Metabolic Syndrome, Testosterone, and Cardiovascular Mortality in Men
Metabolic Syndrome, Testosterone, and Cardiovascular Mortality in Men
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DOI：
10.1111/j.1743-6109.2011.02343.x
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发表时间：
2011-08-01
影响因子：
3.5
通讯作者：
Lin, Yu-Sheng
中科院分区：
文献类型：
--
作者：
Lin, Jou-Wei;Lee, Jen-Kuang;Lin, Yu-Sheng
介绍。睾酮、代谢综合征（MetS）和男性死亡风险之间的相互作用仍有待阐明。在美国中年和老年男性中，研究睾酮、met和心血管死亡风险之间的关系。分析对象为第三次全国健康与营养调查（NHANES III）第一阶段（1988-1991）的40岁及以上男性。测定血清睾酮和性激素结合球蛋白，计算游离睾酮和生物可利用睾酮。MetS根据成人治疗组III （ATP-III）标准确定。主要结果测量。心血管和其他死因的死亡数据来自于截至2006年12月31日的NHANES iii相关随访文件。应用多变量Cox回归模型评估相关关系。在分析的596名男性中，187名男性被发现患有MetS。在15.6年的中位随访期间，97名男性死于心血管原因（心血管死亡率：有和没有MetS的人分别为9.84和5.77 / 1000人年）。较高的计算生物可利用睾酮（CBT）与MetS受试者较低的风险（优势比：0.80每ng/mL， 95%可信区间[CI]: 0.76-0.84, P < 0.001）和较低的心血管死亡风险（风险比[hr]: 0.72每log ng/mL， 95% CI: 0.54-0.96, P = 0.03）相关。未发生MetS的患者未观察到CBT的影响（HR: 0.84 / log ng/mL, 95% CI: 0.68-1.04, P = 0.10）。较低的生物可利用睾酮和atp - iii定义的MetS与40岁及以上男性心血管死亡率增加有关。林建伟，李建奎，吴昌奎，Caffrey JL，张明辉，黄建军，Dowling N，林玉生。男性代谢综合征、睾酮和心血管死亡率。性医学杂志2011；8:2350-2360。
Introduction. Interactions among testosterone, metabolic syndrome (MetS), and mortality risk in men remain to be elucidated.Aim. To examine relationships among testosterone, MetS, and cardiovascular mortality risk in U. S. men, middle-aged and older.Methods. The analysis included the men aged 40 years and above in Phase 1 (1988-1991) of the Third National Health and Nutrition Examination Survey (NHANES III). Serum testosterone and sex hormone binding globulin were measured, and free testosterone and bioavailable testosterone were calculated. MetS was determined according to the Adult Treatment Panel III (ATP-III) criteria.Main Outcome Measures. Cardiovascular and other causes of mortality were obtained from the NHANES III-linked follow-up file through December 31, 2006. Multivariate Cox regression models were applied to assess associations of interest.Results. Of 596 men included in the analysis, 187 men were found to have MetS. During a median follow-up of 15.6 years, 97 men died of cardiovascular causes (cardiovascular mortality rate: 9.84 and 5.77 per 1,000 person-years for those with and without MetS, respectively). Higher calculated bioavailable testosterone (CBT) was associated with a lower odds of MetS (odds ratio: 0.80 for each ng/mL, 95% confidence interval [CI]: 0.76-0.84, P < 0.001) and lower risk of cardiovascular mortality (hazard ratios [HRs]: 0.72 for each log ng/mL, 95% CI: 0.54-0.96, P = 0.03) in subjects with MetS. The influence of CBT was not observed in those without MetS (HR: 0.84 for each log ng/mL, 95% CI: 0.68-1.04, P = 0.10).Conclusions. The combination of lower bioavailable testosterone and ATP-III-defined MetS is associated with an increased cardiovascular mortality in the men aged 40 years and above. Lin J-W, Lee J-K, Wu C-K, Caffrey JL, Chang MH, Hwang J-J, Dowling N, and Lin Y-S. Metabolic syndrome, testosterone, and cardiovascular mortality in men. J Sex Med 2011;8:2350-2360.