Bulkhi Adeeb A, Shepard Kirk V, Casale Thomas B, Cardet Juan Carlos
Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Morsani College of Medicine and James A. Haley Veterans' Hospital, Tampa, Fla; Department of Internal Medicine, College of Medicine, Umm Al Qura University, Makkah, Saudi Arabia.
Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Morsani College of Medicine and James A. Haley Veterans' Hospital, Tampa, Fla.
J Allergy Clin Immunol Pract. 2020 Oct;8(9):3029-3035.e4. doi: 10.1016/j.jaip.2020.05.022. Epub 2020 May 30.
Asthma prevalence decreases postpuberty in males. Testosterone inhibits airway smooth muscle contraction and attenuates type 2 inflammation.
To investigate the relationship between serum testosterone and current asthma prevalence and lung function in a nationally representative data set.
Serum testosterone and self-reported physician-diagnosed current asthma data were obtained from 7584 participants aged 6 to 80 years from the cross-sectional 2011-2012 National Health and Nutrition Examination Survey. We used logistic regression to test associations between testosterone and current asthma, adjusting for demographic characteristics and stratifying by sex and age; linear regression to evaluate correlations between testosterone and lung function among patients with asthma; and interaction terms to test for effect modification by blood eosinophils and fractional exhaled nitric oxide.
Serum testosterone inversely associated with odds of current asthma in both men and women, but this association was nonlinear. Similar protective effect sizes were observed for both sexes after log-transformation of serum testosterone. For every 1-unit increase in log testosterone, the odds of current asthma decreased by 11% in men and 10% in women, although the association was statistically significant in women only among those 12 years or older after multiple imputation. Serum testosterone did not associate with current asthma prevalence among those younger than 12 years. Testosterone associated with increases in FEV in participants with asthma of both sexes. Neither blood eosinophils nor fractional exhaled nitric oxide modified the association between testosterone and current asthma.
Serum testosterone inversely associates with current asthma prevalence regardless of sex and correlates with better lung function in a nationally representative database. Androgen therapy for asthma should be further investigated.
男性青春期后哮喘患病率降低。睾酮可抑制气道平滑肌收缩并减轻2型炎症。
在一个具有全国代表性的数据集中研究血清睾酮与当前哮喘患病率及肺功能之间的关系。
从2011 - 2012年全国健康与营养检查调查的横断面研究中获取了7584名6至80岁参与者的血清睾酮和自我报告的医生诊断的当前哮喘数据。我们使用逻辑回归来检验睾酮与当前哮喘之间的关联，对人口统计学特征进行调整并按性别和年龄分层；使用线性回归来评估哮喘患者中睾酮与肺功能之间的相关性；并使用交互项来检验血液嗜酸性粒细胞和呼出一氧化氮分数的效应修正。
血清睾酮与男性和女性当前哮喘的患病几率呈负相关，但这种关联是非线性的。血清睾酮经对数转换后，两性观察到相似的保护效应大小。每增加1个单位的对数睾酮，男性当前哮喘的患病几率降低11%，女性降低10%，尽管在多次插补后仅在12岁及以上的女性中该关联具有统计学意义。血清睾酮与12岁以下人群的当前哮喘患病率无关。睾酮与两性哮喘患者的第一秒用力呼气容积（FEV）增加相关。血液嗜酸性粒细胞和呼出一氧化氮分数均未改变睾酮与当前哮喘之间的关联。
在一个具有全国代表性的数据库中，无论性别如何，血清睾酮均与当前哮喘患病率呈负相关，且与更好的肺功能相关。哮喘的雄激素治疗应进一步研究。
