TESTOSTERONE LEVELS DURING SYSTEMIC AND INHALED CORTICOSTEROID-THERAPY
TESTOSTERONE LEVELS DURING SYSTEMIC AND INHALED CORTICOSTEROID-THERAPY
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DOI：
10.1016/s0954-6111(05)80062-9
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发表时间：
1994-10-01
影响因子：
4.3
通讯作者：
RIADFAHMY, D
中科院分区：
文献类型：
--
作者：
MORRISON, D;CAPEWELL, S;RIADFAHMY, D
替吉奥作为性激素和促进骨形成的合成代谢类固醇都很重要。骨质疏松症与性腺功能减退和皮质类固醇治疗有关。长期泼尼松龙治疗可降低睾酮水平。尽管大剂量吸入皮质类固醇治疗可能引起多种全身效应，包括肾上腺抑制、皮肤变薄和总骨钙减少，但其对睾酮水平的影响尚不清楚。因此，对35例门诊男性呼吸系统疾病患者进行了睾酮、促黄体生成素、促卵泡激素和性激素结合球蛋白的测定（中位年龄58岁，范围21-75岁）。他们根据类固醇治疗进行分组，并与19名年龄匹配的对照组进行比较，12名长期口服泼尼松龙的男性的平均（SD）睾酮水平降低了33%[14.5（6.0）nmol l（-1）]比对照组[21.7（6.3）nmol l（-1）]，但在10名接受低剂量吸入倍氯米松[200-800 μ g/天（-1）：19.7（3.7）]，13例接受高剂量吸入性倍氯米松的男性[1500-2250 μ g/天（-1）：17.9（5.6）]。促黄体激素、促卵泡激素和性激素结合球蛋白水平在所有四组中相似。这些横断面数据证实长期全身皮质类固醇治疗可降低睾酮水平。然而，长期吸入皮质类固醇仅使睾酮降低18%（Ns）。现在应该探索解释骨代谢紊乱的其他机制。
Testosterone has importance both as a sex hormone and as an anabolic steroid promoting bone formation. Osteoporosis is associated with both hypogonadism and corticosteroid therapy. Testosterone levels are reduced by long term prednisolone treatment. Although high dose inhaled corticosteroid therapy may cause a variety of systemic effects including adrenal suppression, dermal thinning and a reduction in total bone calcium, its effect on testosterone levels is not known.Testosterone, luteinizing hormone, follicle stimulating hormone and sex hormone binding globulin were therefore measured in 35 male patients with respiratory disease attending an outpatient clinic (median age 58, range 21-75 years). They were grouped according to steroid therapy and compared with 19 age matched controls.Mean (SD) testosterone levels were 33% lower in 12 men on long term oral prednisolone [14.5 (6.0) nmol l(-1)] than in controls [21.7 (6.3) nmol l(-1)], but were not significantly reduced in 10 patients on low dose inhaled beclomethasone [200-800 mu g day(-1): 19.7 (3.7)] nor in 13 men taking high dose inhaled beclomethasone [1500-2250 mu g day(-1): 17.9 (5.6)]. Levels of luteinizing hormone, follicle stimulating hormone and sex hormone binding globulin were similar in all four groups.These cross sectional data confirm that long term systemic corticosteroid therapy reduces testosterone levels. However, testosterone was reduced by only 18% (Ns) by long term inhaled corticosteroids. Other mechanisms to explain the disordered bone metabolism should now be explored.