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目的 探讨中老年男性体质指数BMI与生殖激素水平关系.方法 研究共纳入954名40~80岁健康男性.检测其血清白蛋白(ALB)、总睾酮(TT)、黄体生成素(LH)和性激素结合球蛋白(SHBG),并计算游离睾酮(cFT)、生物可利用睾酮(Bio-t)、睾酮分泌指数(TSI)、游离睾酮指数(FTI)及BMI.使用STATA 14.0和SAS 9.2进行统计分析.结果 不同生殖激素在各BMI组间变化模式不同.当BMI≤20kg/m2时,TT、cFT和Bio-T随BMI增加而增加,LH随BMI增加而下降;当BMI在20~28 kg/m2之间时,TT、cFT和Bio-T呈下降趋势,但TT下降趋势更为明显,LH则呈上升趋势;当BMI≥28kg/m2时,cFT和Bio-T下降速度明显增大,LH上升速度明显增大.另外,SHBG随BMI增加而降低.方差分析结果与Logistic回归结果一致,显示超质量和肥胖组,TT或cFT缺乏、TSI低下风险显著增加(P<0.05).结论 过高或过低BMI与男性雄激素下降有关.将BMI控制在理想范围内有利于维持生殖激素代谢稳态.“,”Objective To analyze the associations between body mass index (BMI) and serum levels of reproductive hormones in middle-aged and elderly men. Methods A total of 954 men aged 40~80 were recruited from general healthy population in a cross-sectional study. Blood samples were collected to measure the serum levels of ALB (albumin), TT (total testosterone), LH (luteinizing hormone), SHBG (sex hormone-binding globulin), and cFT (calculated free testosterone). Bio-T (bioavailable testosterone), TT/LH, Free TT index, and BMI (Body mass index) were calculated. Data analyses were performed by Stata, version 14.0 and SAS, version 9.2. Results The patterns in reproductive hormones varied in different BMI groups. TT, cFT and Bio-t were increased with increase of BMI when BMI ≤20kg/m2. However, they started to decrease when BMI=20kg/m2. The levels of cFT and Bio-t decreased faster when BMI ≥28 kg/m2. LH was decreased with increase of BMI when BMI ≤20kg/m2, and started to increase when BMI=20 kg/m2, and LH increased faster when BMI≥28kg/m2. Except TT, when BMI was between 20kg/m2 and 28kg/m2, the slopes of cFT, Bio-T and LH were all very slow. SHBG was decreased with increase of BMI. Logistic model showed the risks of TT, cFT deficiency were increased significantly in overweight and especially obese men (P<0.05). Conclusion Higher or lower value of BMI might be associated with a decrease in androgen hormone levels in men. BMI within normal range benefits the balance of reproductive hormones.