Endocrine Research Unit, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, MN 55905, USA.
Am J Physiol Endocrinol Metab. 2012 Mar 15;302(6):E724-30. doi: 10.1152/ajpendo.00520.2011. Epub 2012 Jan 17.
Chronic hyperglycemia inhibits the male gonadal axis. The present analyses test the hypothesis that acute glucose ingestion also suppresses LH and testosterone (T) secretion and blunts the LH-T dose-response function. The design comprised a prospectively randomized crossover comparison of LH and T secretion after glucose vs. water ingestion in a Clinical Translational Research Center. The participants were healthy men (n = 57) aged 19-78 yr with body mass index (BMI) of 20-39 kg/m(2). The main outcome measurements were deconvolution and LH-T dose-response analyses of 10-min data. LH-T responses were regressed on glucose, insulin, leptin, adiponectin, age, BMI, and CT-estimated abdominal visceral fat. During the first 120 min after glucose ingestion, for each unit decrease in LH concentrations, T concentrations decreased by 86 (27-144) ng/dl (r = 0.853, P < 0.001). Based upon deconvolution analysis, glucose compared with water ingestion reduced 1) basal (nonpulsatile; P < 0.001) and total (P < 0.001) T secretion without affecting pulsatile T output and 2) pulsatile (P = 0.043) but not basal LH secretion. By multivariate analysis, pulsatile LH secretion positively predicted basal T secretion after glucose ingestion (r = 0.374, P = 0.0042). In addition, the glucose-induced fall in pulsatile LH secretion was exacerbated by higher fasting insulin concentrations (P = 0.054) and attenuated by higher adiponectin levels (P = 0.0037). There were no detectable changes in the analytically estimated LH-T dose-response curves (P > 0.30). In conclusion, glucose ingestion suppresses pulsatile LH and basal T secretion acutely in healthy men. Suppression is influenced by age, glucose, adiponectin, and insulin concentrations.
慢性高血糖会抑制男性性腺轴。本分析检验了这样一个假设,即急性葡萄糖摄入也会抑制 LH 和睾酮 (T) 的分泌,并削弱 LH-T 剂量反应功能。该设计包括在临床转化研究中心前瞻性随机交叉比较葡萄糖与水摄入后 LH 和 T 的分泌。参与者为健康男性 (n = 57),年龄 19-78 岁,体重指数 (BMI) 为 20-39 kg/m(2)。主要观察指标为 10 分钟数据的解卷积和 LH-T 剂量反应分析。LH-T 反应与葡萄糖、胰岛素、瘦素、脂联素、年龄、BMI 和 CT 估计的腹部内脏脂肪进行回归。在葡萄糖摄入后的前 120 分钟内,LH 浓度每降低一个单位,T 浓度就会降低 86(27-144)ng/dl(r = 0.853,P < 0.001)。基于解卷积分析,与水摄入相比,葡萄糖摄入 1)减少了基础 (非脉冲;P < 0.001) 和总 (P < 0.001)T 分泌,而不影响脉冲 T 输出,2)减少了脉冲 (P = 0.043),但不减少基础 LH 分泌。通过多元分析,脉冲 LH 分泌可预测葡萄糖摄入后基础 T 分泌 (r = 0.374,P = 0.0042)。此外,空腹胰岛素浓度较高 (P = 0.054) 会加剧葡萄糖引起的脉冲 LH 分泌下降,而脂联素水平较高 (P = 0.0037) 则会减弱其下降。在分析估计的 LH-T 剂量反应曲线时没有发现任何变化 (P > 0.30)。总之,葡萄糖摄入会在健康男性中急性抑制脉冲 LH 和基础 T 的分泌。抑制作用受年龄、葡萄糖、脂联素和胰岛素浓度的影响。