Ramsay B, Alaghband-Zadeh J, Carter G, Wheeler M J, Cream J J
Department of Dermatology, Charing Cross Hospital, London, UK.
Clin Endocrinol (Oxf). 1995 Sep;43(3):305-10. doi: 10.1111/j.1365-2265.1995.tb02036.x.
Acne vulgaris is androgen dependent but the hormonal mechanisms are unclear. Although there have been many studies of serum hormones in women with acne there are few studies in men and the results are conflicting. We have therefore carried out a further study in men.
Fifty men with acne vulgaris were age-matched against 50 normal men.
Serum levels of dehydroepiandrosterone sulphate (DHEAS), 17 alpha-hydroxyprogesterone, 11-deoxycortisol, androstenedione and testosterone were measured by radioimmunoassay, sex hormone binding globulin (SHBG) by immunoradiometric assay and LH, FSH and oestradiol by automated ELISA.
The acne patients had higher levels of androstenedione, median 7.35 nmol/l, (interquartile range 2-7) vs 6.05 (2.3), P = 0.004; testosterone, 21.7 nmol/l (7.5) vs 17.55 (7.7), P = 0.04; and free androgen index (FAI) 78.26 (40) vs 65.06 (20), P = 0.007, but also had higher levels of 11-deoxycortisol, 13.65 nmol/l (4.3) vs 12.0 (4.3), P = 0.022. The LH, FSH, 17 alpha-hydroxyprogesterone, DHEAS, oestradiol and SHBG levels were not significantly different. Examination of the Spearman rank correlation coefficient matrices for the serum levels of 17 alpha-hydroxyprogesterone, androstenedione and 11-deoxycortisol showed that the strongest correlation was between androstenedione and 11-deoxycortisol.
Although there was overlap between the results of the acne patients and controls the acne patients tended to have higher levels of androstenedione, testosterone, free androgen index and 11-deoxycortisol. The higher levels of 11-deoxycortisol are suggestive of 11 beta-hydroyxlase dysfunction which could be due to a primary adrenal defect or a consequence of raised androgens. Also, a pathway between androstenedione and 11-deoxycortisol has been described in sheep and, although unsubstantiated in man, requires consideration.
寻常痤疮与雄激素有关，但其激素机制尚不清楚。尽管对患有痤疮的女性血清激素进行了许多研究，但针对男性的研究较少，且结果相互矛盾。因此，我们对男性进行了进一步研究。
50名寻常痤疮男性与50名正常男性进行年龄匹配。
采用放射免疫分析法测定血清硫酸脱氢表雄酮（DHEAS）、17α-羟孕酮、11-脱氧皮质醇、雄烯二酮和睾酮水平，采用免疫放射分析法测定性激素结合球蛋白（SHBG）水平，采用自动酶联免疫吸附测定法测定促黄体生成素（LH）、促卵泡生成素（FSH）和雌二醇水平。
痤疮患者的雄烯二酮水平较高，中位数为7.35 nmol/l（四分位间距为2 - 7），而对照组为6.05（2.3），P = 0.004；睾酮水平为21.7 nmol/l（7.5），对照组为17.55（7.7），P = 0.04；游离雄激素指数（FAI）为78.26（40），对照组为65.06（20），P = 0.007，但11-脱氧皮质醇水平也较高，为13.65 nmol/l（4.3），对照组为12.0（4.3），P = 0.022。LH、FSH、17α-羟孕酮、DHEAS、雌二醇和SHBG水平无显著差异。对17α-羟孕酮、雄烯二酮和11-脱氧皮质醇血清水平的Spearman等级相关系数矩阵进行分析，结果显示雄烯二酮与11-脱氧皮质醇之间的相关性最强。
尽管痤疮患者与对照组的结果存在重叠，但痤疮患者的雄烯二酮、睾酮、游离雄激素指数和11-脱氧皮质醇水平往往较高。11-脱氧皮质醇水平升高提示11β-羟化酶功能障碍，这可能是由于原发性肾上腺缺陷或雄激素升高所致。此外，绵羊体内已描述了一条雄烯二酮与11-脱氧皮质醇之间的途径，尽管在人类中未经证实，但值得考虑。
