AGE, DISEASE, AND CHANGING SEX-HORMONE LEVELS IN MIDDLE-AGED MEN - RESULTS OF THE MASSACHUSETTS MALE AGING STUDY
AGE, DISEASE, AND CHANGING SEX-HORMONE LEVELS IN MIDDLE-AGED MEN - RESULTS OF THE MASSACHUSETTS MALE AGING STUDY
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DOI：
10.1210/jcem-73-5-1016
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发表时间：
1991-11-01
影响因子：
5.8
通讯作者：
LONGCOPE, C
中科院分区：
文献类型：
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作者：
GRAY, A;FELDMAN, HA;LONGCOPE, C
为了评估内分泌谱随年龄增长而变化与特定疾病状态无关的假设，我们研究了来自马萨诸塞州男性衰老研究的两大组成年男性的17种主要性激素、代谢物和相关血清蛋白的年龄趋势，该研究是1986-89年对39-70岁男性进行的一项基于人群的横断面调查。第一组由415名男性组成，他们没有肥胖、酗酒、所有处方药、前列腺问题和慢性疾病（癌症、冠心病、高血压、糖尿病和溃疡）。第二组由1294名报告了上述一种或多种情况的男性组成，每个年龄趋势都可以用39-70岁之间每年的恒定百分比变化来满意地描述。游离睾酮下降1.2%/年，白蛋白结合睾酮下降1.0%/年。性激素结合球蛋白（SHBG），睾酮的主要血清载体，每年增加1.2%，净效应是血清总睾酮下降得更慢在主要的雄激素和代谢物中，雄甾烷-3-α，17-β-二醇（（雄甾烷酮; 0.8%/年）和雄甾烷酮葡糖苷酸（0.6%/年）下降速度低于游离睾酮，而5-α-二氢睾酮在39-70岁之间基本保持不变。雄烯二酮以1.3%/年的速度下降，与游离睾酮的速度相当，而肾上腺雄激素脱氢表雄酮（3.1%/年）及其硫酸盐（2.2%/年）下降速度快2-3倍。睾酮、SHBG和几种雄激素代谢产物的水平在第1组和第2组中遵循平行的过程，在整个研究的年龄范围内，第2组始终保持低10-15%。亚组分析表明，肥胖受试者可能是雄激素水平的组间差异的主要原因，雌激素和皮质醇的血清浓度并不随年龄变化或组间差异显着。在垂体促性腺激素中，FSH以1.9%/年的速度增加，LH以1.3%/年的速度增加，PRL以0.4%/年的速度下降，第1组和第2组之间没有显著差异。这项研究为一些激素年龄趋势提供了流行病学证据，这些趋势以前仅在较小的、未控制的或有疑问的代表性样本中记录。我们发现，健康男性（第1组）和不太健康的男性（第2组）之间在任何血清激素、代谢物或蛋白质浓度的变化百分比方面没有显著差异。在39-70岁之间保持的不太健康的男性中，睾酮、SHBG和一些雄激素代谢物的水平降低了10-15%，这可能是疾病的原因、影响或仅仅是相关因素。
To evaluate the hypothesis that endocrine profiles change with aging independently of specific disease states, we examined the age trends of 17 major sex hormones, metabolites, and related serum proteins in 2 large groups of adult males drawn from the Massachusetts Male Aging Study, a population-based cross-sectional survey of men aged 39-70 yr conducted in 1986-89. Group 1 consisted of 415 men who were free of obesity, alcoholism, all prescription medication, prostate problems, and chronic illness (cancer, coronary heart disease, hypertension, diabetes, and ulcer). Group 2 consisted of 1294 men who reported 1 or more of the above conditions.Each age trend was satisfactorily described by a constant percent change per yr between ages 39-70 yr. Free testosterone declined by 1.2%/yr, and albumin-bound testosterone by 1.0%/yr. Sex hormone-binding globulin (SHBG), the major serum carrier of testosterone, increased by 1.2%/yr, with the net effect that total serum testosterone declined more slowly (0.4%/yr) than the free or albumin-bound pools alone.Among the major androgens and metabolites, androstane-3-alpha,17-beta-diol (androstanediol; 0.8%/yr) and androstanediol glucuronide (0.6%/yr) declined less rapidly than free testosterone, while 5-alpha-dihydrotestosterone remained essentially constant between ages 39-70 yr. Androstenedione declined at 1.3%/yr, a rate comparable to that of free testosterone, while the adrenal androgen dehydroepiandrosterone (3.1%/yr) and its sulfate (2.2%/yr) declined 2-3 times more rapidly.The levels of testosterone, SHBG, and several androgen metabolites followed a parallel course in groups 1 and 2, remaining consistently 10-15% lower in group 2 across the age range of the study. Subgroup analyses suggested that obese subjects might be responsible for much of the group difference in androgen level.Serum concentrations of estrogens and cortisol did not change significantly with age or differ between groups. Of the pituitary gonadotropins, FSH increased at 1.9%/yr, LH increased at 1.3%/yr, and PRL declined at 0.4%/yr, with no significant difference between groups 1 and 2.This study provides epidemiological evidence for some hormone age trends that were previously documented only in smaller, uncontrolled, or questionably representative samples. We found no significant difference between healthy men (group 1) and less healthy men (group 2) with respect to the percent rate of change of any of the serum hormone, metabolite, or protein concentrations measured. The 10-15% lower levels of testosterone, SHBG, and some androgen metabolites in the less healthy men, which were maintained between ages 39-70 yr, might be causes, effects, or mere correlates of disease.