic ovary syndrome,PCOS）患者经综合干预治疗后雄激素浓度的变化。方法 选取2019年3月至2020年2月就诊于首都医科大学附属北京妇产医院接受综合干预治疗的PCOS患者88例为PCOS组,按2：1的比例匹配同期就诊的健康女性44例为对照组,比较PCOS组治疗前后、PCOS组治疗后与对照组观察指标间的差异,包括：体质量指数（body mass index,BMI）、腰围、卵泡刺激素（follicle stimulating hormone,FSH）、黄体生成素（luteinizing hormone,LH）、LH/FSH、总睾酮（total testosterone,TT）、游离睾酮（free testosterone,FT）、性激素结合球蛋白（sex hormone binding globulin,SHBG）、抗苗勒管激素（anti Müllerian hormone,AMH）。结果 治疗前两组患者年龄、身高差异无统计学意义（P>0.05）,PCOS组患者的体质量、BMI、腰围、AMH、LH、LH/FSH、TT、FT均显著高于对照组（P<0.05）,FSH、SHBG显著低于对照组（P<0.05）;PCOS组综合干预治疗前后比较,体质量、BMI、腰围、AMH、TT、FT、LH、LH/FSH均显著下降（P<0.05）,SHBG显著升高（P<0.05）;治疗后PCOS组与同期对照组的AMH、LH/FSH、TT比较,差异无统计学意义（P>0.05）。结论 综合干预治疗3个月后能显著降低PCOS患者的雄激素浓度,尤其总睾酮浓度达到健康女性浓度。     

老年男性雄激素水平与冠状动脉粥样硬化病变程度的相关性分析

目的:探讨老年男性雄激素水平与冠状动脉粥样硬化病变程度之间的关系。方法:选择住院并接受冠状动脉造影检查的老年男性患者,并根据冠脉造影结果分为冠脉正常组(对照组)、单支病变组(SV group)、双支病变组(DV group)、三支病变组(TV group),每组32例,共128例。于入院24 h内空腹抽血,测总睾酮(TT)及性激素结合蛋白(SHBG)值,并根据Vermeulen公式计算游离睾酮(FT)。比较各组间TT、FT的差异,并分析TT及FT与冠脉病变程度的相关性。结果:FT在各组间存在显著差异(P<0.05或P<0.01),在冠心病各组中均低于正常对照组,且与冠脉病变程度呈负相关。虽然病变组与对照组的TT存在统计学差异(P<0.05),但是各病变组之间TT则无统计学差异(P>0.05)。结论:FT比TT更能反映冠脉病变程度,其水平越低提示冠脉病变越严重。     

内源性雄激素与男性冠心病及血脂关系的研究

目的:探讨内源性雄激素与男性冠心病及血脂之间的关系。方法:用断面调查的方法收集200例行择期冠状动脉造影的男性患者作为研究对象,根据冠状动脉造影结果分为冠心病组104例,对照组96例,用放免法检测血清游离睾酮、总睾酮、去氢表雄酮、去氢表雄酮硫酸酯、雌二醇和性激素结合球蛋白。结果:校正体重指数、血压及血脂因素的影响后,冠心病组血清游离睾酮、总睾酮、总睾酮/雌二醇及性激素结合球蛋白水平显著低于对照组(P<0.01或P<0.05);冠心病组与对照组血清去氢表雄酮、去氢表雄酮硫酸酯及雌二醇水平无显著性差异(均P>0.05)。冠心病患者血清游离睾酮、总睾酮及总睾酮/雌二醇与总胆固醇、甘油三酯及低密度脂蛋白胆固醇显著负相关(P<0.01或P<0.05);与高密度脂蛋白胆固醇显著正相关(P<0.01或P<0.05);性激素结合球蛋白与总胆固醇及甘油三酯显著负相关(P<0.01或P<0.05)。多元Logistic回归分析结果显示血清游离睾酮与冠心病的发生独立负相关。结论:男性冠心病患者血清睾酮水平降低,对血脂代谢具有不利影响,血清游离睾酮水平减低可能是冠心病的独立预测因子。     

中年男性2型糖尿病患者性激素水平与颈动脉内膜中层厚度的关系

目的:分析糖尿病患者性激素水平及颈动脉内膜中层厚度(IMT),研究性激素水平及与IMT之间的关系。方法:对100例中年男性糖尿病患者和100例中年健康男性(作为对照组)采集其晨起静脉血,低温离心后取血清,测定总睾酮、游离睾酮(FT)、脱氢表雄酮硫酸酯(DHEAS)、性激素结合球蛋白(SHBG)、雌二醇、黄体生成素(LH)、卵泡刺激素(FSH)水平,并行颈动脉超声检查,测定内膜中层厚度平均值及斑块厚度,并行血糖及血脂等检查。结果:(1)糖尿病患者总睾酮、FT、DHEAS明显降低(P<0.01),SHBG水平显著增加(P<0.01)。(2)糖尿病患者内膜中层较对照组明显增厚(P<0.05),斑块检出率显著增高(P<0.05)。(3)FT水平与IMT呈显著负相关(r=-0.516,P=0.023)。结论:中年男性2型糖尿病患者雄激素水平显著降低,且FT水平与IMT呈负相关。     

1166例成年男性肥胖与血清睾酮水平的关系

目的 探讨社区成年男性肥胖与血清睾酮水平的关系.方法 以社区为单位分层整群抽取遵义市20岁及以上男性居民共1 166例行问卷调查和体格检查,空腹抽取肘静脉血检测血清总睾酮(TT)、性激素结合球蛋白(SHBG)和黄体生成素(LH),计算游离睾酮(cFT)、游离睾酮指数(FTI)和睾酮分泌指数(TSI).结果 1 166例成年男性血清TT、SHBG、eFT、FTI、TSI、LH水平分别为(16.83±4.90) nmol/L、(42.15±20.21) nmol/L、(0.31±0.10) nmol/L、0.46=±0.19、3.40±2.04、(6.77±5.14)IU/L.Pearson相关分析显示腰围身高比(WHtR)、体质量指数(BMI)、腰围(WC)分别与TT、SHBG、TSI和LH呈负相关,与FTI呈正相关;WHtR与cFT呈负相关,BMI和WC与LH呈负相关,差异均有统计学意义(P＜0.05).多元线性回归分析显示WHtR与TT、SHBG、TSI、LH均呈负相关;与FTI呈正相关,差异均有统计学意义(P＜0.01).结论 成年男性向心性肥胖可能与血清TT、SHBG、TSI、LH下降及FTI上升有关.     

老年男性动脉粥样硬化与雄激素水平的研究

目的:观察动脉粥样硬化(AS)时雄激素水平的变化,分析两者之间的关系.方法:彩色多普勒超声检查双侧颈动脉和双侧下肢动脉,明显动脉硬化伴多发粥样斑块甚至全程粥样斑块形成者为病例组,提示血管未见明显异常、血流通畅者为对照组.放射免疫法测定总睾酮(TT)、游离睾酮(FT)、雌二醇(E2),比色法测定高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)和甘油三酯(TG),双抗体夹心ELISA法测定血管内皮细胞生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、细胞间黏附分子-1(sICAM-1)水平.比较两组各因子水平的差异,组内分析FT与各因子的相关性.结果:病例组FT显著低于对照组,P<0.01,而TT、E2两组无明显差异,并且与FT无相关性.对照组HDL-C显著比病例组高,P<0.01,病例组TC、TG显著比对照组高,P<0.05,而LDL-C无显著差异.对照组HDL-C、LDL-C与FT分别呈正相关和负相关,病例组TC和TG均与FT呈负相关.病例组VEGF较对照组明显高,P<0.05,且VEGF与两组FT均呈负相关.病例组TNF-α、IL-6均比对照组高,P<0.05,并且与FT负相关,对照组sICAM-1水平明显低于病例组,P<0.01.结论:正常水平雄激素(主要是FT)对老年男性AS有保护作用,低FT水平同时伴有脂质代谢絮乱和炎症反应等危险因素,低FT水平很可能也是老年男性AS的一个独立危险因素.     

男性甲亢性低钾周瘫患者血清甲状腺激素及性激素水平的变化

目的　观察男性甲亢性低钾周瘫（THPP）患者血清甲状腺激素、黄体生成素（LH）、卵泡刺激素（FSH）、催乳素（PRL）、孕酮（P）、总睾酮（T）、雌二醇（E2）的水平变化。方法分析了38例男性甲亢患者血清钾、总三碘甲腺原氨酸（TT3）、游离三碘甲腺原氨酸（FT3）、总甲状腺素（TT4）、游离甲状腺素（FT4）、促性腺激素与性激素的水平,其中THPP患者19例,无THPP的甲亢患者19例。结果（1）甲亢患者中THPP组血清TT3、FT3、TT4及T水平明显高于无THPP组（P均＜0．01）。血清LH、FSH、PRL、P及E2水平两组无显著差异性。（2）血清TT3、TT4、FT3及T与血清钾水平呈负相关关系,血清TT3与T水平呈正相关关系。结论男性甲亢患者血清甲状腺激素水平明显升高者易发生THPP;伴有THPP的男性甲亢患者T水平升高,其原因尚有待进一步研究。     

血清睾酮水平与2型糖尿病合并骨质疏松症的相关性研究

目的 探讨血清睾酮水平与2型糖尿病(type 2 diabetes mellitus, T2DM)合并骨质疏松症的相关性.方法 回顾性分析2015年9月至2016年5月于四川大学华西医院住院的T2DM合并骨质疏松症患者53例(DO组)、单纯性骨质疏松症患者60例(OP组)和骨量正常者42例(N组),分析比较3组患者之间的骨密度、血清总睾酮(TT)、性激素结合球蛋白(SHBG)和血清游离睾酮(FT)水平.结果 与N组比较,DO组和OP组患者腰椎(L1-L4)、股骨颈部、W-三角和粗隆的骨密度均降低,差异有统计学意义(P<0.05);血清SHBG水平显著降低,差异有统计学意义(P<0.05);血清总睾酮和游离睾酮水平无明显改变,差异无统计学意义(P>0.05).与OP组比较,DO组患者骨密度、血清TT、SHBG和FT水平比较,差异均无统计学意义(P>0.05).线性回归分析发现,性别与总睾酮(r=-21.339,P<0.001)和游离睾酮(r=-22.8,P<0.001)呈负相关.亚组分析发现,女性DO患者FT水平明显高于女性OP患者,差异有统计学意义(P<0.05);但骨密度比较,差异无统计学意义(P>0.05).男性DO患者Ward-三角及粗隆骨密度明显升高,差异有统计学意义(P<0.05);血清TT水平DO组高于OP组,差异有统计学意义(P<0.05).结论 血清睾酮水平与2型糖尿病合并骨质疏松的关系可能存在性别差异.对于男性可能是保护因素,对于女性则可能是危险因素.     

青春期多囊卵巢综合征胰岛素抵抗及其与生殖内分泌代谢异常的相关性分析

目的：分别比较青春期多囊卵巢综合征（PCOS）与青春期健康人群、青春期PCOS胰岛素抵抗（IR）与非IR患者的生殖内分泌指标,认识青春期PCOS的IR及其与生殖内分泌代谢异常的相关性,为该疾病的早期诊断和治疗提供循证医学依据。方法青春期PCOS患者（青春期PCOS组）88例,青春期健康对照人群（对照组）87例,并根据胰岛素抵抗稳态模型指数（HOMA- IR）将青春期PCOS患者分为IR组（40例）和非IR组（48例）。测定LH、FSH、硫酸脱氢表雄酮（DHEAS）、性激素结合蛋白（SHBG）、总睾酮（TT）、FBG、空腹胰岛素（FINS）、瘦素（LEP）和脂联素（ADPN）水平,并加以对照研究。结果（1）青春期PCOS组与对照组的比较：青春期PCOS组LH、LH/FSH、DHEAS、TT、FAI、FINS、HOMA- IR、LEP均明显高于对照组,SHBG明显低于对照组,两组间FBG、ADPN未见有统计学差异。（2）青春期PCOS IR组与非IR组的比较：IR组LH明显低于非IR组,而DHEAS、FAI均明显高于非IR组,两组间LH/FSH、TT无统计学差异。IR组SHBG明显低于非IR组,且SHBG与BMI （r=-0.31,P＜0.05）、血DHEAS （r=-0.225,P＜0.05）均呈明显负相关。IR组FINS、FBG、HOMA- IR均明显高于非IR组,且FBG与BMI呈明显正相关（r=0.348,P＜0.05）。IR组LEP水平明显高于非IR组,而ADPN明显低于非IR组,且LEP水平与BMI呈明显正相关（r=0.605,P＜0.05）,ADPN水平与BMI呈明显负相关（r=-0.418,P＜0.05）。结论 PCOS在青春期即出现不同程度的胰岛素敏感性下降,IR发病率增高,并与高雄激素血症、肥胖相互作用,形成内分泌代谢的恶性循环,促进PCOS疾病进展,使得代谢综合征等远期并发症风险增高。脂肪因子ADPN和LEP或可成为机体胰岛素敏感性的预测指标,但还需进一步大样本研究。