Winters Stephen J
Division of Endocrinology, Metabolism and Diabetes, University of Louisville, ACB-A3G11, 550 Jackson Street, Louisville, KY 40202 USA.
Clin Diabetes Endocrinol. 2020 Sep 29;6:17. doi: 10.1186/s40842-020-00106-3. eCollection 2020.
Adult onset male hypogonadism (AOH) is a common clinical condition whose diagnosis and management are controversial, and is often characterized by a low level of SHBG, but our understanding of why testosterone levels are low when SHBG is low is incomplete.
This retrospective chart review was performed to compare the relationship between SHBG and testosterone in the plasma of men presenting for evaluation of AOH with a cohort of men treated chronically with transdermal testosterone.
The level of SHBG was < 30 nmol/L in 73% of men who presented for evaluation of AOH, and was inversely proportional to BMI in both the untreated and the testosterone-treated men. As in previous populations, the level of SHBG was highly positively correlated ( = 0.71, < 0.01) with the total testosterone level in untreated men presenting for evaluation of AOH, but no relationship was found between the level of SHBG and total testosterone among men who were being treated with a transdermal testosterone preparation.
These findings further support the idea that SHBG regulates testicular negative feedback either directly or by modulating the entry of testosterone or estradiol into cells in the hypothalamus and/or pituitary to control gonadotropin synthesis and secretion which explains in part the low testosterone levels in men with AOH.
Not applicable.
成人迟发性性腺功能减退（AOH）是一种常见的临床病症，其诊断和管理存在争议，且常表现为性激素结合球蛋白（SHBG）水平较低，但我们对SHBG水平低时睾酮水平为何也低的理解并不完整。
进行这项回顾性病历审查，以比较前来评估AOH的男性血浆中SHBG与睾酮之间的关系，并与一组长期接受透皮睾酮治疗的男性进行对比。
前来评估AOH的男性中，73%的人SHBG水平低于30 nmol/L，在未治疗和接受睾酮治疗的男性中，SHBG水平均与体重指数呈负相关。与之前的人群一样，前来评估AOH的未治疗男性中，SHBG水平与总睾酮水平高度正相关（r = 0.71，P < 0.01），但在接受透皮睾酮制剂治疗的男性中，未发现SHBG水平与总睾酮之间存在关联。
这些发现进一步支持了这样一种观点，即SHBG直接或通过调节睾酮或雌二醇进入下丘脑和/或垂体细胞来调节睾丸负反馈，从而控制促性腺激素的合成和分泌，这部分解释了AOH男性睾酮水平低的原因。
不适用。
