Laaksonen David E, Niskanen Leo, Punnonen Kari, Nyyssönen Kristiina, Tuomainen Tomi-Pekka, Valkonen Veli-Pekka, Salonen Jukka T
Department of Medicine, Kuopio University, P.O. Box 1627, FIN-70211 Kuopio, Finland.
J Clin Endocrinol Metab. 2005 Feb;90(2):712-9. doi: 10.1210/jc.2004-0970. Epub 2004 Nov 9.
In men, hypoandrogenism is associated with features of the metabolic syndrome. It is not known whether men with the metabolic syndrome are at a higher risk of developing hypogonadism. We therefore assessed whether the metabolic syndrome predicts development of hypogonadism 11 yr later in 651 middle-aged Finnish men participating in a population-based cohort study. Men with the metabolic syndrome at baseline as defined by the World Health Organization (n = 114, 20%) had a 2.6-fold increased risk of developing hypogonadism as defined by total testosterone levels less than 11 nmol/liter at the 11-yr follow-up independent of age, smoking, and other potential confounders. Further adjustment for body mass index (OR, 2.0; 95% CI, 1.1-3.8) or baseline total testosterone levels (OR, 1.9; 95% CI, 1.0-3.4) attenuated the association. The association of the metabolic syndrome with hypogonadism as defined by calculated free testosterone levels less than 225 pmol/liter was similar, but weaker. The adjusted decrease in testosterone concentrations during the 11-yr follow-up was also greater in men with than without the metabolic syndrome. Smokers had a nonsignificantly lower risk of developing hypogonadism during follow-up, whereas a decrease in smoking increased the risk of hypogonadism. The metabolic syndrome predisposes to development of hypogonadism in middle-aged men. Prevention of abdominal obesity and the accompanying metabolic syndrome in middle age may decrease the risk of hypogonadism in men, especially in those who quit smoking.
在男性中，雄激素缺乏与代谢综合征的特征相关。目前尚不清楚患有代谢综合征的男性是否患性腺功能减退的风险更高。因此，我们在一项基于人群的队列研究中，评估了651名中年芬兰男性的代谢综合征是否能预测11年后性腺功能减退的发生。根据世界卫生组织定义，基线时患有代谢综合征的男性（n = 114，20%）在11年随访时，因总睾酮水平低于11 nmol/升而被定义为性腺功能减退的风险增加了2.6倍，且独立于年龄、吸烟和其他潜在混杂因素。进一步调整体重指数（比值比，2.0；95%置信区间，1.1 - 3.8）或基线总睾酮水平（比值比，1.9；95%置信区间，1.0 - 3.4）后，这种关联减弱。代谢综合征与游离睾酮水平低于225 pmol/升所定义的性腺功能减退之间的关联相似，但较弱。在11年随访期间，患有代谢综合征的男性睾酮浓度的调整下降幅度也大于未患代谢综合征的男性。吸烟者在随访期间患性腺功能减退的风险略低，而吸烟量减少会增加患性腺功能减退的风险。代谢综合征易导致中年男性发生性腺功能减退。预防中年期腹部肥胖及随之而来的代谢综合征可能会降低男性患性腺功能减退的风险，尤其是那些戒烟的男性。
