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目的 :探讨中老年男性睾酮水平与动脉粥样硬化之间的相关性。方法:选取2012年10月至2013年3月40~75岁的广州男性居民413例作为研究对象,收集人口学资料、临床资料及身体测量指标,实验室检测性激素、血糖、血脂等指标,彩色多普勒超声诊断仪测定颈动脉内膜中层厚度(CIMT)。结果:以CIMT=0.9 mm作为切点将人群分为颈动脉硬化组与非硬化组,游离睾酮(FT)在两组间的中位数分别为57.41 pmol/L及59.72 pmol/L(P=0.005),总睾酮(TT)两组间未见差异。Spearman相关分析提示TT、FT与CIMT呈负相关,r分别为-0.126(P=0.011)和-0.188(P<0.01)。以四分位数点作为切点由低到高将FT分为Q1、Q2、Q3、Q4组,各组颈动脉硬化患病率分别为23.30%、13.46%、17.48%、7.77%(P for trend=0.008)。TT各组颈动脉硬化的患病率分别为17.48%、18.27%、16.50%、9.71%(P for trend=0.116)。多因素Logistic回归分析评估FT各组颈动脉硬化患病优势比(OR)提示,以Q4组作为对照,在校正了年龄、腰围、收缩压、糖基化血红蛋白的影响后,Q1组的患病风险明显增高(OR1=2.491,95%CI:1.01~6.149)。同样在TT的分组中采取Logistic回归分析,以Q4组作为对照,各组患病风险未见明显差异。结论:中国40岁以上男性,血清FT低下可能是动脉粥样硬化的危险因素。
Objective: To investigate the correlation between testosterone level and atherosclerosis in middle-aged and elderly men. Methods: A total of 413 males from 40 to 75 years old in Guangzhou from October 2012 to March 2013 were selected as research objects to collect demographic data, clinical data and body measurements, laboratory tests of sex hormones, blood glucose, blood lipids and other indicators, color Doppler ultrasonography was used to measure carotid intima-media thickness (CIMT). Results: The population was divided into carotid atherosclerosis group and non-sclerotic group by CIMT = 0.9 mm. The median free testosterone (FT) in the two groups was 57.41 pmol / L and 59.72 pmol / L, respectively (P = 0.005), total testosterone (TT) no difference between the two groups. Spearman correlation analysis showed that TT, FT and CIMT were negatively correlated with r = -0.126 (P = 0.011) and -0.188 (P <0.01), respectively. FT was divided into Q1, Q2, Q3 and Q4 from low to high with the quartile as the cut-off point. The prevalences of carotid atherosclerosis in each group were 23.30%, 13.46%, 17.48% and 7.77%, respectively trend = 0.008). The prevalence of carotid atherosclerosis in TT group was 17.48%, 18.27%, 16.50% and 9.71%, respectively (P for trend = 0.116). Multivariate Logistic regression analysis was used to evaluate the prevalence odds ratio (OR) of carotid atherosclerosis in each group. Q4 group was used as a control. After adjustment for age, waist circumference, systolic blood pressure, and glycosylated hemoglobin, The risk was significantly higher (OR1 = 2.491, 95% CI: 1.01 ~ 6.149). Logistic regression analysis was also carried out in TT subgroups. Q4 group was used as control, and there was no significant difference in the risk of each group. Conclusion: Low serum FT may be a risk factor for atherosclerosis in Chinese men over the age of 40.