Martínez-Montoro José Ignacio, Molina-Vega María, Asenjo-Plaza Maite, García-Ruiz María Concepción, Varea-Marineto Enrique, Plaza-Andrade Isaac, Álvarez-Millán Juan J, Cabezas-Sánchez Pablo, Tinahones Francisco J, Fernández-García José Carlos
Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain.
Laboratorio de Investigación, Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain.
J Clin Med. 2020 Nov 28;9(12):3873. doi: 10.3390/jcm9123873.
Obesity is associated with decreased circulating testosterone levels, the main male sex hormone. However, there are a number of different male sex hormones whose dynamics remain poorly understood regarding this pathology. In this regard, 17 hydroxyprogesterone (17-OH progesterone), as an important precursor of testosterone synthetized in testes and adrenal glands, could play an essential role in testosterone deficiency in male obesity. Moreover, similarly to testosterone, 17-OH progesterone could be closely associated with visceral fat distribution and metabolic dysfunction. Thus, the aim of this study was to assess serum 17-OH progesterone levels in non-diabetic obese young men and to evaluate their relationship with clinical, analytical, and anthropometric parameters. We conducted a cross-sectional study including 266 non-diabetic men with obesity (BMI ≥ 30 kg/m) aged 18-49 years; 17-OH progesterone and total testosterone (TT) were determined by high-performance liquid chromatography mass spectrometry. 17-OH progesterone levels were significantly lower in tertile 3 of body fat percentage in comparison with tertile 1 (0.74 ng/mL vs. 0.94 ng/mL, < 0.01; Bonferroni correction) and in comparison with tertile 2 (0.74 ng/mL vs. 0.89 ng/mL, = 0.02; Bonferroni correction). 17-OH progesterone levels correlated negatively with weight, BMI, waist circumference, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and visceral fat, and positively with TT, free testosterone (FT), luteinizing hormone, and fat-free mass percentage. Multivariate linear-regression analysis showed that body fat percentage and HOMA-IR were inversely associated with 17-OH progesterone levels, while FT and ACTH were positively linked to circulating 17-OH progesterone levels. In conclusion, in a population of non-diabetic obese young men, 17-OH progesterone levels were inversely associated with adiposity. Body fat percentage and insulin resistance were negatively related to 17-OH progesterone levels, whereas FT and ACTH levels were positively associated with 17-OH progesterone levels.
肥胖与循环睾酮水平降低有关,睾酮是主要的男性性激素。然而,有许多不同的男性性激素,关于这种病理状态,它们的动态变化仍知之甚少。在这方面,17-羟孕酮作为睾丸和肾上腺中合成睾酮的重要前体,可能在男性肥胖导致的睾酮缺乏中起重要作用。此外,与睾酮类似,17-羟孕酮可能与内脏脂肪分布和代谢功能障碍密切相关。因此,本研究的目的是评估非糖尿病肥胖青年男性的血清17-羟孕酮水平,并评估其与临床、分析和人体测量参数的关系。我们进行了一项横断面研究,纳入了266名年龄在18至49岁之间的非糖尿病肥胖男性(BMI≥30kg/m²);通过高效液相色谱质谱法测定17-羟孕酮和总睾酮(TT)。与第1三分位数相比,体脂百分比第3三分位数的17-羟孕酮水平显著降低(0.74ng/mL对0.94ng/mL,P<0.01;Bonferroni校正),与第2三分位数相比也显著降低(0.74ng/mL对0.89ng/mL,P = 0.02;Bonferroni校正)。17-羟孕酮水平与体重、BMI、腰围、胰岛素、胰岛素抵抗稳态模型评估(HOMA-IR)和内脏脂肪呈负相关,与TT、游离睾酮(FT)、促黄体生成素和去脂体重百分比呈正相关。多变量线性回归分析表明,体脂百分比和HOMA-IR与17-羟孕酮水平呈负相关,而FT和促肾上腺皮质激素与循环17-羟孕酮水平呈正相关。总之,在非糖尿病肥胖青年男性人群中,17-羟孕酮水平与肥胖呈负相关。体脂百分比和胰岛素抵抗与17-羟孕酮水平呈负相关,而FT和促肾上腺皮质激素水平与17-羟孕酮水平呈正相关。