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睾酮治疗可改善与迟发性性腺功能减退相关的男性代谢综合征患者对传统治疗的临床反应。

Testosterone therapy improves the clinical response to conventional treatment for male patients with metabolic syndrome associated to late onset hypogonadism.

作者信息

La Vignera S, Calogero A E, D'Agata R, Di Mauro M, Tumino S, Condorelli R, Lanzafame F, Finocchiaro C, Giammusso B, Vicari E

机构信息

Endocrinology, Andrology and Internal Medicine Unit, Department of Biomedic Scieces, University of Catania, Garibaldi Hospital, Catania, Italy.

出版信息

Minerva Endocrinol. 2008 Sep;33(3):159-67.

Abstract

AIM

Recently, the clinic characterization of the gonadic male function has been put in tight correlation on the pathogenetic level with the main variables forming the condition of metabolic syndrome (MS); probably the serum testosterone (T) concentration in males is to be considered as an additional parameter completely related to the traditional clinical-metabolic findings. Currently the matter of the substitutive hormonal therapy with androgens is apparently influenced by some important unresolved aspects: 1) who really benefits from the T therapy? 2) are the actual dosage methods of T reliable? 3) which vascular and metabolic targets are to be monitored during the T therapy?

METHODS

In an analytical longitudinal study, carried out 12 months long on 60 men (average age 58 years, range 54-63 years) affected by metabolic syndrome (MS) and combined hypogonadism late onset (LOH), authors have evaluated the clinical response (androgenic asset, non-invasive hospital monitoring of the arterial pressure, lipidic asset study, body composition and the biologic resistance to the insulinic action) after conventional medical therapy (insulin-sensibilizing and anti-hypertensive) and after substitutive hormonal therapy with testosterone (T) by transdermic way. A group of five patients with MS and LOH, not treated, was used as group of control.

RESULTS

The group of patients treated with T showed a profile of clinical response better than the group of controls.

CONCLUSIONS

In conclusion, the seric determination of T is useful to better characterize the dismetabolic patient at the moment of the first level active medical therapy planning on the controls of the main risk factors constituting MS, expressing a potential role of conditioning.

摘要

目的

最近,性腺男性功能的临床特征在发病机制层面上与构成代谢综合征(MS)状况的主要变量紧密相关;男性血清睾酮(T)浓度可能应被视为与传统临床代谢结果完全相关的一个额外参数。目前,雄激素替代激素治疗的问题显然受到一些重要未解决方面的影响:1)谁真正从T治疗中获益?2)T的实际给药方法可靠吗?3)在T治疗期间应监测哪些血管和代谢指标?

方法

在一项对60名患有代谢综合征(MS)和迟发性性腺功能减退(LOH)的男性(平均年龄58岁,范围54 - 63岁)进行的为期12个月的分析性纵向研究中,作者评估了常规药物治疗(胰岛素增敏和抗高血压)后以及经皮给予睾酮(T)替代激素治疗后的临床反应(雄激素状况、无创医院血压监测、脂质状况研究、身体成分以及对胰岛素作用的生物抵抗)。一组五名未接受治疗的患有MS和LOH的患者用作对照组。

结果

接受T治疗的患者组显示出比对照组更好的临床反应特征。

结论

总之,血清T测定有助于在针对构成MS的主要危险因素进行一级积极药物治疗规划时,更好地表征代谢紊乱患者,显示出一种调节的潜在作用。

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