Tamer Cengaver, Oksuz Huseyin, Sogut Sadik
Department of Ophthalmology, Mustafa Kemal University Medical Faculty, Antakya, Turkey.
Ophthalmic Res. 2006;38(5):280-6. doi: 10.1159/000095771. Epub 2006 Sep 15.
To evaluate androgen levels of patients diagnosed with nonautoimmune dry eye, either with meibomian gland dysfunction (MGD) or without MGD (non-MGD), and normal control subjects. This is a prospective, comparative, case-control study.
Sixty-four (32 men and 32 women) subjects were enrolled for each of the three diagnostic groups. All dry eye patients were symptom positive. Nonfasting testosterone (T), sex hormone-binding globulin, serum albumin, dehydroepiandrosterone (DHEA), and DHEA sulphate levels of all study participants were determined using either automated immunoenzymatic assay, or standard radioimmunoassay. Analysis of variance was used to compare androgen levels among the three diagnostic groups in a gender-based design, followed by post-hoc multiple comparisons with the Tukey honestly significant difference test.
Mean T levels in men and women of the three diagnostic groups were not significantly different (p = 0.808, p = 0.156, respectively; ANOVA). Statistical analyses of the three diagnostic groups revealed a significant difference for men and women in bioavailable T levels (p = 0.002, p = 0.014, respectively; ANOVA), DHEA levels (p = 0.009, p = 0.004, respectively; ANOVA), and DHEA sulphate levels (p = 0.001, p = 0.001, respectively; ANOVA), whereas there was no statistically significant difference between non-MGD dry eye patients and controls for any of the measured androgen levels according to the post-hoc tests.
This study demonstrates that the androgen pool of nonautoimmune dry eye patients with MGD is significantly depleted compared with that of non-MGD and control cases.
评估诊断为非自身免疫性干眼症的患者(包括患有睑板腺功能障碍[MGD]或未患有MGD[非MGD])以及正常对照者的雄激素水平。这是一项前瞻性、比较性病例对照研究。
三个诊断组每组招募64名受试者(32名男性和32名女性)。所有干眼症患者症状均呈阳性。使用自动免疫酶测定法或标准放射免疫测定法测定所有研究参与者的非空腹睾酮(T)、性激素结合球蛋白、血清白蛋白、脱氢表雄酮(DHEA)和硫酸脱氢表雄酮水平。采用方差分析在基于性别的设计中比较三个诊断组之间的雄激素水平,随后使用Tukey真实显著差异检验进行事后多重比较。
三个诊断组男性和女性的平均T水平无显著差异(分别为p = 0.808,p = 0.156;方差分析)。对三个诊断组的统计分析显示,男性和女性的生物可利用T水平(分别为p = 0.002,p = 0.014;方差分析)、DHEA水平(分别为p = 0.009,p = 0.004;方差分析)和硫酸脱氢表雄酮水平(分别为p = 0.001,p = 0.001;方差分析)存在显著差异,而根据事后检验,非MGD干眼症患者与对照组之间在任何测量的雄激素水平上均无统计学显著差异。
本研究表明,与非MGD和对照病例相比,患有MGD的非自身免疫性干眼症患者的雄激素储备显著减少。