Kojo Gloria, Yoshida Takuya, Ohkawa Sakae, Odamaki Mari, Kato Akihiko, Takita Takako, Maruyama Yukitaka, Kumagai Hiromichi
Department of Clinical Nutrition, School of Food and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Shizuoka, 422-8526, Japan.
Int Urol Nephrol. 2014 May;46(5):985-91. doi: 10.1007/s11255-013-0543-7. Epub 2013 Aug 25.
Although skeletal muscle wasting can occur in chronic kidney diseases, its relationship with the serum testosterone concentration remains uncertain. This study investigates the relationship between serum testosterone and skeletal muscle mass in men under hemodialysis (HD).
Sixty men aged between 41 and 89 years undergoing HD for 15.0 ± 8.1 years were enrolled for this study. The muscle areas of the thigh (TMA) and abdomen (AMA) were measured by computed tomography (CT), and the association between these muscle areas and serum total testosterone was examined with adjustment of age and other nutritional variables.
The mean serum total testosterone in our HD patients (6.33 ± 2.90 ng/mL) was not lower than that of the Japanese general population, but showed a positive correlation with TMA (r = 0.39, p < 0.05), AMA (r = 0.52, p < 0.001), serum creatinine (r = 0.33, p < 0.05), and the creatinine generation rate (r = 0.26, p < 0.05). Serum total testosterone was inversely correlated with age (r = -0.32, p < 0.05), CRP (r = -0.31, p < 0.05), and IL-6 (r = -0.24, p < 0.05). A multiple-regression analysis showed both serum total testosterone and age to be an independent determinant of the muscle mass in these patients.
This study identified testosterone as a determinant of muscle mass in HD men.
尽管骨骼肌萎缩可发生于慢性肾脏疾病，但血清睾酮浓度与骨骼肌萎缩之间的关系仍不明确。本研究调查血液透析（HD）男性患者血清睾酮与骨骼肌质量之间的关系。
本研究纳入60名年龄在41至89岁之间、接受HD治疗15.0±8.1年的男性。通过计算机断层扫描（CT）测量大腿肌肉面积（TMA）和腹部肌肉面积（AMA），并在调整年龄和其他营养变量后，检查这些肌肉面积与血清总睾酮之间的关联。
我们HD患者的血清总睾酮平均水平（6.33±2.90 ng/mL）不低于日本普通人群，但与TMA（r = 0.39，p < 0.05）、AMA（r = 0.52，p < 0.001）、血清肌酐（r = 0.33，p < 0.05）和肌酐生成率（r = 0.26，p < 0.05）呈正相关。血清总睾酮与年龄（r = -0.32，p < 0.05）、CRP（r = -0.31，p < 0.05）和IL-6（r = -0.24，p < 0.05）呈负相关。多元回归分析显示，血清总睾酮和年龄均为这些患者肌肉质量的独立决定因素。
本研究确定睾酮是HD男性患者肌肉质量的决定因素。
