Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Careggi Hospital, Viale Pieraccini, 6, 50134, Florence, Italy.
Intensive Care Respiratory Unit, Carlo Poma Hospital, Mantova, Italy.
J Endocrinol Invest. 2022 Mar;45(3):639-648. doi: 10.1007/s40618-021-01682-6. Epub 2021 Nov 3.
Objective of this study was to assess the association between testosterone (T) levels and biochemical markers in a cohort of female patients admitted for SARS-CoV-2 infection in a respiratory intensive care unit (RICU).
A consecutive series of 17 women affected by SARSCoV-2 pneumonia and recovered in the RICU of the Hospital of Mantua were analyzed. Biochemical inflammatory markers as well as total testosterone (TT), calculated free T (cFT), sex hormone-binding globulin (SHBG), and luteinizing hormone (LH) were determined.
TT and cFT were significantly and positively associated with PCT, CRP, and fibrinogen as well as with a worse hospital course. We did not observe any significant association between TT and cFT with LH; conversely, both TT and cFT showed a positive correlation with cortisol. By LOWESS analysis, a linear relationship could be assumed for CRP and fibrinogen, while a threshold effect was apparent in the relationship between TT and procalcitonin, LDH and ferritin. When the TT threshold value of 1 nmol/L was used, significant associations between TT and PCT, LDH or ferritin were observed for values above this value. For LDH and ferritin, this was confirmed also in an age-adjusted model. Similar results were found for the association of cFT with the inflammatory markers with a threshold effect towards LDH and ferritin with increased LDH and ferritin levels for values above cFT 5 pmol/L. Cortisol is associated with serum inflammatory markers with similar trends observed for TT; conversely, the relationship between LH and inflammatory markers had different trends.
Opposite to men, in women with SARS-CoV-2 pneumonia, higher TT and cFT are associated with a stronger inflammatory status, probably related to adrenal cortex hyperactivity.
本研究旨在评估在呼吸重症监护病房（RICU）因 SARS-CoV-2 感染住院的女性患者队列中，睾丸激素（T）水平与生化标志物之间的关联。
对 17 名患有 SARS-CoV-2 肺炎并在曼图亚医院 RICU 康复的女性连续系列患者进行了分析。测定了生化炎症标志物以及总睾酮（TT）、计算游离 T（cFT）、性激素结合球蛋白（SHBG）和黄体生成素（LH）。
TT 和 cFT 与 PCT、CRP 和纤维蛋白原呈显著正相关，与更差的住院病程相关。我们没有观察到 TT 和 cFT 与 LH 之间存在任何显著关联；相反，TT 和 cFT 均与皮质醇呈正相关。通过 LOWESS 分析，可以假设 CRP 和纤维蛋白原之间存在线性关系，而 TT 与降钙素原、LDH 和铁蛋白之间的关系则存在阈值效应。当 TT 阈值为 1 nmol/L 时，TT 值高于此值时，TT 与 PCT、LDH 或铁蛋白之间存在显著关联。对于 LDH 和铁蛋白，在调整年龄后模型中也得到了证实。cFT 与炎症标志物的关联也存在类似的结果，即存在阈值效应，cFT 5 pmol/L 以上时，LDH 和铁蛋白水平升高与 LDH 和铁蛋白相关。皮质醇与血清炎症标志物相关，与 TT 观察到的趋势相似；相反，LH 与炎症标志物之间的关系则呈现出不同的趋势。
与男性不同，在患有 SARS-CoV-2 肺炎的女性中，较高的 TT 和 cFT 与更强的炎症状态相关，这可能与肾上腺皮质过度活跃有关。
