Hypogonadism in patients with chronic obstructive pulmonary disease: relationship with airflow limitation, muscle weakness and systemic inflammation
Hypogonadism in patients with chronic obstructive pulmonary disease: relationship with airflow limitation, muscle weakness and systemic inflammation
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DOI：
10.1016/j.ajme.2015.01.002
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发表时间：
2016-03-01
影响因子：
0.9
通讯作者：
Khalil, Gihane Ibrahim
中科院分区：
文献类型：
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作者：
Daabis, Rasha Galal;Rehem, Rania Naguib Abdel;Khalil, Gihane Ibrahim
目的：了解男性慢性阻塞性肺疾病(COPD)患者性腺功能低下的发生率，研究其对骨骼肌功能的影响，评价全身炎症标志物对睾酮水平和肌肉功能的影响。方法：对50例稳定期男性COPD患者和30例健康男性患者进行炎症标志物(超敏C反应蛋白(hs-CRP)和白介素6(IL-6))、性激素(包括血清总(T)和游离睾酮(FT)、性激素结合球蛋白(SHBG)、黄体生成素(LH)、卵泡刺激素(FSH)和17b雌二醇水平(E_2)、6分钟步行距离(6MWT))和股四头肌肌力(1次重复最大肌力(1RM)和肌电图(EMG))检测。结果：COPD患者性腺功能减退症的发生率高于对照组(62%比17%)。血清睾酮水平(T、FT)与气道阻塞程度呈显著负相关。COPD患者股四头肌肌力和运动能力显着低于对照组，但与睾酮水平无相关性。COPD患者的炎症标志物显著高于对照组，且与气流阻塞的严重程度显著相关。Hs-CRP水平与股四头肌力量和运动能力呈负相关，而IL-6仅与股四头肌力量呈负相关。结论：性腺功能低下症在临床稳定的COPD患者中非常普遍，尤其与气道阻塞的严重程度有关。慢性阻塞性肺疾病稳定期患者存在全身炎症，其强度与基础疾病的严重程度有关，并易导致骨骼肌无力和运动耐量不足。然而，我们没有发现性腺功能减退与肌肉无力或全身炎症之间的显著联系。(C)2015年提交人。亚历山大大学医学院。爱思唯尔B.V.制作和主办。
Objectives: To determine the prevalence of hypogonadism in male patients with Chronic obstructive pulmonary diseases (COPD), and to study its impact on skeletal muscle dysfunction and assess the effect of systemic markers of inflammation on testosterone level and muscle function. The study included 50 stable male COPD patients and 30 controls.Methods: Both groups were subjected to the following measurements; inflammatory markers levels (high-sensitivity C-reactive protein (hs-CRP) and interleukin - 6 (IL-6)), sex hormones including; serum total (T) and free testosterone (FT), sex hormone binding globulins (SHBG), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and 17b estradiol levels (E2), the exercise capacity (6-minute walk distance (6MWT)) and quadriceps muscle force (One repetition maximum (1RM) and EMG). COPD patients underwent spirometry.Results: There was a higher prevalence of hypogonadism in COPD patients than the controls (62% versus 17%). There was a significant negative correlation between serum testosterone levels (T and FT) and the severity of airway obstruction. Quadriceps muscle force and the exercise capacity were significantly lower in COPD patients than controls but they showed no correlation with the testosterone level. Inflammatory markers were significantly higher in COPD patients compared to controls and showed a significant correlation with the severity of airflow obstruction. The higher inflammatory markers levels were related to more muscle weakness as hs-CRP was inversely correlated with the quadriceps strength and exercise capacity, while IL-6 was inversely correlated to quadriceps strength only.Conclusion: Hypogonadism is highly prevalent in clinically stable COPD patients and is particularly related to the severity of the airway obstruction. Systemic inflammation is present in stable COPD patients and its intensity is related to the severity of the underlying disease and it predisposes to skeletal muscle weakness and exercise intolerance. However, we failed to find a significant association between hypogonadism and muscle weakness or systemic inflammation. (C) 2015 The Authors. Alexandria University Faculty of Medicine. Production and hosting by Elsevier B.V.