Barbonetti Arcangelo, Vassallo Maria Rosaria C, Felzani Giorgio, Francavilla Sandro, Francavilla Felice
a Department of Life, Health and Environment Sciences , University of L'Aquila , 67100 L'Aquila , Italy.
b San Raffaele Sulmona Institute , 67039 Sulmona , Italy.
J Spinal Cord Med. 2016 May;39(3):246-52. doi: 10.1179/2045772315Y.0000000050. Epub 2015 Aug 27.
As an independent linear association between 25-hydroxyvitamin D (25(OH)D) and testosterone levels is controversial, this study aimed to explore this topic in men with chronic spinal cord injury (SCI), who exhibit a high prevalence of both androgen and vitamin D deficiency.
Forty-nine men with chronic SCI consecutively admitted to a rehabilitation program underwent clinical/biochemical evaluations.
Deficiency of 25(OH)D (<20 ng/mL) was found in 36 patients (73.5%). They exhibited significantly lower total testosterone and free testosterone levels, higher parathyroid hormone (PTH) and HOMA-IR, a poorer functional independence degree, and were engaged in poorer weekly leisure time physical activity (LTPA). Significant correlates of 25(OH)D levels were: total testosterone, free testosterone, PTH, functional independence degree and weekly LTPA. At the linear regression models, lower 25(OH)D levels were associated with both lower total and free testosterone after adjustment for age, smoking, alcohol consumption, comorbidities and HOMA-IR. However, after full adjustment, also including functional independence degree, BMI and LTPA, only the association of lower 25(OH)D with lower free testosterone was still significant.
In men with SCI, 25(OH)D correlates with total and free testosterone and exhibits an independent linear association with free testosterone. Regardless of this independent link, hypovitaminosis D and androgen deficiency are markers of poor health, sharing common risk factors to take into account in the rehabilitative approach to patients with SCI.
由于25-羟基维生素D（25(OH)D）与睾酮水平之间的独立线性关联存在争议，本研究旨在探讨慢性脊髓损伤（SCI）男性患者中的这一话题，这类患者同时存在雄激素和维生素D缺乏的高患病率。
连续纳入49名参加康复项目的慢性SCI男性患者，进行临床/生化评估。
36名患者（73.5%）存在25(OH)D缺乏（<20 ng/mL）。他们的总睾酮和游离睾酮水平显著较低，甲状旁腺激素（PTH）和胰岛素抵抗指数（HOMA-IR）较高，功能独立程度较差，每周休闲时间身体活动（LTPA）较少。25(OH)D水平的显著相关因素包括：总睾酮、游离睾酮、PTH、功能独立程度和每周LTPA。在多元线性回归模型中，调整年龄、吸烟、饮酒、合并症和HOMA-IR后，较低的25(OH)D水平与较低的总睾酮和游离睾酮均相关。然而，在进行全面调整后，包括功能独立程度、体重指数（BMI）和LTPA，只有较低的25(OH)D与较低的游离睾酮之间的关联仍然显著。
在SCI男性患者中，25(OH)D与总睾酮和游离睾酮相关，且与游离睾酮存在独立的线性关联。尽管存在这种独立联系，但维生素D缺乏和雄激素缺乏都是健康状况不佳的标志，在对SCI患者的康复治疗中需要考虑共同的风险因素。
