[The relationship between testosterone and dehydroepiandrosterone sulfate concentrations, insulin resistance and visceral obesity in elderly men].
[The relationship between testosterone and dehydroepiandrosterone sulfate concentrations, insulin resistance and visceral obesity in elderly men].
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发表时间：
2005-11
影响因子：
2.1
通讯作者：
M. Rabijewski;J. Kozakowski;W. Zgliczyński
中科院分区：
文献类型：
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作者：
M. Rabijewski;J. Kozakowski;W. Zgliczyński
引言性激素缺乏症-低睾酮血症（20-30%的男性）和硫酸脱氢表雄酮缺乏症（60-70%的男性），经常在老年男性中观察到。在这些男性中，身体组成的变化（内脏肥胖、脂肪量增加）和代谢紊乱（高胆固醇血症、高胰岛素血症和胰岛素抵抗）也是常见的疾病。内脏肥胖和胰岛素抵抗可能是睾酮缺乏的原因或影响。DHEA-S缺乏可能也是内脏肥胖和胰岛素抵抗的危险因素，但尚不清楚这种可能的影响是否独立于睾酮缺乏。本研究的目的是分析睾酮和脱氢表雄酮缺乏与老年男性腰臀比（WHR）、血糖水平和胰岛素抵抗（HOMA和FG/FI）之间的关系，以及这些性激素是否单独影响测量参数。材料和方法共分析了85名年龄在60 - 70岁之间的男性（平均66.3+/-1.5岁;平均值+/-SEM）。包括标准：睾酮水平<4 ng/ml或DHEA水平<2000 ng/ml和BMI<30 kg/m2。将患者分为三组：睾酮缺乏组（L-T）52例，脱氢表雄酮缺乏组（L-DHEA-S）32例，两种性激素缺乏组（L-T/DHEA-S）67例。使用Student-t、Kruskal-Wallis和Mann-Whitney检验进行统计分析。结果L-T、L-DHEA和L-T/DHEA组的睾酮水平分别为3.19 ± 0.23 ng/ml、4.89 ± 0.45 ng/ml和3.25 ± 0.34 g/ml（p<0.002）。而DHEA-S水平分别为2498+/-98 ng/ml、1435+/-1010 ng/ml和1501+/-89 ng/ml）。BMI值在各组之间没有差异。L-T/DHEA-S组WHR比值最高（p<0.05 vs. L-T），L-T组显著低于L-DHEA-S组（p<0.005 vs. L-DHEA-S），L-DHEA-S组最低。空腹胰岛素水平L-DHEA-S组最低，L-T组较高（p<0.01），L-T/DHEA-S组最高（p<0.001）。FG/FI值以L-DHEA-S组最高，L-T组（NS）次之，L-T/DHEA组最低（p<0.002）。同样，HOMA比值在L-T组（6.6+/-3.21）和L-DHEA-S组（5.5+/-2.92）之间也没有显着变化，尽管注意到L-T组有较高值的趋势，而L-T/DHEA组的WHR比值显着较高（7.3+/-2.45; p<0.002与L-T组相比）。结论DHEA-S和睾酮缺乏与胰岛素抵抗和肥胖独立相关。WHR比BMI比更能反映雄激素缺乏对老年男性肥胖和体成分的影响。
INTRODUCTION Sex hormones deficiency--hypotestosteronemia (20-30% of men) and dehydroepian-drosterone sulfate deficiency (60-70% of men) are often observed in elderly men. In these men also changes of body composition (visceral obesity, increasing of fat mass), and metabolic disturbances (hypercholesterolemia, hyperinsulinism and insulin resistance) are common disorders. Visceral obesity and insulin resistance may be either reasons or effects of testosterone deficiency. Probably also DHEA-S deficiency is the risk factor of visceral obesity and insulin resistance, but it is not clear, whether this possible influence is independent from testosterone deficiency. OBJECTIVES The aim of this study was to analyze the association between testosterone and DHEA deficiency and waist/hip ratio (WHR), levels of glucose and insulin resistance (HOMA and FG/FI) in elderly men as well as analysis, whether these sex hormones influent on measured parameters separately. MATERIAL AND METHODS Together 85 men with age from 60 to 70 years men (mean 66.3+/-1.5 years; mean+/-SEM) was analyzed. Testosterone levels<4 ng/ml or DHEA levels<2000 ng/ml and BMI<30 kg/m2 were including criteria. Patients were divided into three groups: 52 with testosterone deficiency (L-T), 32 with DHEA deficiency (L-DHEA-S) and 67 with deficiency of both sex hormones (L-T/DHEA-S). Statistical analysis was made using Student-t, Kruskal-Wallis, and Mann-Whitney tests. RESULTS Testosterone levels in L-T, L-DHEA and L-T/DHEA groups were respectively 3.19+/-0.23 ng/ml, 4.89+/-0.45 ng/ml and 3.25+/-0.34 g/ml (p<0.002). While DHEA-S levels were respectively 2498+/-98 ng/ml, 1435+/-1010 ng/ml and 1501+/-89 ng/ml). BMI values do not differ between groups. WHR ratio values were the highest in L-T/DHEA-S group (p<0.05 vs. L-T) group, significant lower in L-T group (p<0.005 vs. L-DHEA-S) and the lowest in L-DHEA-S group. Insulin fasting levels were lowest in L-DHEA-S group, higher in L-T group (p<0.01) and the highest in L-T/DHEA-S group (p<0.001 vs, L-T group). FG/FI values were the highest in L-DHEA-S group, lower in L-T group (NS) and lowest in L-T/DHEA group (p<0.002 vs. L-T group). HOMA ratio values similarly did not change significantly between L-T (6.6+/-3.21) and L-DHEA-S group (5.5+/-2.92), although tendency to higher values in L-T group was noticed, while WHR ratio values were significantly higher in L-T/DHEA group (7.3+/-2.45; p<0.002 vs. L-T group). CONCLUSIONS DHEA-S and testosterone deficiency were independently associated with higher insulin resistance and obesity. WHR ratio seems to be more sensitive then BMI ratio to reflect the androgen deficiency on obesity and body composition in elderly men.