Serum adiponectin levels in hypogonadal males: influence of testosterone replacement therapy
Serum adiponectin levels in hypogonadal males: influence of testosterone replacement therapy
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DOI：
10.1111/j.1365-2265.2004.02007.x
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发表时间：
2004-04-01
影响因子：
3.2
通讯作者：
Nieschlag, E
中科院分区：
文献类型：
--
作者：
Lanfranco, F;Zitzmann, M;Nieschlag, E
目的脂联素是一种脂肪细胞特异性分泌蛋白，具有抗动脉粥样硬化、抗炎和抗糖尿病的作用。我们假设睾酮在调节其分泌中起着重要作用，因为女性的脂联素浓度高于男性，并且睾酮给药伴随着动物血清脂联素的减少和培养脂肪细胞蛋白质分泌的减少。在一项回顾性研究中，对31名性腺功能减退男性[HM;年龄，平均± SEM：36.5 ± 2.4岁;体重指数（BMI）24.6 +/- 0.8 kg/m2]和29名体重匹配的性腺正常男性（EM;年龄30.8 +/- 1.5岁; BMI 23.4 +/- 0.6 kg/m2）。13例HM（年龄33.9 ± 3.2岁; BMI 24.2 ± 0.9 kg/m2）在睾酮替代治疗6个月后也评估了相同的参数。结果高脂血症患者血清睾酮、游离睾酮和雌二醇水平均显著低于高脂血症患者（HM中分别为4.4 +/- 0.4 nmol/l、78.4 +/- 10.9 pmol/l和36.1 +/- 3.0 pmol/l，而HM中分别为21.9 +/- 0.7 nmol/l、507.9 +/- 13.8 pmol/l和65.2 +/- 1.8 pmol/l，而HM的SHBG水平高于EM（54.4 +/- 7.5 vs. 30.9 +/- 2.2 nmol/l，P < 0.005）。HM组血清脂联素水平显著高于EM组（9.53 ± 0.73 vs.6.80 ± 0.55 μ g/ml，P < 0.01）。Pearson相关系数分析显示，人乳中脂联素水平与人体测量学和激素指标均无相关性，但与血清甘油三酯呈显著负相关（r =-0.38，P < 0.05）。EM患者血清脂联素水平与体重呈负相关（r =-0.41，P < 0.05），而与其他人体测量学、激素及生化指标无相关性。在开始睾酮替代治疗（将睾酮和游离睾酮水平升高至正常范围）后6个月，HM患者的脂联素水平显著降低。（6.37 +/- 0.93对9.26 +/- 1.01 μ g/ml，P < 0.01）并且与EM中记录的那些相似。性腺功能减退的男性表现出较高的脂联素水平，其通过睾酮替代疗法而降低。本研究表明，睾酮对人体脂联素的分泌具有调节作用。
OBJECTIVE Adiponectin is an adipocyte-specific secretory protein which exhibits antiatherogenic, anti-inflammatory and antidiabetic properties. We hypothesized that testosterone plays an important role in the regulation of its secretion in humans, as adiponectin concentrations are higher in women than in men and as testosterone administration is accompanied by a reduction in serum adiponectin in animals and by reduced protein secretion in cultured adipocytes. This study aimed to evaluate adiponectin levels in hypogonadal men prior to and during testosterone replacement therapy.SUBJECTS AND METHODS In a retrospective study, adiponectin, total and free testosterone, oestradiol, SHBG, total cholesterol and triglyceride levels were evaluated in 31 hypogonadal men [HM; age, mean +/- SEM: 36.5 +/- 2.4 years; body mass index (BMI) 24.6 +/- 0.8 kg/m(2)] and 29 weight-matched eugonadal men (EM; age 30.8 +/- 1.5 years; BMI 23.4 +/- 0.6 kg/m(2)). In 13 HM (age 33.9 +/- 3.2 years; BMI 24.2 +/- 0.9 kg/m(2)) the same parameters were also evaluated after 6 months of testosterone replacement therapy. Correlation analysis between adiponectin and hormonal, biochemical and anthropometric parameters was performed in all subjects.RESULTS Testosterone, free testosterone and oestradiol concentrations were significantly lower in HM than in EM (4.4 +/- 0.4 nmol/l, 78.4 +/- 10.9 pmol/l and 36.1 +/- 3.0 pmol/l, respectively, in HM vs. 21.9 +/- 0.7 nmol/l, 507.9 +/- 13.8 pmol/l and 65.2 +/- 1.8 pmol/l, respectively, in EM, P < 0.0001), while SHBG levels in HM were higher than in EM (54.4 +/- 7.5 vs. 30.9 +/- 2.2 nmol/l, P < 0.005). Serum adiponectin levels in HM were significantly higher than in EM (9.53 +/- 0.73 vs. 6.80 +/- 0.55 mug/ml, P < 0.01). Calculation of the Pearson coefficient showed that adiponectin levels in HM were not correlated with any of the anthropometric and hormonal parameters examined, but showed a significant negative correlation with serum triglycerides (r = -0.38, P < 0.05). Serum adiponectin levels were negatively correlated with body weight (r = -0.41, P < 0.05) in EM but not with other anthropometric, hormonal or biochemical parameters. Six months after initiation of testosterone replacement therapy, which increased testosterone and free testosterone levels to the normal range, adiponectin levels were significantly reduced in HM (6.37 +/- 0.93 vs. 9.26 +/- 1.01 mug/ml, P < 0.01) and similar to those recorded in EM.CONCLUSIONS Compared to eugonadal subjects, hypogonadal men show higher adiponectin levels which are reduced by testosterone replacement therapy. This study indicates that testosterone exerts a regulatory role on adiponectin secretion in humans.