Monteagudo Patrícia T, Falcão Adriana A, Verreschi Ieda T N, Zanella Maria-Teresa
a Endocrinology Outpatient Clinic of Kidney and Hypertension Hospital and Endocrinology Division, Escola Paulista de Medicina, Federal University of São Paulo , São Paulo , Brazil.
Aging Male. 2016;19(1):20-6. doi: 10.3109/13685538.2015.1084500. Epub 2015 Oct 21.
Obese men may present hypogonadothrofic hypogonadism, mainly related to higher insulinemia and aromatase activity. Our objectives were to evaluate the relationship of sex-hormones profiles and frequency of depressive symptoms in 43 obese men, in a cross-sectional study. They had 19-60 years, and body mass index 30-50 kg/m(2). LH, total and free testosterone (TT and FT), estradiol (E2), sex hormone binding globulin, estradiol/total testosterone ratio (E2/T) were analyzed. Depressive symptoms were evaluated by "beck depression inventory" (BDI), and significant depression was considered if BDI ≥ 16.Thirty-four (80%) presented low TT levels, but only 4 (14%) had low free testosterone and hypogonadism symptoms; 12 of 43 (28%) presented increased E2. Forty five (56%) presented depressive symptoms, but 16 (28% of the 45) had significant depression. BDI correlated positively with E2 (r = 0.407; p = 0.001) and E2/T (r = 0.473; p = 0.001), but not TT or FT. Patients with significant depressive showed higher levels of estradiol (136 ± 48 versus 103 ± 48 pg/ml, p = 0.02) and E2/T (16.0 ± 9.9 versus 9.8 ± 4.6; p = 0.002) (mean ± SD).In conclusion, obese men may present relatively excess of estradiol and deficiency in testosterone, leading to an imbalance between these two hormones. The greater this imbalance, the more depressive symptoms had our patients.
肥胖男性可能存在性腺功能减退性性腺功能低下,主要与较高的胰岛素血症和芳香化酶活性有关。在一项横断面研究中,我们的目的是评估43名肥胖男性的性激素谱与抑郁症状发生频率之间的关系。他们年龄在19至60岁之间,体重指数为30至50kg/m²。分析了促黄体生成素、总睾酮和游离睾酮(TT和FT)、雌二醇(E2)、性激素结合球蛋白、雌二醇/总睾酮比值(E2/T)。通过“贝克抑郁量表”(BDI)评估抑郁症状,若BDI≥16则认为存在明显抑郁。34名(80%)患者TT水平较低,但只有4名(14%)游离睾酮水平低且有性腺功能减退症状;43名中有12名(28%)E2升高。45名(56%)有抑郁症状,但其中16名(占45名中的28%)有明显抑郁。BDI与E2(r = 0.407;p = 0.001)和E2/T(r = 0.473;p = 0.001)呈正相关,但与TT或FT无关。有明显抑郁的患者雌二醇水平较高(136±48对103±48pg/ml,p = 0.02),E2/T也较高(16.0±9.9对9.8±4.6;p = 0.002)(均值±标准差)。总之,肥胖男性可能存在相对过量的雌二醇和睾酮缺乏,导致这两种激素失衡。这种失衡越大,我们的患者抑郁症状越严重。