La Vignera S, Calogero A E, D'Agata R, Di Mauro M, Tumino S, Condorelli R, Lanzafame F, Finocchiaro C, Giammusso B, Vicari E
Endocrinology, Andrology and Internal Medicine Unit, Department of Biomedic Scieces, University of Catania, Garibaldi Hospital, Catania, Italy.
Minerva Endocrinol. 2008 Sep;33(3):159-67.
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?
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.
The group of patients treated with T showed a profile of clinical response better than the group of controls.
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.
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?
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。
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。
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。