寻常痤疮患者性激素水平与痤疮分级的相关性：一项在北京开展的横断面研究
The Relevant of Sex Hormone Levels and Acne Grades in Patients with Acne Vulgaris: A Cross-Sectional Study in Beijing.
作者信息
Zhang Rui, Zhou Lanhua, Lv Meiyu, Yue Na, Fei Wenting, Wang Linyuan, Liu Zhaolan, Zhang Jianjun
机构信息
School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 102488, People's Republic of China.
Department of Dermatology, Beijing Jingcheng Skin Hospital, Beijing, 100192, People's Republic of China.
出版信息
Clin Cosmet Investig Dermatol. 2022 Oct 18;15:2211-2219. doi: 10.2147/CCID.S385376. eCollection 2022.
BACKGROUND
The tests of sex hormones play pivotal roles in the clinical diagnosis and treatment of acne vulgaris, but the majority of patients with acne vulgaris present regular sex hormone levels within the normal reference range.
OBJECTIVE
To determine the correlation among levels of sex hormones, ratio of androgen to estrogen and acne grades in patients with acne vulgaris.
METHODS
A cross-sectional study was applied to collect 693 patients with acne vulgaris. All samples were screened by cluster sampling among those who underwent tests of sex hormones at Beijing Jingcheng Skin Hospital from July 2021 to June 2022. A gender stratified analysis was performed to classify acne grades I-IV. Spearman correlation analysis was used to analyze the relationship between age, sex hormones, ratio of androgen to estrogen and acne grades, with multinomial logistic regression to analyze the association of sex hormones with acne grades in patients with acne.
RESULTS
(1) The testosterone levels were mostly within normal reference values for both males and females with varying degrees of acne. For females, the serum follicle-stimulating hormone, estradiol, progesterone, testosterone, and ratio of androgen to estrogen were significantly different between acne grades. For males, there were significant differences in serum estradiol, testosterone, and ratio of androgen to estrogen across acne grades. (2) The acne grade was negatively correlated with estradiol and positively correlated with the ratio of androgen to estrogen; the female acne grade was also negatively correlated with age and progesterone, but positively correlated with follicle-stimulating hormone. (3) Multivariate logistic regression analysis indicated that the ratio of androgen to estrogen was independently correlated with the grade of acne and that acne grade worsened as the ratio increased.
CONCLUSION
The increase in the ratio of androgen to estrogen may aggravate the acne grade in patients with acne vulgaris.
背景
性激素检测在寻常痤疮的临床诊断和治疗中起着关键作用，但大多数寻常痤疮患者的性激素水平在正常参考范围内。
目的
确定寻常痤疮患者性激素水平、雄激素与雌激素比值和痤疮分级之间的相关性。
方法
采用横断面研究方法，收集693例寻常痤疮患者。所有样本均通过整群抽样从2021年7月至2022年6月在北京京城皮肤医院接受性激素检测的患者中选取。进行性别分层分析以将痤疮分级为I-IV级。采用Spearman相关性分析来分析年龄、性激素、雄激素与雌激素比值和痤疮分级之间的关系，并采用多项逻辑回归分析来分析性激素与寻常痤疮患者痤疮分级的关联。
结果
（1）不同程度痤疮的男性和女性的睾酮水平大多在正常参考值范围内。对于女性，血清促卵泡生成素、雌二醇、孕酮、睾酮以及雄激素与雌激素比值在不同痤疮分级之间存在显著差异。对于男性，血清雌二醇、睾酮以及雄激素与雌激素比值在不同痤疮分级之间存在显著差异。（2）痤疮分级与雌二醇呈负相关，与雄激素与雌激素比值呈正相关；女性痤疮分级也与年龄和孕酮呈负相关，但与促卵泡生成素呈正相关。（3）多变量逻辑回归分析表明，雄激素与雌激素比值与痤疮分级独立相关，且随着该比值增加痤疮分级加重。
结论
雄激素与雌激素比值升高可能会加重寻常痤疮患者的痤疮分级。
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