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目的:探讨肥胖类型与性激素水平的关系。方法:采用横断面研究,以927例中老年男性为对象,统一获得其体质量指数(BMI)、腰高比(WHt R),测定血清总睾酮(TT)、性激素结合球蛋白(SHBG),并计算游离睾酮(c FT)和生物利用性睾酮(Bio-T),分析BMI、WHt R与性激素相关性,比较不同WHt R组性激素水平,并应用Logistic回归分析WHt R、肥胖类型与性激素低下关联。结果:WHt R与所有性激素指标TT、c FT、Bio-T和SHBG呈负相关(P<0.05),而BMI仅与TT、SHBG呈负相关(P<0.05);与低WHt R组(WHt R≤0.5)比,高WHt R组(WHt R>0.5)血清TT、c FT、Bio-T和SHBG均显著下降(P<0.05)。Logistic模型显示,双重肥胖组即BMI和WHt R都超标者,TT和c FT低下风险增加(P<0.05),但仅有一般性肥胖或中心性肥胖与TT、c FT低下关联未显示统计学差异(P>0.05)。结论:一般性肥胖和中心性肥胖共存是中老年男性血清TT、c FT低下的危险因素。
Objective: To investigate the relationship between obesity types and sex hormone levels. Methods: A total of 927 middle-aged and older men were recruited for the study. The body mass index (BMI), waist-height ratio (WHt R), total serum testosterone (TT) and sex hormone binding globulin (SHBG) Free testosterone (c FT) and bio-available testosterone (Bio-T) were calculated. The correlations between BMI and WHt R and sex hormones were analyzed. The levels of sex hormones in different WHt R groups were compared. Logistic regression analysis was used to analyze WHt R. . Results: WHt R was negatively correlated with all sex hormones TT, c FT, Bio-T and SHBG (P <0.05), while BMI only negatively correlated with TT and SHBG (P <0.05) R≤0.5), serum TT, c FT, Bio-T and SHBG in high WHt R group (WHt R> 0.5) decreased significantly (P <0.05). The Logistic model showed that the risk of TT and c FT was increased (P <0.05) in both obese patients, ie, those with BMI and WHt R overweight, but only general obesity or central obesity associated with TT and c FT was not statistically significant Difference (P> 0.05). Conclusions: The coexistence of general obesity and central obesity is a risk factor for low serum TT and c FT in middle-aged and elderly men.