Low estradiol concentrations in men with subnormal testosterone concentrations and type 2 diabetes.
Low estradiol concentrations in men with subnormal testosterone concentrations and type 2 diabetes.
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DOI：
10.2337/dc11-0208
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发表时间：
2011-08
期刊：
影响因子：
16.2
通讯作者：
Dandona P
中科院分区：
文献类型：
--
作者：
Dhindsa S;Furlanetto R;Vora M;Ghanim H;Chaudhuri A;Dandona P
有研究表明，2型糖尿病患者游离睾酮浓度低于正常水平的高患病率，以及促性腺激素水平低或不适当正常，可能是由于脂肪组织中芳香化酶活性增加导致血浆雌二醇浓度增加，从而导致下丘脑-垂体-性腺轴受到抑制。为了验证这一假设，我们测量了240名2型糖尿病男性空腹血液样本中血浆雌二醇、睾酮、亮氨酸生成素、卵泡刺激素和性激素结合球蛋白（SHBG）的浓度。用免疫分析法测定总雌二醇和SHBG计算游离雌二醇浓度（n = 198），或直接用液相色谱串联质谱法（LC-MS/MS）和平衡透析法测定游离雌二醇浓度（n = 102）。游离睾酮浓度低于正常值的男性计算的游离雌二醇浓度低于游离睾酮浓度正常值的男性（中位数0.047 vs 0.063 ng/dL, P < 0.001）。游离睾酮浓度低于正常值的男性，直接测量（LC-MS/MS）游离雌二醇浓度也较低（中位数0.025 vs 0.045 ng/dL, P = 0.008）。游离雌二醇浓度与游离睾酮直接相关，但与BMI或年龄无关。这些数据表明，在游离睾酮浓度低于正常水平和2型糖尿病患者中，下丘脑-下丘脑-性腺轴的抑制与雌二醇浓度升高无关。2型糖尿病游离睾酮浓度过低的发病机制有待进一步研究。
It has been suggested that the high prevalence of subnormal free testosterone concentrations, along with low or inappropriately normal gonadotropins in men with type 2 diabetes, may be the result of an increase in plasma estradiol concentrations secondary to an increase in aromatase activity in the adipose tissue that leads to the suppression of the hypothalamo-hypophyseal-gonadal axis. To investigate this hypothesis, plasma estradiol, testosterone, leutinizing hormone, follicle-stimulating hormone, and sex hormone–binding globulin (SHBG) concentrations were measured in fasting blood samples of 240 men with type 2 diabetes. Free estradiol concentrations were either calculated (n = 198) using total estradiol and SHBG measured by immunoassay or directly measured by liquid chromatography tandem mass spectrometry (LC-MS/MS) and equilibrium dialysis (n = 102). The calculated free estradiol concentration in men with subnormal free testosterone concentrations was lower than that in men with normal free testosterone concentrations (median 0.047 vs. 0.063 ng/dL, P < 0.001). Directly measured (LC-MS/MS) free estradiol concentrations were also lower in men with subnormal free testosterone concentrations (median 0.025 vs. 0.045 ng/dL, P = 0.008). Free estradiol concentrations were directly related to free testosterone but not to BMI or age. These data show that the suppression of the hypothalamo-hypophyseal-gonadal axis in patients with subnormal free testosterone concentrations and type 2 diabetes is not associated with increased estradiol concentrations. The pathogenesis of subnormal free testosterone concentrations in type 2 diabetes needs to be investigated further.
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影响因子：
5.8
作者：
SCHNEIDER, G;KIRSCHNER, MA;ERTEL, NH
通讯作者：
ERTEL, NH
影响因子：
5.8
作者：
Grossmann, Mathis;Thomas, Merlin C.;Jerums, George
通讯作者：
Jerums, George
影响因子：
5.8
作者：
Dhindsa, S;Prabhakar, S;Dandona, P
通讯作者：
Dandona, P
影响因子：
16.2
作者：
Bhatia, Vishal;Chaudhuri, Ajay;Dandona, Paresh
通讯作者：
Dandona, Paresh
影响因子：
5.8
作者：
Vermeulen, A;Verdonck, L;Kaufman, JM
通讯作者：
Kaufman, JM