Schneider G, Kirschner M A, Berkowitz R, Ertel N H
J Clin Endocrinol Metab. 1979 Apr;48(4):633-8. doi: 10.1210/jcem-48-4-633.
Serum estrone (E1) and 17beta-estradiol (E2) were noted to be 2-fold elevated in a group of morbidly obese men. Urinary E1 and E2 production rates were elevated in proportion to the degree of obesity, with values as high as 127 and 157 micrograms/day, respectively. Although serum testosterone (T) concentrations were reduced in obese men, averaging 348 +/- 35 vs. 519 +/- 42 ng/dl in lean controls, the dialyzable T fractions were elevated and, hence, the calculated free T concentrations were normal in obese men. Further, the obese men exhibited normal serum LH, FSH, and T responses to clomiphene citrate, indicating intact hypothalamic-pituitary-Leydig cell axes. MCRs of T and peripheral conversion of T to E2 and androstenedione (delta) to E1 were all increased in obese men in proportion to the percentage above ideal weight. Although the obese mean exhibited increased blood levels and production rates of estrogens, there were no signs of feminization, increased T-estrogen-binding, globulin levels, or suppressed basal gonadotropin levels, suggesting a lack of biological effect. We postulate that obese men exhibit defective estrogen receptors, leading to decreased T-estrogen-binding globulin, increased clearance of androgenic hormones, and elevated estrogen production rates.
在一组病态肥胖男性中，血清雌酮（E1）和17β-雌二醇（E2）升高了2倍。尿E1和E2的生成率随肥胖程度的增加而升高，分别高达127和157微克/天。尽管肥胖男性的血清睾酮（T）浓度降低，肥胖男性平均为348±35 ng/dl，而瘦素对照组为519±42 ng/dl，但可透析的T组分升高，因此，肥胖男性计算出的游离T浓度正常。此外，肥胖男性对枸橼酸氯米芬的血清促黄体生成素（LH）、促卵泡生成素（FSH）和T反应正常，表明下丘脑-垂体-莱迪希细胞轴完整。肥胖男性中T的代谢清除率（MCR）以及T外周转化为E2和雄烯二酮（δ）转化为E1均与超过理想体重的百分比成比例增加。尽管肥胖男性的雌激素血水平和生成率升高，但没有女性化迹象、T-雌激素结合球蛋白水平增加或基础促性腺激素水平受到抑制，这表明缺乏生物学效应。我们推测肥胖男性存在雌激素受体缺陷，导致T-雌激素结合球蛋白减少、雄激素清除增加以及雌激素生成率升高。
