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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STATA14.0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/m~2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/m~2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/m~2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 explore the relationship between body mass index (BMI) and reproductive hormone in middle-aged and elderly men. Methods A total of 954 healthy men aged 40-80 years were included. Serum albumin (ALB), total testosterone (TT), luteinizing hormone (LH) and sex hormone binding globulin (SHBG) were measured and free testosterone (cFT), bioavailable testosterone Index (TSI), Free Testosterone Index (FTI) and BMI. Use STATA14.0 and SAS 9.2 for statistical analysis. Results Different reproductive hormones varied among BMI groups. When BMI≤20kg / m ~ 2, TT, cFT and Bio-T increased with the increase of BMI and LH decreased with the increase of BMI. When BMI was between 20 and 28 kg / m ~ 2, TT, cFT and Bio -T showed a downward trend, but the trend of TT decreased more obviously while that of LH increased. When the BMI≥28kg / m ~ 2, the decreasing speed of cFT and Bio-T increased obviously, and the rising speed of LH increased obviously. In addition, SHBG decreases with increasing BMI. ANOVA results were in good agreement with Logistic regression, indicating a lack of TT or cFT in the overweight and obese groups, with a significantly increased risk of low TSI (P <0.05). Conclusion High or low BMI is associated with decreased male androgen levels. Control of BMI in the ideal range is conducive to maintaining reproductive hormone metabolism and homeostasis.