Spruit Martijn A, Thomeer Michiel J, Gosselink Rik, Wuyts Wim A, Van Herck Erik, Bouillon Roger, Demedts Maurits G, Decramer Marc
Department of Research, Development & Education, Centre for Integrated Rehabilitation of Organ failure (CIRO), Hornerheide 1, 6085 NM, Horn, The Netherlands.
Respir Med. 2007 Dec;101(12):2502-10. doi: 10.1016/j.rmed.2007.07.009. Epub 2007 Sep 12.
Hypogonadism is assumed to be present in sarcoidosis. Nevertheless, a comparison of circulating sex hormone concentrations of male sarcoidosis patients with those of healthy men has never been done. Moreover, it remains unknown if hypogonadism may contribute to a reduced muscle function, exercise intolerance, diminished vitality and depressed mood in male sarcoidosis patients. Pulmonary function, muscle function, exercise tolerance, vitality, mood, circulating sex hormone concentrations and C-reactive protein were assessed in 30 male sarcoidosis patients and 26 age-matched men with a normal pulmonary function. On average, patients had a restrictive pulmonary function, worse inspiratory and quadriceps muscle function, functional exercise intolerance, diminished vitality, depressed mood and increased systemic inflammation. Moreover, patients had significantly lower circulating (free) testosterone concentrations, while circulating sex hormone-binding globulin tended to be lower (p=0.0515). Circulating gonadotrophin concentrations were comparable. Non-significant relationships were found between sex hormones, clinical outcomes and C-reactive protein in patients with sarcoidosis. A significant number of male outpatients with sarcoidosis (46.7%) had low circulating testosterone concentrations, which was most probably caused by hypogonadotrophism. The clinical relevance of hypogonadism in male outpatients with sarcoidosis, however, remains currently unknown. Indeed, poor inspiratory and quadriceps muscle function, exercise intolerance, diminished vitality and depressed mood were not related to hypogonadism in these patients.
结节病患者被认为存在性腺功能减退。然而，从未对男性结节病患者与健康男性的循环性激素浓度进行过比较。此外，性腺功能减退是否可能导致男性结节病患者肌肉功能下降、运动不耐受、活力降低和情绪低落仍不清楚。对30名男性结节病患者和26名年龄匹配、肺功能正常的男性进行了肺功能、肌肉功能、运动耐力、活力、情绪、循环性激素浓度和C反应蛋白的评估。平均而言，患者存在限制性肺功能、吸气和股四头肌功能较差、功能性运动不耐受、活力降低、情绪低落以及全身炎症增加。此外，患者的循环（游离）睾酮浓度显著降低，而循环性激素结合球蛋白则有降低趋势（p = 0.0515）。循环促性腺激素浓度相当。在结节病患者中，未发现性激素、临床结局和C反应蛋白之间存在显著关系。相当数量的男性结节病门诊患者（46.7%）循环睾酮浓度较低，这很可能是由促性腺激素缺乏引起的。然而，性腺功能减退在男性结节病门诊患者中的临床相关性目前仍不清楚。实际上，这些患者的吸气和股四头肌功能差、运动不耐受、活力降低和情绪低落与性腺功能减退无关。
