Low testosterone level as a predictor of cardiovascular events in Japanese men with coronary risk factors
Low testosterone level as a predictor of cardiovascular events in Japanese men with coronary risk factors
复制标题
DOI：
10.1016/j.atherosclerosis.2009.10.037
复制
发表时间：
2010-05-01
期刊：
影响因子：
5.3
通讯作者：
Ouchi, Yasuyoshi
中科院分区：
文献类型：
--
作者：
Akishita, Masahiro;Hashimoto, Masayoshi;Ouchi, Yasuyoshi
目的：最近的流行病学研究发现，睾酮缺乏与社区老年男性的心血管（CV）疾病死亡率较高有关。我们研究了低血浆睾酮水平是否可以预测具有冠状动脉危险因素的中年日本男性的心血管事件。方法：对 171 名患有任何冠状动脉危险因素（高血压、糖尿病、血脂异常、吸烟和肥胖）且既往无心血管病史的男性门诊患者（30-69 岁，平均+/- SD = 48 +/- 13 岁）进行随访。在基线时，受试者接受了冠状动脉危险因素检查、测量肱动脉血流介导扩张 (FMD) 作为血管内皮功能的指标，并检测血浆总睾酮、硫酸脱氢表雄酮 (DHEA-S)、雌二醇和皮质醇。 结果：在平均 77 个月的随访期内，总共发生了 20 例心血管事件。按血浆激素水平三分位数进行的 Kaplan-Meier 生存分析显示，睾酮三分位数最低的受试者比睾酮三分位数最高的受试者更容易发生 CV 事件（对数秩检验 P < 0.01）。 Cox 比例风险模型显示，血浆睾酮水平最低的受试者（
Objective: Recent epidemiological studies have found that testosterone deficiency is associated with higher mortality largely due to cardiovascular (CV) disease in community-dwelling older men. We investigated whether a low plasma testosterone level could predict cardiovascular events in middle-aged Japanese men with coronary risk factors.Methods: One hundred and seventy-one male outpatients (30-69 years old, mean +/- SD= 48 +/- 13 years) who had any coronary risk factor (hypertension, diabetes, dyslipidemia, smoking, and obesity) without a previous history of CV disease were followed up. At baseline, the subjects underwent examination of coronary risk factors, measurement of flow-mediated dilation (FMD) of the brachial artery as an indicator of vascular endothelial function and assays of plasma total testosterone, dehydroepiandrosterone-sulfate (DHEA-S), estradiol and cortisol.Results: During the mean follow-up period of 77 months, a total of 20 CV events occurred. Kaplan-Meier survival analysis by tertile of plasma hormone levels revealed that the subjects with the lowest testosterone tertile were more likely to develop CV events than those with the highest tertile (P < 0.01 by log-rank test). Cox proportional hazards models showed that the subjects with the lowest tertile of plasma testosterone (