High serum testosterone levels are associated with excessive erythrocytosis of chronic mountain sickness in men
High serum testosterone levels are associated with excessive erythrocytosis of chronic mountain sickness in men
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DOI：
10.1152/ajpendo.90940.2008
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发表时间：
2009-06-01
影响因子：
5.1
通讯作者：
Gonzales-Castaneda, Cynthia
中科院分区：
文献类型：
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作者：
Gonzales, Gustavo F.;Gasco, Manuel;Gonzales-Castaneda, Cynthia
Gonzales GF、Gasco M、Tapia V、Gonzales-Castaneda C。高血清睾酮水平与男性慢性高山病红细胞过多有关。 Am J Physiol Endocrinol Metab 296：E1319-E1325，2009。首次发表于 2009 年 3 月 24 日； doi:10.1152/ajpendo.90940.2008.-慢性高山病 (CMS) 的特点是继发于通气不足的红细胞过多 (EE)。促红细胞生成素 (Epo) 和睾酮调节红细胞的产生。甲状腺激素水平低也与通气不足有关。因此，这些激素可以在 EE 的发病机制中发挥作用。本研究的目的是阐明秘鲁利马 (150 m) 和塞罗德帕斯科 (4,340 m) 居民的性激素、甲状腺激素和 EPO 的影响，以及对人绒毛膜促性腺激素刺激 (hCG) 的反应。研究了三组，一组在低海拔地区，两组在高海拔地区[第一组血红蛋白值 >16-21 g/dl，第二组 Hb >= 21 g/dl (EE)]。 hCG以单剂量（1,000 IU）肌肉注射，注射后0、6、12、24、48和72小时采集血样。与海拔 150 m 的人相比，高海拔地区的人的促性腺激素和甲状腺激素水平相似，但硫酸脱氢表雄酮 (DHEAS) 水平较低 (P < 0.01)，Epo (P < 0.01)、17 α-羟孕酮 (P < 0.01) 和睾酮水平 (P < 0.01) 较高。 EE 中的血清睾酮水平（524.13 +/- 55.91 mu g/dl 对比 328.14 +/- 53.23 ng/dl，平均值 +/- SE；P < 0.05）和睾酮/DHEAS 比率较高（7.98 +/- 1.1 对比 3.65 +/- 1.1；P < 0.01），DHEAS 水平较低组（83.85 +/- 14.60 μg/dl vs. 148.95 +/- 19.11 ug/dl；P < 0.05），而 Epo 没有进一步受到影响。在 hCG 刺激后，EE 组的睾酮水平始终最高，而 DHEAS 水平最低。总之，高雄激素活性可能参与 CMS 的发病机制。这一证据为开发新的治疗策略提供了机会。
Gonzales GF, Gasco M, Tapia V, Gonzales-Castaneda C. High serum testosterone levels are associated with excessive erythrocytosis of chronic mountain sickness in men. Am J Physiol Endocrinol Metab 296: E1319-E1325, 2009. First published March 24, 2009; doi:10.1152/ajpendo.90940.2008.-Chronic mountain sickness (CMS) is characterized by excessive erythrocytosis (EE) secondary to hypoventilation. Erythropoietin (Epo) and testosterone regulate erythrocyte production. Low thyroid hormone levels are also associated to hypoventilation. Hence, these hormones can play a role in etiopathogeny of EE. The purpose of this study was to elucidate the effect of sexual and thyroid hormones and Epo in residents from Lima (150 m) and Cerro de Pasco (4,340 m), Peru, and the response to human chorionic gonadotrophin stimulation (hCG). Three groups, one at low altitude and two at high altitude [1 with hemoglobin values >16-21 g/dl and the second with Hb >= 21 g/dl (EE)], were studied. hCG was administered intramuscularly in a single dose (1,000 IU), and blood samples were obtained at 0, 6, 12, 24, 48, and 72 h after injection. High-altitude natives present similar levels of gonadotropins and thyroid hormones but lower dehydroepiandrosterone sulphate (DHEAS) levels (P < 0.01) and greater Epo (P < 0.01), 17 alpha-hydroxyprogesterone (P < 0.01), and testosterone levels (P < 0.01) than those at 150 m. Serum testosterone levels (524.13 +/- 55.91 mu g/dl vs. 328.14 +/- 53.23 ng/dl, means +/- SE; P < 0.05) and testosterone/DHEAS ratios are higher (7.98 +/- 1.1 vs. 3.65 +/- 1.1; P < 0.01) and DHEAS levels lower in the EE group (83.85 +/- 14.60 mu g/dl vs. 148.95 +/- 19.11 ug/dl; P < 0.05), whereas Epo was not further affected. Testosterone levels were highest and DHEAS levels lowest in the EE group at all times after hCG stimulation. In conclusion, high androgen activity could be involved in the etiopathogeny of CMS. This evidence provides an opportunity to develop new therapeutic strategies.