Association between sex hormone levels and metabolic syndrome in a population of elderly men in Shanghai community
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摘要:
目的 探究上海市社区≥60岁老年男性人群中睾酮和雌二醇水平与代谢综合征(metabolic syndrome, MetS)以及MetS各组分之间的关联。 方法 本研究共纳入≥60岁上海市社区老年男性201名，通过问卷调查收集年龄、生活方式(包括吸烟、饮酒、身体活动情况)和既往病史信息。测量身高、体重、腰围、血压(blood pressure, BP)、空腹血糖(fasting plasma glucose, FPG)、三酰甘油(triglyceride, TG)、高密度脂蛋白(high-density lipoprotein cholesterol, HDL-C)、睾酮和雌二醇等指标。使用多元logistic回归分析模型分析性激素水平与MetS以及MetS各组分之间的关联。 结果 调整年龄、吸烟、饮酒、身体活动情况、BMI后，高睾酮水平与更低的MetS患病风险相关(OR=0.76, 95% CI: 0.61~0.95, P=0.016)。将睾酮进行三分位数分类，结果显示, 相较于最低水平组，最高水平组的MetS患病风险降低了66%(T3∶T1: OR=0.34, 95% CI: 0.13~0.90, P=0.030)；将雌二醇进行三分位数分类，结果显示, 相较于最低水平组，最高水平组的MetS患病风险降低了68%(T3∶T1: OR=0.32, 95% CI: 0.11~0.88, P=0.027)。对MetS各组分的分析结果表明，≥60岁老年男性中，高水平睾酮组的高血糖患病风险低。 结论 上海市社区老年男性血清睾酮及雌二醇水平与MetS风险呈负相关，睾酮与MetS组分中的高血糖风险呈负相关。 Abstract:Objective To investigate the association between testosterone and estradiol levels and the components of metabolic syndrome (MetS) in elderly men aged ≥ 60 years in Shanghai communities. Methods This study included a total of 201 elderly men aged ≥ 60 from Shanghai communities. Information on age, lifestyle (including smoking, drinking, and physical activity), and medical history was gathered via a questionnaire survey. Physical measurements included height, weight, waist circumference, blood pressure (BP), fasting plasma glucose (FPG), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and testosterone. A multivariate logistic regression model was employed to analyze the association between sex hormone levels and MetS and its components. Results After adjusting for age, smoking, drinking, physical activity, and BMI, high testosterone levels were associated with a lower risk of MetS (OR=0.76, 95% CI: 0.61-0.95, P=0.016). The results showed that compared with the lowest level group, the risk of MetS in the highest level group was reduced by 66% (T3∶T1: OR=0.34, 95% CI: 0.13-0.90, P=0.030); Compared with the lowest level group, the risk of MetS in the highest level group was reduced by 68% (T3∶T1: OR=0.32, 95% CI: 0.11-0.88, P=0.027). The analysis of MetS components showed that among older men ≥ 60 years old, the high-level testosterone group had a low risk of hyperglycemia. Conclusions The serum testosterone and estradiol levels of elderly men in Shanghai community were negatively correlated with MetS risk, and testosterone was negatively correlated with the risk of hyperglycemia in MetS components. -
Key words:
- Elderly men /
- Sex hormones /
- Metabolic syndrome /
- Metabolic syndrome components
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表 1 上海市松江区新桥街道新东苑社区≥60岁老年男性人群的特征描述
Table 1. Characteristics of elderly males aged ≥60 years in xindongyuan community, Xinqiao street, Songjiang District, Shanghai
变量Variable 总体Total①
(n=201)MetS组group ①
(n=49)非MetS组
Non-MetS group ①
(n=152)t/χ2值
valueP值
value年龄组/岁Age group/years 71.7±5.1 70.3±4.2 72.2±5.2 2.537 0.013 BMI/(kg·m-2) 24.6±3.4 27.1±3.3 23.8±3.1 -6.422 ＜0.001 吸烟Smoking 2.566 0.109 是Yes 75(37.3) 23(46.9) 52(34.2) 否No 126(62.7) 26(53.1) 100(65.8) 饮酒Drinking 0.011 0.916 是Yes 71(35.3) 17(34.7) 54(35.5) 否No 130(64.7) 32(65.3) 98(64.5) 身体活动情况Physical activity status 0.073 0.788 活跃Active 91(45.3) 23(46.9) 68(44.7) 不活跃Inactive 110(54.7) 26(53.1) 84(55.3) 婚姻状况Marital status 1.475 0.393 在婚Married 190(94.5) 48(98.0) 142(93.4) 未在婚Not married 11(5.5) 1(2.0) 10(6.6) 文化水平Education 0.888 0.641 文盲illiterate 31(15.4) 9(18.4) 22(14.5) 小学Primary 94(46.8) 24(49.0) 70(46.1) 初中及以上Junior high school or above 76(37.8) 16(32.6) 60(39.4) 卒中Stroke 10(5.0) 3(6.1) 7(4.6) 0.180 0.963 冠心病Coronary heart disease 16(8.0) 3(6.1) 13(8.6) 0.299 0.808 腰围Waist/cm 85.4±8.8 92.3±6.0 83.1±8.4 -7.025 ＜0.001 收缩压Systolic blood pressure/mmHg 132.2±16.7 139.7±17.4 129.8±15.7 -3.356 0.001 舒张压Diastolic blood pressure/mmHg 79.1±10.0 81.3±9.9 78.3±10.0 -1.754 0.084 HDL-C/(mmol·L-1) 1.3±0.5 1.0±0.2 1.4±0.5 8.213 ＜0.001 TG/(mmol·L-1), 1.4±0.8 2.1±1.1 1.1±0.4 -8.465 ＜0.001 FPG/(mmol·L-1) 5.8±1.2 6.5±1.7 5.6±1.0 -4.747 ＜0.001 睾酮Testosterone/(ng·mL-1) 5.8±2.1 4.8±1.7 6.1±2.1 4.708 ＜0.001 雌二醇Estradio/(pg·mL-1) 33.5±10.8 30.4±7.3 34.5±11.6 2.289 0.023 注：MetS，代谢综合征；HDL-C, 高密度脂蛋白；TG，三酰甘油；FPG，空腹血糖。
①以人数(占比/%)或x±s表示。
Note: MetS, metabolic syndrome; HDL-C, high-density lipoprotein cholesterol; TG, triglyceride; FPG, fasting plasma glucose.
① Number of people(proportion/%) or x±s.
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表 2 性激素与MetS的多因素logistic回归分析
Table 2. Multivariate logistic regression analysis of sex hormones and MetS
变量
Variable组别
GroupModel 1 Model 2 OR值value
(95% CI)P值
valueOR值value
(95% CI)P值
value睾酮Testosterone/(ng·mL-1) 定量资料Continuous variables 0.67(0.54~0.82) < 0.001 0.76(0.61~0.95) 0.016 T1 1.00 1.00 T2 0.36(0.14~0.95) 0.039 0.75(0.26~2.20) 0.603 T3 0.24(0.11~0.57) 0.001 0.34(0.13~0.90) 0.030 雌二醇Estradiol/(pg·mL-1) 定量资料Continuous variables 0.96(0.93~1.00) 0.026 0.96(0.92~1.00) 0.056 T1 1.00 1.00 T2 0.84(0.41~1.74) 0.644 0.79(0.34~1.81) 0.572 T3 0.29(0.11~0.73) 0.009 0.32(0.11~0.88) 0.027 注：MetS，代谢综合征；Model 1, 单变量模型；Model 2, 调整了年龄、吸烟、饮酒、身体活动情况和BMI。睾酮, T1, T≤5.00; T2, 5.00＜T＜6.73; T3, T≥6.73；雌二醇, T1, E2≤29.00; T2, 29.00＜E2＜37.00；T3, E2≥37.00。
Note: MetS, metabolic syndrome; Model 1, univariate model; Model 2, age, smoking, alcohol consumption, physical activity, and BMI were adjusted; Testosterone, T1, T≤5.00; T2, 5.00＜T＜6.73; T3, T≥6.73；Estradiol, T1, E2≤29.00; T2, 29.00＜E2＜37.00；T3, E2≥37.00.
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表 3 性激素与MetS亚组异常鉴别的logistic回归分析
Table 3. Logistic regression analysis of abnormal differentiation of sex hormones and MetS subgroups
变量
Variable组别
Group腰围Waist≥ 90 cm FPG≥6.1 /(mmol·L-1)或糖尿病
FPG≥ 6.1 /(mmol·L-1) or diabetesOR值value
(95% CI)P值
valueOR值value
(95% CI)P值
value睾酮Testosterone/(ng·mL-1) T1 1.00 1.00 T2 1.10 (0.32~3.73) 0.889 0.50 (0.19~1.32) 0.245 T3 0.83 (0.27~2.54) 0.557 0.44 (0.20~0.98) 0.044 雌二醇Estradiol/(pg·mL-1) T1 1.00 1.00 T2 0.53 (0.18~1.58) 0.549 1.03 (0.49~2.18) 0.098 T3 0.85 (0.27~2.67) 0.957 0.57 (0.24~1.32) 0.349 变量
Variable组别
GroupBP≥130/85 mmHg或高血压
BP ≥ 130/85 mmHg or hypertension空腹TG Fasting TG
≥ 1.7 /(mmol·L-1)空腹HDL-C Fasting HDL-C
＜1.04 /(mmol·L-1)OR值value
(95% CI)P值
valueOR值value
(95% CI)P值
valueOR值value
(95% CI)P值
value睾酮Testosterone/(ng·mL-1) T1 1.00 1.00 1.00 T2 0.58 (0.23~1.49) 0.578 0.71 (0.23~2.23) 0.646 0.83 (0.26~2.64) 0.975 T3 0.60 (0.28~1.32) 0.360 0.55 (0.21~1.42) 0.147 0.59 (0.23~1.53) 0.093 雌二醇Estradiol/(pg·mL-1) T1 1.00 1.00 1.00 T2 1.33 (0.60~2.98) 0.194 0.70 (0.29~1.70) 0.584 1.27 (0.51~3.14) 0.308 T3 1.04 (0.46~2.35) 0.846 0.50 (0.18~1.36) 0.161 0.91 (0.33~2.50) 0.842 注：MetS，代谢综合征；FPG，空腹血糖；BP，血压；TG，三酰甘油；HDL-C，低高密度脂蛋白；调整因素，年龄、身体活动情况、吸烟、饮酒和BMI。睾酮, T1, T≤5.00; T2, 5.00＜T＜6.73; T3, T≥6.73；雌二醇, T1, E2≤29.00; T2, 29.00＜E2＜37.00；T3, E2≥37.00。
Note: MetS, metabolic syndrome; FPG, fasting plasma glucose; BP, blood pressure; TG, triglyceride; HDL-C, high-density lipoprotein cholesterol; Adjusting factors, age, physical activity, smoking, alcohol consumption, and BMI; Testosterone, T1, T≤5.00; T2, 5.00＜T＜6.73; T3, T≥6.73；Estradiol, T1, E2≤29.00; T2, 29.00＜E2＜37.00；T3, E2≥37.00.
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