Nilsson P M, Møller L, Solstad K
Health Sciences Centre, University of Lund, Sweden.
J Intern Med. 1995 May;237(5):479-86. doi: 10.1111/j.1365-2796.1995.tb00873.x.
To investigate the relationship between gonadal function, insulin and psychosocial stress in middle-aged men.
A population-based, cross-sectional, observational study.
Glostrup Hospital, Copenhagen, Denmark.
Four hundred and thirty-nine males, all aged 51 years.
Body-mass index (BMI), waist-to-hip ratio (WHR), insulin, C-peptide, free testosterone, luteinizing hormone (LH), lipids, fibrinogen, lung function tests (FVC, FEV1, PEF), blood pressure, a self-administered questionnaire with questions on psychosocial variables, lifestyle and self-rated health.
Free testosterone correlated inversely (P < 0.05) with weight, BMI, WHR, and fibrinogen, and positively with FEV1. An independent correlation between free testosterone and insulin (P < or = 0.03), but not with C-peptide, was seen after controlling for BMI and WHR. Subjects with low levels of free testosterone, or those in the lowest quintile of the distribution of the hypogonadal index (HI: free testosterone/LH), showed a cluster of negative psychosocial variables, and psychological as well as health-related problems. Furthermore, hypogonadal men had lower (P < 0.05) levels of FEV1, peak flow and FVC, but higher (P < 0.01) levels of fibrinogen and higher pulse pressure than men with normal gonadal function. This gradient of variables, relative to HI, was not seen for possible confounders like BMI, WHR, and tobacco or alcohol consumption.
Psychosocial stress may be associated with a process of premature ageing in middle-aged males, corresponding to a hypogonadal state as well as to indirect signs of increased insulin resistance.
探讨中年男性性腺功能、胰岛素与心理社会压力之间的关系。
基于人群的横断面观察性研究。
丹麦哥本哈根格罗斯特鲁普医院。
439名男性，均为51岁。
体重指数（BMI）、腰臀比（WHR）、胰岛素、C肽、游离睾酮、促黄体生成素（LH）、血脂、纤维蛋白原、肺功能测试（FVC、FEV1、PEF）、血压、一份关于心理社会变量、生活方式和自我健康评分的自填问卷。
游离睾酮与体重、BMI、WHR和纤维蛋白原呈负相关（P<0.05），与FEV1呈正相关。在控制BMI和WHR后，游离睾酮与胰岛素之间存在独立相关性（P≤0.03），但与C肽无关。游离睾酮水平低的受试者，或性腺功能减退指数（HI：游离睾酮/LH）分布处于最低五分位数的受试者，表现出一系列负面的心理社会变量以及心理和健康相关问题。此外，性腺功能减退的男性FEV1、峰值流速和FVC水平较低（P<0.05），但纤维蛋白原水平较高（P<0.01），脉压高于性腺功能正常的男性。对于BMI、WHR以及吸烟或饮酒等可能的混杂因素，未观察到相对于HI的这种变量梯度。
心理社会压力可能与中年男性的早衰过程有关，这与性腺功能减退状态以及胰岛素抵抗增加的间接迹象相对应。
