Mohammed Adel Gassab, Mansour Abbas Ali, Ahmed Jawad Hassan
Thi-Qar Specialized Diabetes, Endocrine and Metabolism Center, Endocrine and Metabolism Division, Department of Medicine, College of Medicine, University of Thi-Qar, Nasiriyah, Thi-Qar 64001, Iraq.
Faiha Specialized Diabetes, Endocrine and Metabolism Center, Endocrine and Metabolism Division, Department of Pharmacology, College of Medicine, University of Basrah, Basrah 61013, Iraq.
Biomed Rep. 2020 Sep;13(3):12. doi: 10.3892/br.2020.1319. Epub 2020 Jun 26.
The aim of the present study was to investigate the effects of exogenous glucocorticoids (GCs), a potent cause of male hypogonadism, on the function of the hypothalamic-pituitary-gonadal axis, and to determine their secondary effects in male patients. The present study was a case-controlled study conducted in Basrah, Iraq. Of the 152 participants who met the inclusion criteria, 100 patients used different types of GCs. Of these 100 patients, 57 patients (57%) were current GC users, and 43 patients (43%) were not currently using GCs (had not used GCs in the past 30 days). The control group was comprised of 52 men (34.21%), considered as healthy participants, although 7 men (13.65%) were biochemically diagnosed with hypogonadism. Current GC exposure significantly decreased the total and free testosterone levels, whereas previous GC exposure increased estradiol (E2) levels, with the 31 patients on oral dexamethasone (cumulative dose, 18.9 mg) exhibiting a 7.5-fold increased risk of being diagnosed with hypogonadism. For previous GC users, a significant increase in the E2 level was observed, whereas all other gonadal hormonal levels were within normal reference ranges, including the total and free testosterone levels. The total cumulative dose of equivalent GCs was 240 mg, which resulted in a decrease in total testosterone levels, and subsequent hypogonadism. Oral dexamethasone at a lower total cumulative dose resulted in hypogonadism.
本研究的目的是调查外源性糖皮质激素（GCs）这一男性性腺功能减退的主要病因，对下丘脑 - 垂体 - 性腺轴功能的影响，并确定其在男性患者中的继发效应。本研究是在伊拉克巴士拉进行的一项病例对照研究。在152名符合纳入标准的参与者中，100名患者使用了不同类型的GCs。在这100名患者中，57名患者（57%）为当前GC使用者，43名患者（43%）目前未使用GCs（过去30天内未使用GCs）。对照组由52名男性（34.21%）组成，尽管其中7名男性（13.65%）经生化诊断为性腺功能减退，但仍被视为健康参与者。当前GC暴露显著降低了总睾酮和游离睾酮水平，而既往GC暴露则增加了雌二醇（E2）水平，31名口服地塞米松的患者（累积剂量为18.9 mg）被诊断为性腺功能减退的风险增加了7.5倍。对于既往GC使用者，观察到E2水平显著升高，而所有其他性腺激素水平均在正常参考范围内，包括总睾酮和游离睾酮水平。等效GCs的总累积剂量为240 mg，导致总睾酮水平下降及随后的性腺功能减退。较低总累积剂量的口服地塞米松导致了性腺功能减退。
