摘要
目的评估青年男性黑棘皮病患者的性激素水平变化及发生机制。方法纳入125例青年男性肥胖患者[年龄（27．7±6．5）岁，体重指数（body mass index，BMI）≥28kg／m^2]的临床资料，分成单纯肥胖组（OB）62例、黑棘皮病组（AN）63例，另选取60名正常人作对照组，检测和计算各组患者的人体测量学指标[体重、BMI、腰围及体脂比例（fat％）]，测定血脂、胰岛素、性激素分泌水平及炎症指标，各组间进行比较，并将睾酮水平与各检测指标进行相关性分析。结果男性肥胖患者（OB组和AN组）的总睾酮水平较正常对照组明显下降（P〈0．05），其中AN组总睾酮水平明显低于OB组（P〈0．05）。肥胖症男性患者的体重指数和体脂含量明显高于正常对照组（P〈0．01）。OB组和AN组的空腹胰岛素水平和HOMA-IR明显高于正常对照组（P〈0．01），AN组明显高于OB组（P〈0．05）。OB组和AN组的三酰甘油（TG）均明显高于正常对照组（P〈0．05），组间无差异；而高密度脂蛋白胆固醇（HDL-C）明显低于正常对照组（P〈0．05），AN组明显低于OB组（P〈0．05）。AN组的总睾酮水平与与体重、腰围、臀围负相关，与糖代谢指标[胰岛素、稳态模型评估的胰岛素抵抗指数（HOMA-IR）]呈负相关，与炎症因子[C反应蛋白（CRP）、血沉（ESR）、肿瘤坏死因子α（TNF-α）、尿酸（uA）]负相关，而与脂代谢指标[总胆固醇（TC）、TG、HDL-C、低密度脂蛋白胆固醇（LDL-C）]无相关性。结论青年男性黑棘皮病患者存在继发性性腺功能减退，高胰岛素血症、胰岛素抵抗和炎症因子是继发性男性性腺功能减退的危险因素。
Objective To assess the variation of sexual hormone and mechanisms of low testosterone in young male obesity with aeanthosis nigricans. Methods Retrospective analysis was performed in 125 male obesity patients [ body mass index（BMI）≥28 kg/m2 ]. According to their clinical characteristics, they were divided into two groups including obesity without acanthosis nigricans （ OB group, n = 62 ） and obesity with acanthosis nigricans （ AN group, n = 63 ）. 60 normal weight men were also recruited as a control group. Body fat and body weight were measured. Blood insulin, lipid profile, sex hormones levels, and inflammation factors were measured. Parameters of each group were compared and the correlations between total testosterone level and other index were analyzed. Results All the male obesities have the significant lower total testosterone levels than those of control group （ P〈0.05 ）, and those in AN group were lower than those in OB group （ P〈0.05 ）. The BMI and body fat in OB group and AN group were both significantly higher than those in control group（ P〈0.05 ）. The fasting insulin levels in all obese men were significantly higher than those in control group（ P〈0.05 ）, highest in AN group. Triglycerides（TG） in both OB and AN group were higher than those in controls, and not significant between later 2 groups. But high-density lipoprotein-cholesterol （ HDL-C ） in the two groups were significantly lower than control, which in AN group were significantly lower than OB group. Total testosterone levels in AN group were negatively correlated with weight, waist circumference, hip circumference, fasting insulin, and homeostasis model assessment for insulin resistance （ HOMA-IR ） , and also negatively correlated with inflammation factors including C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR）, tumor necrosis factor-α（ TNF-α）, and uric acid. However, total testosterone levels in AN group were not correlated with lipid metabolism index. Conclusion
作者
钱春花
朱翠玲
高晶扬
曲伸
Qian Chunhua;Zhu Cuiling;Gao Jingyang;Qu Shen(Endocrine and Metabolic Department, Shanghai Tenth People＇ s Hospital, Shanghai 200072, Chin)
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2018年第5期383-388,共6页
Chinese Journal of Endocrinology and Metabolism
基金
国家自然科学基金（81500650）
中央高校基本科研业务费-交叉类项目（1501219107）
