Haring Robin, Baumeister Sebastian E, Völzke Henry, Dörr Marcus, Kocher Thomas, Nauck Matthias, Wallaschofski Henri
Institute of Clinical Chemistry, and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch Str, Greifswald, Germany.
J Androl. 2012 Sep-Oct;33(5):944-50. doi: 10.2164/jandrol.111.015065. Epub 2011 Dec 29.
The suggested associations between sex hormone concentrations and inflammatory biomarkers in men originate from cross-sectional studies and small-scale clinical trials. But prior studies have not investigated longitudinal associations. Overall, 1344 men aged 20-79 years from the population-based cohort Study of Health in Pomerania were followed up for 5.0 (median) years. We used multivariable regression models to analyze cross-sectional and longitudinal associations of serum sex hormone concentrations (total testosterone [TT], sex hormone-binding globulin [SHBG], calculated free testosterone [free T], and dehydroepiandrosterone sulfate [DHEAS]) with biomarkers of inflammation (fibrinogen, high-sensitive C-reactive protein [hsCRP], and white blood cell count [WBC]) and oxidative stress (γ-glutamyl transferase [GGT]) using ordinary least square regression and generalized estimating equation models, respectively. Cross-sectional models revealed borderline associations of sex hormone concentrations with hsCRP, WBC, and GGT levels that were not retained after multivariable adjustment. Longitudinal multivariable analyses revealed an inverse association of baseline TT, free T, and DHEAS concentrations with change in fibrinogen levels (per SD decrement in TT, 0.25 [95% confidence interval, 0.04-0.45]; in free T, 0.30 [0.09-0.51]; and in DHEAS, 0.23 [0.11-0.36]). Furthermore, baseline DHEAS concentrations were inversely associated with change in WBC levels (per SD decrement, 0.53 [0.24-0.82]). Baseline TT, SHBG, free T, and DHEAS concentrations were also inversely associated with change in GGT after multivariable adjustment. The present study is the first to demonstrate prospective inverse associations between sex hormone concentrations and markers of inflammation and oxidative stress in men. Additional studies are warranted to elucidate potential mechanisms underlying the revealed associations.
关于男性性激素浓度与炎症生物标志物之间的关联，此前的研究多源于横断面研究和小规模临床试验。但既往研究尚未探究两者之间的纵向关联。总体而言，来自基于人群的波美拉尼亚健康队列研究的1344名年龄在20至79岁之间的男性接受了为期5.0年（中位数）的随访。我们使用多变量回归模型，分别采用普通最小二乘法回归和广义估计方程模型，分析血清性激素浓度（总睾酮[TT]、性激素结合球蛋白[SHBG]、计算得出的游离睾酮[游离T]和硫酸脱氢表雄酮[DHEAS]）与炎症生物标志物（纤维蛋白原、高敏C反应蛋白[hsCRP]和白细胞计数[WBC]）以及氧化应激（γ-谷氨酰转移酶[GGT]）之间的横断面和纵向关联。横断面模型显示性激素浓度与hsCRP、WBC和GGT水平之间存在临界关联，但在多变量调整后这些关联不再显著。纵向多变量分析显示，基线TT、游离T和DHEAS浓度与纤维蛋白原水平的变化呈负相关（TT每降低1个标准差，纤维蛋白原水平降低0.25[95%置信区间，0.04 - 0.45]；游离T每降低1个标准差，纤维蛋白原水平降低0.30[0.09 - 0.51]；DHEAS每降低1个标准差，纤维蛋白原水平降低0.23[0.11 - 0.36]）。此外，基线DHEAS浓度与WBC水平的变化呈负相关（每降低1个标准差，WBC水平降低0.53[0.24 - 0.82]）。多变量调整后，基线TT、SHBG、游离T和DHEAS浓度与GGT的变化也呈负相关。本研究首次证明了男性性激素浓度与炎症和氧化应激标志物之间存在前瞻性负相关。有必要开展更多研究以阐明所揭示关联背后的潜在机制。
