在年轻和中年男性中，睾酮和促性腺激素而非性激素结合球蛋白随 CKD 分期而变化。
Testosterone and gonadotropins but not SHBG vary with CKD stages in young and middle aged men.
机构信息
Department of Nephrology, Karolinska Institute and Karolinska University Hospital, Solna, Stockholm, S-17173 Sweden.
Department of Endocrinology, Metabolism and Diabetes, C2:94, Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm, S-141 86 Sweden.
出版信息
Basic Clin Androl. 2015 Dec 2;25:9. doi: 10.1186/s12610-015-0027-y. eCollection 2015.
BACKGROUND
The aim of this study was to assess the effects chronic kidney disease (CKD) had on sex hormones and lipids in a subgroup of men between 18 and 50 years old with CKD 1-5 stage without diabetes and not treated with hemodialysis.
METHODS
Data were collected from 101 men with different CKD stages.
RESULTS
Higher CKD stage (lower function) had a significant negative linear trend on total testosterone level (p < 0.01) and free testosterone level (p < 0.01), with a significant increase of luteinizing hormone (LH) (p < 0.01), and prolactin (p < 0.01), while SHBG remained unchanged between the CKD stages. Triglycerides but not total cholesterol, HDL -cholesterol or LDL-cholesterol increased with higher CKD stage. A negative correlation was observed between BMI, SHBG and free testosterone (p < 0.01 for both) but not with other sex hormones. Age per se was related to a significant decrease of total and free testosterone level (p < 0.01 for both) even after correction for BMI. Decreased levels of total testosterone and estimated free testosterone levels had a significant correlation with an increased level of triglyceride levels (p <0.01).
CONCLUSIONS
Our results indicate that CKD stage per se is a factor affecting testosterone levels in combination with age in men between 18 and 50 years old with CKD 1-5 stage, not treated with hemodialysis. With increased CKD stage there was a significant increase in LH level and a pattern of hypergonadotropic hypogonadism. SHBG remained unchanged between the CKD stages.
背景
本研究旨在评估慢性肾脏病（CKD）在 18-50 岁患有 1-5 期 CKD 且未接受血液透析治疗的无糖尿病男性亚组中对性激素和脂质的影响。
方法
从 101 名不同 CKD 分期的男性中收集数据。
结果
更高的 CKD 分期（功能越低）与总睾酮水平（p<0.01）和游离睾酮水平（p<0.01）呈显著负线性趋势，促黄体生成素（LH）（p<0.01）和催乳素（p<0.01）显著增加，而 CKD 分期之间 SHBG 保持不变。甘油三酯而非总胆固醇、HDL-胆固醇或 LDL-胆固醇随 CKD 分期升高而升高。BMI、SHBG 和游离睾酮之间存在负相关（两者均 p<0.01），但与其他性激素无相关性。年龄本身与总睾酮和游离睾酮水平显著降低相关（两者均 p<0.01），即使校正 BMI 后也是如此。总睾酮和估算游离睾酮水平降低与甘油三酯水平升高显著相关（p<0.01）。
结论
我们的结果表明，在 18-50 岁患有 1-5 期 CKD 且未接受血液透析治疗的男性中，CKD 分期本身是影响睾酮水平的因素之一，与年龄相关。随着 CKD 分期的增加，LH 水平显著升高，呈现高促性腺激素性腺功能减退症的模式。SHBG 在 CKD 分期之间保持不变。
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