Smith A M, English K M, Malkin C J, Jones R D, Jones T H, Channer K S
Hormone & Vascular Biology Group, Academic Unit of Endocrinology, Division of Genomic Medicine, The University of Sheffield, Sheffield S10 2RX, UK.
Eur J Endocrinol. 2005 Feb;152(2):285-91. doi: 10.1530/eje.1.01848.
In women, sex hormones cause increased morbidity and mortality in patients with coronary heart disease (CHD) and adversely affect the coagulation profile. We have studied the effect of physiological testosterone replacement therapy in men on coagulation factor expression, to determine if there is an increased risk of thrombosis.
Double-blind, randomized, placebo-controlled trial of testosterone in 46 men with chronic stable angina. Measurements of free, total and bioavailable testosterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH), estradiol, plasminogen activator inhibitor-1 (PAI-1), fibrinogen, tissue plasminogen activator (tPA) and full blood count were made at 0, 6 and 14 weeks.
Bioavailable testosterone levels were: 2.58 +/- 0.58 nmol/l at baseline, compared with 3.35 +/- 0.31 nmol/l at week 14 (P < 0.001) after treatment compared with 2.6 +/- 0.18 nmol/l and 2.44 +/- 0.18 nmol/l in the placebo group (P was not significant). There was no change in fibrinogen (3.03 +/- 0.18 g/l at baseline and 3.02 +/- 0.18 g/l at week 14, P = 0.24), tPA activity (26.77 +/- 4.9 Iu/ml and 25.67 +/- 4.4 Iu/ml, P = 0.88) or PAI-1 activity (0.49 +/- 0.85 Iu/ml and 0.36 +/- 0.06 Iu/ml, P = 0.16) with active treatment and no differences between the groups (at week 14, P value 0.98, 0.59 and 0.8 for fibrinogen, PAI-1 and tPA respectively). Haemoglobin concentration did not change over time, in the testosterone group (1.44 +/- 0.02 g/l and 1.45 +/- 0.02 g/l, P = 0.22).
Physiological testosterone replacement does not adversely affect blood coagulation status.
在女性中，性激素会增加冠心病（CHD）患者的发病率和死亡率，并对凝血指标产生不利影响。我们研究了男性生理睾酮替代疗法对凝血因子表达的影响，以确定是否存在血栓形成风险增加的情况。
对46名慢性稳定型心绞痛男性患者进行睾酮的双盲、随机、安慰剂对照试验。在第0、6和14周测量游离、总及生物可利用睾酮、促黄体生成素（LH）、促卵泡生成素（FSH）、雌二醇、纤溶酶原激活物抑制剂-1（PAI-1）、纤维蛋白原、组织纤溶酶原激活物（tPA）和全血细胞计数。
生物可利用睾酮水平在基线时为2.58±0.58nmol/l，治疗后第14周为3.35±0.31nmol/l（P<0.001），而安慰剂组第14周为2.6±0.18nmol/l和2.44±0.18nmol/l（P无统计学意义）。纤维蛋白原（基线时3.03±0.18g/l，第14周时3.02±0.18g/l，P = 0.24）、tPA活性（26.77±4.9Iu/ml和25.67±4.4Iu/ml，P = 0.88）或PAI-1活性（0.49±0.85Iu/ml和0.36±0.06Iu/ml，P = 0.16）在积极治疗后无变化，且组间无差异（第14周时，纤维蛋白原、PAI-1和tPA的P值分别为0.98、0.59和0.8）。睾酮组血红蛋白浓度随时间无变化（1.44±0.02g/l和1.45±0.02g/l，P = 0.22）。
生理睾酮替代不会对血液凝固状态产生不利影响。
