Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland.
Endokrynol Pol. 2021;72(4):347-352. doi: 10.5603/EP.a2021.0042. Epub 2021 May 19.
Testosterone deficiency is frequently found in male patients with chronic kidney disease (CKD) and may participate in the pathogenesis of osteoporosis, sarcopaenia, anaemia, impotence, infertility, and other comorbidities observed in these patients. The aim of the study was the evaluation of the frequency of testosterone deficiency in male patients with CKD on maintenance haemodialysis (HD).
In 79 male HD patients, serum total (TT), free (FT) testosterone, C-reactive protein (CRP), and interleukin 6 (IL-6) serum concentrations were assessed before an HD procedure. Patients were divided into three subgroups based on age categories: 19-39 years (18 patients), 40-59 years (34 patients), and ≥ 60 years (27 patients). TT insufficiency and deficiency were diagnosed when the serum TT concentration was below 4.0 ng/mL and 2.9 ng/mL, respectively. FT deficiency was diagnosed in patients with serum FT concentration below 8.9, 6.6, and 4.9 pg/mL in the abovementioned age subgroups, respectively.
In the abovementioned age subgroups the serum TT concentration was 5.9 (4.6-7.1), 4.8 (3.9-5.4), and 4.6 (3.9-5.3) ng/mL, respectively. The serum FT concentration was 7.9 (5.2-10.1), 6.1 (5.1-7.2), and 6.0 (5.0-7.1) pg/mL, respectively. In the whole group TT insufficiency was found in 40%, TT deficiency in 15% of patients, and FT deficiency in 50% of patients. Significant negative correlations were found between both serum TT and FT concentrations and age (r = -0.23, p = 0.05 and r = -0.27, p = 0.02, respectively). Additionally, negative correlations were found between both serum TT and FT and IL-6 concentrations (r = -0.43, p < 0.05 and r = -0.29, p < 0.05), respectively.
睾酮缺乏症在慢性肾脏病（CKD）男性患者中很常见，可能参与了这些患者骨质疏松症、肌肉减少症、贫血、阳痿、不育和其他合并症的发病机制。本研究的目的是评估接受维持性血液透析（HD）的 CKD 男性患者的睾酮缺乏症频率。
在 79 名男性 HD 患者中，在进行 HD 程序前评估了血清总（TT）、游离（FT）睾酮、C 反应蛋白（CRP）和白细胞介素 6（IL-6）的血清浓度。根据年龄分为三组：19-39 岁（18 例）、40-59 岁（34 例）和≥60 岁（27 例）。当血清 TT 浓度低于 4.0ng/mL 和 2.9ng/mL 时，分别诊断为 TT 不足和缺乏。当血清 FT 浓度分别低于上述年龄组的 8.9、6.6 和 4.9pg/mL 时，诊断为 FT 缺乏。
在上述年龄组中，血清 TT 浓度分别为 5.9（4.6-7.1）、4.8（3.9-5.4）和 4.6（3.9-5.3）ng/mL。血清 FT 浓度分别为 7.9（5.2-10.1）、6.1（5.1-7.2）和 6.0（5.0-7.1）pg/mL。在整个组中，40%的患者 TT 不足，15%的患者 TT 缺乏，50%的患者 FT 缺乏。发现血清 TT 和 FT 浓度与年龄之间存在显著的负相关（r=-0.23，p=0.05 和 r=-0.27，p=0.02）。此外，还发现血清 TT 和 FT 与 IL-6 浓度之间存在负相关（r=-0.43，p<0.05 和 r=-0.29，p<0.05）。
