Changes Of Sex Hormones And Shbg In Male Patients With Nephrotic Syndrome And Its Significance

BackgroundNephrotic syndrome(NS)can be caused by a variety of causes,the glomerular filtration membrane permeability increased significantly,the clinical manifestation of massive proteinuria(> 3.5 g / 24 hours),low albumin(< 30 g/L),hyperlipidemia,and edema.A large number of protein lost cause hypoalbuminemia,which is characterized of NS,causing substances such as protein,fat,carbohydrate metabolism disorder.Clinical studies showed and also confirmed that it is common in patients with chronic renal failure having the hypothalamus-pituitary-gonadal axis dysfunction.The main reason to decline is the low glomerular filtration rate and the accumulation of toxin.So sexual dysfunction is a common clinical symptoms of patients with chronic renal failure.When uremic stage is coming,the need for renal replacement therapy is necessary,and renal transplantation is recognized as the most effective method for treatment of uremia.Whether hemodialysis or peritoneal dialysis,the sex hormone levels and sexual dysfunction can not be obviously improved;But after renal transplantation,the patient's sex hormone levels and sexual dysfunction can get some relief.And in the clinical work,it is commonly found that the NS patients also are ill with sexual dysfunction.The presence of abnormal sex hormones levels rarely reported.The purpose of this paper is to explore the sex hormone metabolism and its possible relationship with sexual dysfunction.ObjectiveTo investigate the concentration of the sexual hormones and sex hormone binding globulin(SHBG)in male patients with primary nephrotic syndrome(PNS)and its clinical significance.Methods30 male patients with PNS were selected in the control group of 20 male healthy volunteers,using the method of chemiluminescence to detect the concentration of serum estradiol(E2),testosterone(T),prolactin(PRL),luteinizing hormone(LH),promote the follicle-stimulating hormone(FSH)and sex hormone binding globulin(SHBG),then compare the differences of two groups and discuss its clinical significance.Results(1)The level of the PNS group E2 significantly increased compared with normal control group(P < 0.001),FSH than normal control group decreased(P < 0.05),bioavailable testosterone than normal control group decreased(P < 0.05).T,LH,PRL,and SHBG was no statistical significance(P > 0.05).(2)E2 and age are positively correlated,r is 0.3,and negatively correlated with FSH,r is 0.5,P < 0.05,and no obvious correlation with SHBG;SHBG and T are positively correlated,r is 0.5,(P < 0.01).ConclusionsThe male patients with PNS have sex hormones metabolism disorder show off E2 increasing,bioavailable testosterone decreasing and FSH decreasing,and the changes have no obvious correlation with SHBG.