Testosterone, sex hormone-binding globulin and the metabolic syndrome in men: an individual participant data meta-analysis of observational studies.
Testosterone, sex hormone-binding globulin and the metabolic syndrome in men: an individual participant data meta-analysis of observational studies.
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DOI：
10.1371/journal.pone.0100409
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
van der Schouw YT
中科院分区：
文献类型：
--
作者：
Brand JS;Rovers MM;Yeap BB;Schneider HJ;Tuomainen TP;Haring R;Corona G;Onat A;Maggio M;Bouchard C;Tong PC;Chen RY;Akishita M;Gietema JA;Gannagé-Yared MH;Undén AL;Hautanen A;Goncharov NP;Kumanov P;Chubb SA;Almeida OP;Wittchen HU;Klotsche J;Wallaschofski H;Völzke H;Kauhanen J;Salonen JT;Ferrucci L;van der Schouw YT
低总睾酮（TT）和性激素结合球蛋白（SHBG）浓度与男性代谢综合征（MetS）相关，但报告的相关性强度差异很大。我们的目的是调查在特定亚组（根据年龄和体重指数（BMI））和个体MetS组分之间是否存在差异。两项先前发表的荟萃分析，包括PubMed和EMBASE中更新的系统检索。具有男性TT和/或SHBG浓度与MetS联合数据的横断面或前瞻性观察性研究。我们对20项观察性研究进行了个体参与者数据荟萃分析。采用混合效应模型评估TT、SHBG和游离睾酮（FT）与MetS及其单个组分的横断面和前瞻性关联。计算多变量校正比值比（OR）和风险比（HR），并研究年龄和BMI对效应的影响。TT、SHBG或FT浓度低的男性更有可能患有MetS。（每四分位数减少的OR分别为1.69（95% CI 1.60-1.77），1.73（95% CI 1.62-1.85）和1.46（TT、SHBG和FT的95% CI分别为1.36-1.57）和偶发MetS（TT、SHBG和FT每四分位数降低的HR分别为1.25（95% CI 1.16-1.36）、1.44（95% CI 1.30-1.60）和1.14（95% CI 1.01-1.28））。总体而言，非超重男性中的关联程度最大，并且各个组成部分之间存在差异：观察到与高甘油三酯血症、腹部肥胖和高血糖症的关联性较强，与高血压的关联性最弱。睾酮和SHBG与代谢综合征的关联根据BMI和个体代谢综合征组分而变化。这些研究结果为将低睾酮和SHBG浓度与心脏代谢风险联系起来的病理生理机制提供了进一步的见解。
Low total testosterone (TT) and sex hormone-binding globulin (SHBG) concentrations have been associated with the metabolic syndrome (MetS) in men, but the reported strength of association varies considerably. We aimed to investigate whether associations differ across specific subgroups (according to age and body mass index (BMI)) and individual MetS components. Two previously published meta-analyses including an updated systematic search in PubMed and EMBASE. Cross-sectional or prospective observational studies with data on TT and/or SHBG concentrations in combination with MetS in men. We conducted an individual participant data meta-analysis of 20 observational studies. Mixed effects models were used to assess cross-sectional and prospective associations of TT, SHBG and free testosterone (FT) with MetS and its individual components. Multivariable adjusted odds ratios (ORs) and hazard ratios (HRs) were calculated and effect modification by age and BMI was studied. Men with low concentrations of TT, SHBG or FT were more likely to have prevalent MetS (ORs per quartile decrease were 1.69 (95% CI 1.60-1.77), 1.73 (95% CI 1.62-1.85) and 1.46 (95% CI 1.36-1.57) for TT, SHBG and FT, respectively) and incident MetS (HRs per quartile decrease were 1.25 (95% CI 1.16-1.36), 1.44 (95% 1.30-1.60) and 1.14 (95% 1.01-1.28) for TT, SHBG and FT, respectively). Overall, the magnitude of associations was largest in non-overweight men and varied across individual components: stronger associations were observed with hypertriglyceridemia, abdominal obesity and hyperglycaemia and associations were weakest for hypertension. Associations of testosterone and SHBG with MetS vary according to BMI and individual MetS components. These findings provide further insights into the pathophysiological mechanisms linking low testosterone and SHBG concentrations to cardiometabolic risk.
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作者：
Corona, Giovanni;Mannucci, Edoardo;Maggi, Mario
通讯作者：
Maggi, Mario
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Chubb, S. A. Paul;Hyde, Zoe;Yeap, Bu B.
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Yeap, Bu B.
影响因子：
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作者：
Corona, Giovanni;Mannucci, Edoardo;Maggi, Mario
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Wallaschofski H