Blackman M R, Weintraub B D, Rosen S W, Harman S M
Department of Medicine, Francis Scott Key Medical Center, National Institute on Aging, Baltimore, Maryland 21224.
J Clin Endocrinol Metab. 1988 Jan;66(1):88-95. doi: 10.1210/jcem-66-1-88.
We retrospectively determined serum total testosterone (T), fraction of T bound, free T index, LH, and FSH levels in 122 men with malignant lung disease, 32 men with benign lung disease, and 106 normal men. Men with malignant and, to a lesser extent, benign lung disease had decreased serum total T and free T index values at the 5th percentiles, with elevations of LH and FSH levels at the 95th percentiles. Linear regression analysis showed reductions in total T and free T index and increases in FSH, but not LH, levels with age in each group. Using multivariate analysis, we found stronger independent effects of disease than age on serum total T and fraction of T bound, but a greater influence of age on free T index. Serum LH values differed by diagnosis, whereas FSH differed by age. Relative to values in the normal men, mean serum total T levels were reduced in men with lung cancer; the fraction of T bound was decreased in the men with lung cancer and increased in the men with benign lung disease, the free T index was decreased in the men with both malignant and benign lung disease, and LH was increased in the men with lung cancer. The hormone and hormone binding results were similar in men with different types of lung cancer. Biochemical evidence of primary and secondary (or combined primary and secondary) hypogonadism was present in 50-59% and 28-32%, respectively, of the men with malignant and benign lung disease vs. 10% of the normal men. These data suggest that 1) there is an increased prevalence of both pituitary gonadotropic and testicular dysfunction in men with malignant and, to a lesser extent, benign chronic lung disease, and 2) the effects of illness are independent of, and quantitatively greater than, those due to age.
我们回顾性测定了122例男性恶性肺病患者、32例男性良性肺病患者和106例正常男性的血清总睾酮（T）、结合睾酮分数、游离睾酮指数、促黄体生成素（LH）和促卵泡生成素（FSH）水平。恶性肺病患者以及在较小程度上良性肺病患者，其血清总T和游离T指数值在第5百分位数处降低，而LH和FSH水平在第95百分位数处升高。线性回归分析显示，每组中总T和游离T指数降低，FSH水平升高，但LH水平不随年龄变化。通过多变量分析，我们发现疾病对血清总T和结合T分数的独立影响比年龄更强，但年龄对游离T指数的影响更大。血清LH值因诊断而异，而FSH因年龄而异。与正常男性相比，肺癌男性的血清总T平均水平降低；肺癌男性的结合T分数降低，良性肺病男性的结合T分数升高，恶性和良性肺病男性的游离T指数均降低，肺癌男性的LH升高。不同类型肺癌男性的激素及激素结合结果相似。原发性和继发性（或原发性和继发性合并）性腺功能减退的生化证据分别在50 - 59%的恶性肺病男性和28 - 32%的良性肺病男性中存在，而正常男性中这一比例为10%。这些数据表明：1）在患有恶性以及在较小程度上患有良性慢性肺病的男性中，垂体促性腺功能和睾丸功能障碍的患病率增加；2）疾病的影响独立于年龄，且在数量上大于年龄的影响。
