[Features of steroidogenesis and arterial hypertension in men in different types of "physiological" male hyperandrogenism].

Q4 Medicine
V A Filatova, R V Rozhivanov, I Z Bondarenko, V A Ioutsi, E N Andreeva, G A Mel'nichenko, N G Mokrysheva
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引用次数: 0

Abstract

Aim: To reveal the peculiarities of steroidogenesis and arterial hypertension in «physiological» hyperandrogenism in men.

Materials and methods: One-stage simultaneous study. The groups of men with hyperandrogenism caused by increased total testosterone (n=34) and those with hyperandrogenism caused by increased dihydrotestosterone (DHT) (n=66) were compared. In determining the type of hyperandrogenism and allocating patients to groups, DHT and total testosterone levels were determined by enhanced chemiluminescence. Subgroups of men with and without arterial hypertension were compared in the group of patients with hyperandrogenism due to an increase in total testosterone. Body mass index, waist circumference, systolic and diastolic blood pressure, pulse, and LH, SBHG, estradiol, blood multisteroid levels by isotope dilution liquid chromatography/tandem mass spectrometry, glucose, blood lipid spectrum, uric acid, creatinine, renin, potassium, sodium, and blood chloride were assessed in all patients. Patients with arterial hypertension additionally underwent daily BP monitoring, albuminuria assessment, electrocardiography, ocular fundus examination. The baseline threshold level of significance was p<0.05. For multiple comparisons, the p significance level was calculated using the Bonferroni correction.

Results: Statistically significant differences were found in the levels of 17-hydroxypregnenolone, 17-hydroxyprogesterone, and androstenedione, which were higher in men with elevated levels of total testosterone. No statistically significant differences in other laboratory parameters were found. No cases of increased blood pressure were detected in the group of men with elevated DHT. In the group of men with elevated total testosterone, 23,5% of men with arterial hypertension without targetorgan lesions were identified, while hyperandrogenism was associated with 17,6% of cases. Arterial hypertension associated with hyperandrogenism was characterized by a rise in blood pressure in the early morning hours. Estradiol levels, while remaining within normal limits, were statistically significantly lower in patients with arterial hypertension compared with men with elevated testosterone but without hypertension.

Conclusion: No cases of arterial hypertension were observed in «physiological» hyperandrogenism due to elevated DHT levels, whereas its incidence in «physiological» hyperandrogenism due to elevated total testosterone was 23,5%. The features of steroidogenesis were increased production of 17-hydroxypregnenolone, 17-hydroxyprogesterone, and androstenedione in men with testosterone hyperandrogenism and decreased estradiol production in patients with arterial hypertension compared with patients without testosterone hyperandrogenism.

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[不同类型“生理性”男性高雄激素症男性类固醇生成和动脉高血压的特点]。
目的:揭示男性“生理性”高雄激素症中类固醇生成和动脉高血压的特点。材料与方法:一期同步研究。比较总睾酮升高引起的高雄激素症组(n=34)和双氢睾酮(DHT)升高引起的高雄激素症组(n=66)。在确定高雄激素症的类型和分配患者组时,DHT和总睾酮水平通过增强化学发光测定。在总睾酮升高引起的高雄激素症患者组中,对有和无动脉高血压的男性进行亚组比较。评估所有患者的体重指数、腰围、收缩压和舒张压、脉搏、LH、shhg、雌二醇、同位素稀释液相色谱/串联质谱法测定的血液多种类固醇水平、葡萄糖、血脂谱、尿酸、肌酐、肾素、钾、钠和血氯。动脉性高血压患者还接受每日血压监测、蛋白尿评估、心电图、眼底检查。基线阈值显著性水平为p<0.05。对于多重比较,使用Bonferroni校正计算p显著性水平。结果:17-羟基孕烯醇酮、17-羟基孕酮、雄烯二酮水平差异有统计学意义,总睾酮水平升高的男性其含量较高。其他实验室参数差异无统计学意义。在DHT升高的男性组中没有发现血压升高的病例。在总睾酮水平升高的男性组中,23.5%的男性动脉高血压患者没有靶器官病变,而高雄激素症患者的比例为17.6%。动脉高血压与高雄激素血症相关,其特征是清晨血压升高。动脉高血压患者的雌二醇水平虽然保持在正常范围内,但与睾酮升高但无高血压的男性相比,有统计学意义的雌二醇水平明显降低。结论:由于DHT水平升高而引起的“生理性”高雄激素症中未发现动脉高血压病例,而由于总睾酮水平升高而导致的“生理性”高雄激素症中动脉高血压的发生率为23.5%。甾体生成的特征是,与未患睾酮高雄激素症的患者相比,患有睾酮高雄激素症的男性体内17-羟基孕烯醇酮、17-羟基孕酮和雄烯二酮的分泌增加,而动脉高血压患者体内雌二醇的分泌减少。
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来源期刊
Problemy endokrinologii
Problemy endokrinologii Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
1.40
自引率
0.00%
发文量
59
期刊介绍: Since 1955 the “Problems of Endocrinology” (or “Problemy Endocrinologii”) Journal publishes timely articles, balancing both clinical and experimental research, case reports, reviews and lectures on pressing problems of endocrinology. The Journal is aimed to the most topical issues of endocrinology: to chemical structure, biosynthesis and metabolism of hormones, the mechanism of their action at cellular and molecular level; pathogenesis and to clinic of the endocrine diseases, new methods of their diagnostics and treatment. The Journal: features original national and foreign research articles, reflecting world endocrinology development; issues thematic editions on specific areas; publishes chronicle of major international congress sessions and workshops on endocrinology, as well as state-of-the-art guidelines; is intended for scientists, endocrinologists diabetologists and specialists of allied trade, general practitioners, family physicians and pediatrics.
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