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人类免疫缺陷病毒感染男性的代谢状况与性腺功能减退

Metabolic Status and Hypogonadism in Human Immunodeficiency Virus-infected Males.

作者信息

Bajaj Sarita, Pathak Yashaswi, Varma Sharad, Verma Sujit

机构信息

Department of Medicine, Motilal Nehru Medical College, Allahabad, Uttar Pradesh, India.

ART Centre, Swaroop Rani Nehru Hospital, Allahabad, Uttar Pradesh, India.

出版信息

Indian J Endocrinol Metab. 2017 Sep-Oct;21(5):684-687. doi: 10.4103/ijem.IJEM_127_17.

Abstract

AIMS AND OBJECTIVES

The aim of this study is to determine the prevalence of hypogonadism in human immunodeficiency virus (HIV)-infected males and to study its relation to age, CD4 count, body mass index (BMI), duration of highly active antiretroviral therapy (HAART), and metabolic status.

METHODOLOGY

Eighty-one HIV positive cases and 82 healthy controls were included in this case-control study. Each case underwent a complete physical examination and serum fasting plasma glucose, A1c, lipid profile, total testosterone (TT), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) levels were estimated. Serum TT level <300 ng/dl, or TT >300 ng/dl with high LH and FSH (compensatory hypogonadism) were taken as markers for hypogonadism, and it was correlated with age, CD4 count, duration of HAART, and metabolic status of the patient.

RESULTS

Out of 81 cases, 21 (25.9%) were found to have hypogonadism as compared to 4 (4.9%) out of 82 controls. Of these 21, 14 cases had secondary hypogonadism, five had primary, and the remaining two had compensatory hypogonadism. The mean serum TT value among cases (371.7 ± 102.9 ng/dl) was significantly lower than that among controls (419.7 ± 71.5 ng/dl) ( = 0.007). Hypogonadism was found to be significantly associated with the age of the patient ( = 0.007), CD4 count ( = 0.002), and duration of HAART ( = 0.04) and was independent of the BMI ( = 0.9) and the waist circumference ( = 0.8). Dyslipidemia and dysglycemia were significantly more common among cases as compared to controls ( < 0.05) but were not associated with hypogonadism.

CONCLUSION

The prevalence of hypogonadism is higher among HIV-infected males as compared to healthy individuals. Hypogonadism was significantly associated with age, CD4 count, and duration of HAART and was independent of BMI, glycemic status, and dyslipidemia.

摘要

目的

本研究旨在确定感染人类免疫缺陷病毒(HIV)的男性性腺功能减退的患病率,并研究其与年龄、CD4细胞计数、体重指数(BMI)、高效抗逆转录病毒治疗(HAART)持续时间及代谢状态的关系。

方法

本病例对照研究纳入81例HIV阳性病例和82例健康对照。对每个病例进行全面体格检查,并测定空腹血糖、糖化血红蛋白、血脂谱、总睾酮(TT)、促卵泡激素(FSH)和促黄体生成素(LH)水平。血清TT水平<300 ng/dl,或TT>300 ng/dl且LH和FSH升高(代偿性性腺功能减退)被视为性腺功能减退的指标,并将其与患者年龄、CD4细胞计数、HAART持续时间及代谢状态进行关联分析。

结果

81例病例中,21例(25.9%)被发现患有性腺功能减退,而82例对照中为4例(4.9%)。在这21例中,14例为继发性性腺功能减退,5例为原发性,其余2例为代偿性性腺功能减退。病例组血清TT平均水平(371.7±102.9 ng/dl)显著低于对照组(419.7±71.5 ng/dl)(P = 0.007)。发现性腺功能减退与患者年龄(P = 0.007)、CD4细胞计数(P = 0.002)及HAART持续时间(P = 0.04)显著相关,且与BMI(P = 0.9)和腰围(P = 0.8)无关。与对照组相比,病例组血脂异常和血糖异常更为常见(P<0.05),但与性腺功能减退无关。

结论

与健康个体相比,HIV感染男性中性腺功能减退的患病率更高。性腺功能减退与年龄、CD4细胞计数及HAART持续时间显著相关,且与BMI、血糖状态及血脂异常无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6846/5628536/bfdaa518a4f0/IJEM-21-684-g002.jpg

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