School of Public Health (B.H., R.G.C.), University of Sydney, Sydney 2006, New South Wales, Australia; Centre of Education and Research on Ageing (B.H., R.G.C., V.N., F.M.B., D.G.L.C., L.M.W.) and ANZAC Research Institute (R.G.C., D.G.L.C., M.J.S., D.J.H.), University of Sydney and Concord Hospital, Sydney 2139, New South Wales, Australia.
J Clin Endocrinol Metab. 2014 Dec;99(12):E2686-91. doi: 10.1210/jc.2014-2464.
The causal relationship between metabolic syndrome and reproductive hormones is unclear.
This study sought to examine the cross-sectional, longitudinal, and predictive associations between reproductive hormones and SHBG and metabolic syndrome in older men.
DESIGN, SETTING, AND PARTICIPANTS: Men ages 70 years and older from the Concord Health and Ageing in Men Project study (n = 1705) were assessed at baseline and 2-year follow-up. At baseline, T, dihydrotestosterone (DHT), estradiol, and estrone were measured by liquid chromatography-tandem mass spectrometry, and SHBG, LH, and FSH by immunoassay. Metabolic syndrome was defined using the P National Cholesterol Education Program (NCEP) Adult Treatment Panel III criteria.
In cross-sectional data, significant associations between each of T, SHBG, DHT, and calculated free testosterone (cFT) with the metabolic syndrome remained significant after multivariate adjustment. In longitudinal analyses, however, only lower SHBG was significantly associated with incident metabolic syndrome over the 2-year follow-up (P for linear trend = .04).
Although low serum T, DHT, SHBG, and cFT were associated cross-sectionally with metabolic syndrome among community-dwelling older men, over a 2-year follow-up period only SHBG remained significant after multivariate adjustment. This suggests that lowered circulating androgens (T and DHT) may be biomarkers rather than causally related to incident metabolic syndrome.
代谢综合征与生殖激素之间的因果关系尚不清楚。
本研究旨在探讨老年男性生殖激素与 SHBG 与代谢综合征之间的横断面、纵向和预测关联。
设计、地点和参与者：来自 Concord 健康与男性衰老研究项目（n = 1705）的年龄在 70 岁及以上的男性在基线和 2 年随访时进行评估。在基线时，通过液相色谱-串联质谱法测量 T、二氢睾酮 (DHT)、雌二醇和雌酮，通过免疫测定法测量 SHBG、LH 和 FSH。代谢综合征采用国家胆固醇教育计划 (NCEP) 成人治疗专家组 III 标准定义。
在横断面数据中，T、SHBG、DHT 和计算的游离睾酮 (cFT) 与代谢综合征之间的显著关联在多变量调整后仍然显著。然而，在纵向分析中，只有较低的 SHBG 与 2 年随访期间发生代谢综合征显著相关（线性趋势 P =.04）。
尽管社区居住的老年男性中血清 T、DHT、SHBG 和 cFT 水平较低与代谢综合征在横断面相关，但经过多变量调整后，只有 SHBG 在 2 年随访期间仍具有显著意义。这表明循环雄激素（T 和 DHT）水平降低可能是代谢综合征的生物标志物，而不是因果关系。
