Svartberg J, Jenssen T, Sundsfjord J, Jorde R
Department of Medicine, University Hospital of North Norway, N-9038 Tromsø, Norway.
Diabetes Metab. 2004 Feb;30(1):29-34. doi: 10.1016/s1262-3636(07)70086-1.
Low levels of endogenous testosterone have been associated with increased risk of cardiovascular disease and atherosclerosis in men. Long-term hyperglycemia, as measured by glycosylated hemoglobin (HbA1c), is related to cardiovascular mortality, and HbA1c across its normal range is also positively related to coronary heart and cardiovascular disease mortality in men. We therefore undertook an analysis of the cross-sectional associations of total testosterone and SHBG levels with HbA1c levels, in a general population of 1419 men aged 25-84.
Total testosterone, sex hormone-binding globulin (SHBG) and HbA1c were measured by immuno-assay. Partial correlation and multiple regression analyses were used to estimate the associations between total testosterone and SHBG with HbA1c. Analyses of variance and covariance were used to compare men with or without diabetes.
In age-adjusted partial correlation HbA1c was inversely associated with total testosterone (p<0.01) and SHBG (p<0.001). HbA1c was positively associated with body mass index (BMI) and waist circumference (WC) (p<0.001). In multiple regression analyses total testosterone, SHBG, age, number of cigarettes smoked, BMI and WC were independently associated with HbA1c levels. Men with a history of diabetes had lower levels of total testosterone in age-adjusted analyses (p<0.05) and lower levels of SHBG in both age- and WC-adjusted analyses (p<0.001 and p<0.01, respectively).
Lower levels of total testosterone and SHBG were associated with increased HbA1c levels and diabetes independent of concomitant variations in obesity and body fat distribution.
内源性睾酮水平低与男性心血管疾病和动脉粥样硬化风险增加有关。糖化血红蛋白（HbA1c）所测得的长期高血糖与心血管死亡率相关，且在其正常范围内，HbA1c也与男性冠心病和心血管疾病死亡率呈正相关。因此，我们对1419名年龄在25 - 84岁的男性普通人群中总睾酮和性激素结合球蛋白（SHBG）水平与HbA1c水平的横断面关联进行了分析。
采用免疫分析法测定总睾酮、性激素结合球蛋白（SHBG）和HbA1c。使用偏相关分析和多元回归分析来估计总睾酮和SHBG与HbA1c之间的关联。使用方差分析和协方差分析来比较有或无糖尿病的男性。
在年龄校正的偏相关分析中，HbA1c与总睾酮（p<0.01）和SHBG（p<0.001）呈负相关。HbA1c与体重指数（BMI）和腰围（WC）呈正相关（p<0.001）。在多元回归分析中，总睾酮、SHBG、年龄、吸烟数量、BMI和WC与HbA1c水平独立相关。在年龄校正分析中，有糖尿病史的男性总睾酮水平较低（p<0.05），在年龄和WC校正分析中，SHBG水平较低（分别为p<0.001和p<0.01）。
总睾酮和SHBG水平较低与HbA1c水平升高及糖尿病相关，独立于肥胖和体脂分布的伴随变化。
