Azcarate Patrick M, Venincasa Vincent D, Feuer William, Stanczyk Frank, Schally Andrew V, Galor Anat
Miami Veterans Administration Medical Center, Miami, Florida, United States Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States.
Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States.
Invest Ophthalmol Vis Sci. 2014 Jul 3;55(8):5046-53. doi: 10.1167/iovs.14-14689.
To evaluate the relationship between androgen levels and subjective and objective measures of dry eye syndrome (DES).
A total of 263 male patients from the Miami Veterans Affairs Medical Center eye clinic aged ≥50 were recruited for this prospective cross-sectional study. Patients completed Dry Eye Questionnaire 5, underwent tear film evaluation, and had serum androgen levels measured. The correlations between androgen levels, DES composite scores, DES symptoms, and global, lipid, and aqueous tear film parameters were evaluated.
Two hundred sixty-three patients with a mean age of 69 (50-95) were examined. There was no linear association between composite DES scores (generated using latent class analysis) and androgen levels. However, eyes with high DES scores (0.95-1.0) had higher levels of sex hormone-binding globulin (P = 0.03) and lower levels of dehydroepiandrosterone sulfate (DHEAS) (P = 0.02), androstenedione (A) (P = 0.02), and androstane-3α,17β-diol glucuronide (P = 0.03) compared to eyes with intermediate (0.05-0.95) or low (0-0.05) scores. There were no strong correlations between tear film measures and androgen levels. Regarding global parameters, a weak inverse correlation was found between corneal staining and A (r = -0.17, P = 0.009). For lipid parameters, a weak correlation existed between tear breakup time (TBUT) and A (r = 0.15, P = 0.02). When considering aqueous and lipid deficiency independently, the association between TBUT and A existed only with aqueous tear deficiency (r = 0.66, P = 0.002). Regarding aqueous parameters, a weak correlation existed between Schirmer test and DHEAS (r = 0.13, P = 0.047) and A (r = 0.21, P = 0.001).
There was a weak correlation between higher levels of androstenedione and healthier global, lipid, and aqueous tear film parameters.
评估雄激素水平与干眼综合征（DES）主观及客观指标之间的关系。
本前瞻性横断面研究招募了迈阿密退伍军人事务医疗中心眼科门诊的263名年龄≥50岁的男性患者。患者完成干眼问卷5，接受泪膜评估，并测量血清雄激素水平。评估雄激素水平、DES综合评分、DES症状以及整体、脂质和水性泪膜参数之间的相关性。
检查了263名平均年龄为69岁（50 - 95岁）的患者。DES综合评分（使用潜在类别分析生成）与雄激素水平之间无线性关联。然而，与DES评分中等（0.05 - 0.95）或低（0 - 0.05）的眼睛相比，DES评分高（0.95 - 1.0）的眼睛性激素结合球蛋白水平较高（P = 0.03），硫酸脱氢表雄酮（DHEAS）水平较低（P = 0.02），雄烯二酮（A）水平较低（P = 0.02），以及雄烷 - 3α,17β - 二醇葡萄糖醛酸苷水平较低（P = 0.03）。泪膜指标与雄激素水平之间无强相关性。关于整体参数，角膜染色与A之间存在弱负相关（r = -0.17，P = 0.009）。对于脂质参数，泪膜破裂时间（TBUT）与A之间存在弱相关性（r = 0.15，P = 0.02）。当独立考虑水性和脂质缺乏时，TBUT与A之间的关联仅存在于水性泪液缺乏时（r = 0.66，P = 0.002）。关于水性参数，泪液分泌试验与DHEAS（r = 0.13，P = 0.047）和A（r = 0.21，P = 0.001）之间存在弱相关性。
较高水平的雄烯二酮与更健康的整体、脂质和水性泪膜参数之间存在弱相关性。
