性类固醇与2型黄斑毛细血管扩张症

SEX STEROIDS AND MACULAR TELANGIECTASIA TYPE 2.

作者信息

Müller Simone, Allam Jean-Pierre, Bunzek Christopher G, Clemons Traci E, Holz Frank G, Charbel Issa Peter

机构信息

Department of Ophthalmology, University of Bonn, Bonn, Germany.

Department of Dermatology/Andrology Unit, University of Bonn, Bonn, Germany.

出版信息

Retina. 2018 Jan;38 Suppl 1:S61-S66. doi: 10.1097/IAE.0000000000001789.

DOI:10.1097/IAE.0000000000001789

PMID:28837534

Abstract

PURPOSE

To investigate the relationship between macular telangiectasia Type 2 and systemic levels of sex steroids or their antagonization.

METHODS

In a prospective single-center study, 90 patients with macular telangiectasia Type 2 were investigated. Female patients were evaluated for previous surgical (e.g., ovariectomy) and/or pharmacological (e.g., aromatase inhibitors, tamoxifen) therapy resulting in reduced action of sex steroids. In males, free serum testosterone levels were assessed in patients and controls.

RESULTS

Fourteen of 49 (29%) female patients had a history of pharmacological suppression of sex steroids and/or ovariectomy. These patients were younger at disease onset when compared with those without such medical history (mean ± SD: 47.1 ± 7.8, range: 38-59, versus 60.1 ± 7.6, range: 45-76; P < 0.0001). Male patients showed significantly lower free serum testosterone levels compared with controls at younger age (P < 0.0001 and 0.04 in the first and second age quartiles, respectively), as opposed to nonsignificant differences in older patients. In men ≤ 60 years of age, a biochemical hypogonadism (free serum testosterone < 0.05 ng/mL) was present in 53% (8/15) and 4% (2/49) of patients and controls, respectively (P < 0.0001).

CONCLUSION

The results indicate that steroidal sex hormones might be involved in the presumably multifactorial pathophysiology of macular telangiectasia Type 2.

摘要

目的

研究2型黄斑毛细血管扩张症与性类固醇激素的全身水平或其拮抗作用之间的关系。

方法

在一项前瞻性单中心研究中，对90例2型黄斑毛细血管扩张症患者进行了调查。对女性患者评估既往手术（如卵巢切除术）和/或药物治疗（如芳香化酶抑制剂、他莫昔芬）导致性类固醇激素作用降低的情况。在男性患者中，评估患者和对照组的血清游离睾酮水平。

结果

49例女性患者中有14例（29%）有性类固醇激素药物抑制和/或卵巢切除史。与无此类病史的患者相比，这些患者发病时年龄更小（平均±标准差：47.1±7.8，范围：38 - 59岁，而无此类病史患者为60.1±7.6，范围：45 - 76岁；P < 0.0001）。男性患者在较年轻时血清游离睾酮水平显著低于对照组（在第一和第二个年龄四分位数中分别为P < 0.0001和0.04），而老年患者差异不显著。在60岁及以下的男性中，生化性性腺功能减退（血清游离睾酮<0.05 ng/mL）分别在53%（8/15）的患者和4%（2/49）的对照组中出现（P < 0.0001）。