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维生素D与中国男性的睾酮及性腺功能减退相关:横断面研究SPECT-China的结果

Vitamin D is associated with testosterone and hypogonadism in Chinese men: Results from a cross-sectional SPECT-China study.

作者信息

Wang Ningjian, Han Bing, Li Qin, Chen Yi, Chen Yingchao, Xia Fangzhen, Lin Dongping, Jensen Michael D, Lu Yingli

机构信息

Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.

Endocrine Research Unit, Mayo Clinic, Rochester, MN, 55905, USA.

出版信息

Reprod Biol Endocrinol. 2015 Jul 16;13:74. doi: 10.1186/s12958-015-0068-2.

Abstract

BACKGROUND

To date, no study has explored the association between androgen levels and 25-hydroxyvitamin D (25(OH)D) levels in Chinese men. We aimed to investigate the relationship between 25(OH)D levels and total and free testosterone (T), sex hormone binding globulin (SHBG), estradiol, and hypogonadism in Chinese men.

METHODS

Our data, which were based on the population, were collected from 16 sites in East China. There were 2,854 men enrolled in the study, with a mean (SD) age of 53.0 (13.5) years. Hypogonadism was defined as total T <11.3 nmol/L or free T <22.56 pmol/L. The 25(OH)D, follicle-stimulating hormone, luteinizing hormone, total T, estradiol and SHBG were measured using chemiluminescence and free T by enzyme-linked immune-sorbent assay. The associations between 25(OH)D and reproductive hormones and hypogonadism were analyzed using linear regression and binary logistic regression analyses, respectively.

RESULTS

A total of 713 (25.0 %) men had hypogonadism with significantly lower 25(OH)D levels but greater BMI and HOMA-IR. Using linear regression, after fully adjusting for age, residence area, economic status, smoking, BMI, HOMA-IR, diabetes and systolic pressure, 25(OH)D was associated with total T and estradiol (P < 0.05). In the logistic regression analyses, increased quartiles of 25(OH)D were associated with significantly decreased odds ratios of hypogonadism (P for trend <0.01). This association, which was considerably attenuated by BMI and HOMA-IR, persisted in the fully adjusted model (P for trend <0.01) in which for the lowest compared with the highest quartile of 25(OH)D, the odds ratio of hypogonadism was 1.50 (95 % CI, 1.14, 1.97).

CONCLUSIONS

A lower vitamin D level was associated with a higher prevalence of hypogonadism in Chinese men. This association might, in part, be explained by adiposity and insulin resistance and warrants additional investigation.

摘要

背景

迄今为止,尚无研究探讨中国男性雄激素水平与25-羟基维生素D(25(OH)D)水平之间的关联。我们旨在研究中国男性25(OH)D水平与总睾酮和游离睾酮(T)、性激素结合球蛋白(SHBG)、雌二醇及性腺功能减退之间的关系。

方法

我们基于人群的数据来自中国东部的16个地点。共有2854名男性参与本研究,平均(标准差)年龄为53.0(13.5)岁。性腺功能减退定义为总T<11.3nmol/L或游离T<22.56pmol/L。采用化学发光法测定25(OH)D、促卵泡激素、促黄体生成素、总T、雌二醇和SHBG,采用酶联免疫吸附测定法测定游离T。分别采用线性回归和二元逻辑回归分析25(OH)D与生殖激素及性腺功能减退之间的关联。

结果

共有713名(25.0%)男性存在性腺功能减退,其25(OH)D水平显著较低,但BMI和HOMA-IR较高。采用线性回归,在对年龄、居住地区、经济状况、吸烟、BMI、HOMA-IR、糖尿病和收缩压进行充分校正后,25(OH)D与总T和雌二醇相关(P<0.05)。在逻辑回归分析中,25(OH)D四分位数增加与性腺功能减退的比值比显著降低相关(趋势P<0.01)。这种关联在很大程度上被BMI和HOMA-IR减弱,但在充分校正模型中仍然存在(趋势P<0.01),其中与25(OH)D最高四分位数相比,最低四分位数时性腺功能减退的比值比为1.50(95%CI,1.14,1.97)。

结论

维生素D水平较低与中国男性性腺功能减退患病率较高相关。这种关联可能部分由肥胖和胰岛素抵抗解释,值得进一步研究。

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