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。

The association between endogenous androgens and coronary artery disease as well as serum lipid in males

Objective: To investigate association between endogenous androgens and coronary artery disease as well as serum lipid in males.Methods: One hundred and four male subjects with coronary heart disease(CHD) and 96 male subjects without CHD proved by angiography were recruited.Serum free testosterone(FT),total testosterone(TT),dehydroepiandrosterone(DHEA),dehydroepiandrosterone sulfate(DHEAS),estradiol(E2) and sex hormone binding globulin(SHBG) were determined by radioimmunossays(RIA).Results: Men with CHD had significantly lower levels of FT,TT,TT/E2 ratio and SHBG compared with controls after controlling for differences in blood pressure,body mass index and lipid profile(P<0.05 or 0.01).No obvious difference in DHEA,DHEAS and E2 level was found between two groups(all P>0.05).FT,TT and TT/E2 ratio were negatively correlated with total cholesterol,triglyceride and low density lipoprotein cholesterol,and positively correlated with high density lipoprotein cholesterol(P<0.05 or 0.01).Multivariate logistic regression analysis result demonstrated that FT was independently and inversely related to presence of CHD.Conclusion: The decrease of serum testosterone level in men with CHD may adversely affect on lipid metabolism.Low serum FT concentration is an independent predictor of CHD.