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  • 1 Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest
  • 2 Semmelweis Egyetem, Általános Orvostudományi Kar Élettani Intézet Budapest
  • 3 Semmelweis Egyetem, Általános Orvostudományi Kar Laboratóriumi Medicina Intézet Budapest Szentkirályi u. 46. 1088
  • 4 Péterfy Sándor utcai Kórház-Rendelőintézet és Baleseti Központ Mikrobiológiai Laboratórium Budapest
  • 5 Magyar Tudományos Akadémia–Általános Orvostudományi Kar, Semmelweis Egyetem Molekuláris Medicina Kutatócsoport Budapest
  • 6 Magyar Tudományos Akadémia–Semmelweis Egyetem „Lendület” Örökletes Endokrin Daganatok Kutatócsoport Budapest
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Férfiakban és nőkben a legfontosabb ösztrogénhatású hormon az ösztradiol. Férfiakban a magas ösztradiolkoncentráció és a következményes metabolikus eltérések népbetegségnek számító kórképek (cardiovascularis megbetegedések, inzulinrezisztencia, 2-es típusú diabetes mellitus) kialakulását befolyásolhatják; ösztrogéntúlsúly és tesztoszteronhiány társulása esetén növekszik ezeknek a betegségeknek a kockázata. Jelen közleményben a szerzők a férfiakban kialakuló androgénhiány és ösztrogéntúlsúly okait és következményeit, illetve a kezelési lehetőségeket foglalták össze. Orv. Hetil., 2014, 155(23), 891–896.

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  • Bulun, S. E., Sebastian, S., Takayama, K., et al.: The human CYP19 (aromatase P450) gene: update on physiologic roles and genomic organization of promoters. J. Steroid Biochem. Mol. Biol., 2003, 86(3–5), 219–224.

  • Chen, S. A., Besman, M. J., Sparkes, R. S., et al.: Human aromatase: cDNA cloning, Southern blot analysis, and assignment of the gene to chromosome 15. DNA, 1988, 7(1), 27–38.

  • Yeap, B. B., Alfonso, H., Chubb, S. A., et al.: Reference ranges and determinants of testosterone, dihydrotestosterone, and estradiol levels measured using liquid chromatography-tandem mass spectrometry in a population-based cohort of older men. J. Clin. Endocrinol. Metab., 2012, 97(11), 4030–4039.

  • Rothman, M. S., Carlson, N. E., Xu, M., et al.: Reexamination of testosterone, dihydrotestosterone, estradiol and estrone levels across the menstrual cycle and in postmenopausal women measured by liquid chromatography-tandem mass spectrometry. Steroids, 2011, 76(1–2), 177–182.

  • Muller, M., den Tonkelaar, I., Thijssen, J. H., et al.: Endogenous sex hormones in men aged 40–80 years. Eur. J. Endocrinol., 2003, 149(6), 583–589.

  • Vermeulen, A., Goemaere, S., Kaufman, J. M.: Testosterone, body composition and aging. J. Endocrinol. Invest., 1999, 22(5 Suppl.), 110–116.

  • Hemsell, D. L., Grodin, J. M., Brenner, P. F., et al.: Plasma precursors of estrogen. II. Correlation of the extent of conversion of plasma androstenedione to estrone with age. J. Clin. Endocrinol. Metab., 1974, 38(3), 476–479.

  • Van den Beld, A. W., de Jong, F. H., Grobbee, D. E., et al.: Measures of bioavailable serum testosterone and estradiol and their relationships with muscle strength, bone density, and body composition in elderly men. J. Clin. Endocrinol. Metab., 2000, 85(9), 3276–3282.

  • Rohrmann, S., Shiels, M. S., Lopez, D. S., et al.: Body fatness and sex steroid hormone concentrations in US men: results from NHANES III. Cancer Causes Control, 2011, 22(8), 1141–1151.

  • Simpson, E. R.: Sources of estrogen and their importance. J. Steroid Biochem. Mol. Biol., 2003, 86(3–5), 225–230.

  • Fukami, M., Shozu, M., Soneda, S., et al.: Aromatase excess syndrome: identification of cryptic duplications and deletions leading to gain of function of CYP19A1 and assessment of phenotypic determinants. J. Clin. Endocrinol. Metab., 2011, 96(6), E1035–E1043.

  • Carruba, G.: Aromatase in nontumoral and malignant human liver tissues and cells. Ann. N. Y. Acad. Sci., 2009, 1155, 187–193.

  • Moreau, F., Mittre, H., Benhaim, A., et al.: Aromatase expression in the normal human adult adrenal and in adrenocortical tumors: biochemical, immunohistochemical, and molecular studies. Eur. J. Endocrinol., 2009, 160(1), 93–99.

  • Rochira, V., Carani, C.: Aromatase deficiency in men: a clinical perspective. Nat. Rev. Endocrinol., 2009, 5(10), 559–568.

  • Bagatell, C. J., Knopp, R. H., Rivier, J. E., et al.: Physiological levels of estradiol stimulate plasma high density lipoprotein2 cholesterol levels in normal men. J. Clin. Endocrinol. Metab., 1994, 78(4), 855–861.

  • Cho, J. J., Cadet, P., Salamon, E., et al.: The nongenomic protective effects of estrogen on the male cardiovascular system: clinical and therapeutic implications in aging men. Med. Sci. Monit., 2003, 9(3), RA63–RA68.

  • Giri, S., Thompson, P. D., Taxel, P., et al.: Oral estrogen improves serum lipids, homocysteine and fibrinolysis in elderly men. Atherosclerosis, 1998, 137, 359–366.

  • Wang, F., Vihma, V., Badeau, M., et al.: Fatty acyl esterification and deesterification of 17beta-estradiol in human breast subcutaneous adipose tissue. J. Clin. Endocrinol. Metab., 2012, 97(9), 3349–3356.

  • Schneider, G., Kirschner, M. A., Berkowitz, R., et al.: Increased estrogen production in obese men. J. Clin. Endocrinol. Metab., 1979, 48(4), 633–638.

  • Zumoff, B., Strain, G. W., Kream, J., et al.: Obese young men have elevated plasma estrogen levels but obese premenopausal women do not. Metabolism, 1981, 30(10), 1011–1014.

  • Gates, M. A., Mekary, R. A., Chiu, G. R., et al.: Sex steroid hormone levels and body composition in men. J. Clin. Endocrinol. Metab., 2013, 98(6), 2442–2450.

  • Camacho, E. M., Huhtaniemi, I. T., O’Neill, T. W., et al.: Age-associated changes in hypothalamic-pituitary-testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing. Study. Eur. J. Endocrinol., 2013, 168(3), 445–455.

  • Loves, S., de Jong, J., van Sorge, A., et al.: Somatic and psychological effects of low-dose aromatase inhibition in men with obesity-related hypogonadotropic hypotestosteronemia. Eur. J. Endocrinol., 2013, 169(5), 705–714.

  • Wang, F., Vihma, V., Soronen, J., et al.: 17beta-estradiol and estradiol fatty acyl esters and estrogen-converting enzyme expression in adipose tissue in obese men and women. J. Clin. Endocrinol. Metab., 2013, 98(12), 4923–4931.

  • De Ronde, W., de Jong, F. H.: Aromatase inhibitors in men: effects and therapeutic options. Reprod. Biol. Endocrinol., 2011, 9, 93.

  • Vermeulen, A., Kaufman, J. M., Giagulli, V. A.: Influence of some biological indexes on sex hormone-binding globulin and androgen levels in aging or obese males. J. Clin. Endocrinol. Metab., 1996, 81(5), 1821–1826.

  • Plymate, S. R., Tenover, J. S., Bremner, W. J.: Circadian variation in testosterone, sex hormone-binding globulin, and calculated non-sex hormone-binding globulin bound testosterone in healthy young and elderly men. J. Androl., 1989, 10(5), 366–371.

  • Deslypere, J. P., Vermeulen, A.: Leydig cell function in normal men: effect of age, life-style, residence, diet, and activity. J. Clin. Endocrinol. Metab., 1984, 59(5), 955–962.

  • Vermeulen, A.: Androgen replacement therapy in the aging male – a critical evaluation. J. Clin. Endocrinol. Metab., 2001, 86(6), 2380–2390.

  • Mohr, B. A., Guay, A. T., O’Donnell, A. B., et al.: Normal, bound and nonbound testosterone levels in normally ageing men: results from the Massachusetts Male Ageing Study. Clin. Endocrinol. (Oxf.), 2005, 62(1), 64–73.

  • Bremner, W. J., Vitiello, M. V., Prinz, P. N.: Loss of circadian rhythmicity in blood testosterone levels with aging in normal men. J. Clin. Endocrinol. Metab., 1983, 56(6), 1278–1281.

  • Ferrini, R. L., Barrett-Connor, E.: Sex hormones and age: a cross-sectional study of testosterone and estradiol and their bioavailable fractions in community-dwelling men. Am. J. Epidemiol., 1998, 147(8), 750–754.

  • Morley, J. E., Perry, H. M. 3rd.: Androgen deficiency in aging men. Med. Clin. North Am., 1999, 83(5), 1279–1289, vii.

  • Harman, S. M., Metter, E. J., Tobin, J. D., et al.: Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J. Clin. Endocrinol. Metab., 2001, 86(2), 724–731.

  • Feldman, H. A., Longcope, C., Derby, C. A., et al.: Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging study. J. Clin. Endocrinol. Metab., 2002, 87(2), 589–598.

  • Morley, J. E., Charlton, E., Patrick, P., et al.: Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism, 2000, 49(9), 1239–1242.

  • Blümel, J. E., Chedraui, P., Gili, S. A., et al.: Is the Androgen Deficiency of Aging Men (ADAM) questionnaire useful for the screening of partial androgenic deficiency of aging men? Maturitas, 2009, 63(4), 365–368.

  • Tancredi, A., Reginster, J. Y., Schleich, F., et al.: Interest of the androgen deficiency in aging males (ADAM) questionnaire for the identification of hypogonadism in elderly community-dwelling male volunteers. Eur. J. Endocrinol., 2004, 151(3), 355–360.

  • Tajar, A., Huhtaniemi, I. T., O’Neill, T. W., et al.: Characteristics of androgen deficiency in late-onset hypogonadism: results from the European Male Aging Study (EMAS). J. Clin. Endocrinol. Metab., 2012, 97(5), 1508–1516.

  • Ding, E. L., Song, Y., Malik, V. S., et al.: Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta-analysis. JAMA, 2006, 295(11), 1288–1299.

  • Vikan, T., Schirmer, H., Njølstad, I., et al.: Low testosterone and sex hormone-binding globulin levels and high estradiol levels are independent predictors of type 2 diabetes in men. Eur. J. Endocrinol., 2010, 162(4), 747–754.

  • Tivesten, A., Hulthe, J., Wallenfeldt, K., et al.: Circulating estradiol is an independent predictor of progression of carotid artery intima-media thickness in middle-aged men. J. Clin. Endocrinol. Metab., 2006, 91(11), 4433–4437.

  • Abbott, R. D., Launer, L. J., Rodriguez, B. L., et al.: Serum estradiol and risk of stroke in elderly men. Neurology, 2007, 68(8), 563–568.

  • Yeap, B. B., Hyde, Z., Almeida, O. P., et al.: Lower testosterone levels predict incident stroke and transient ischemic attack in older men. J. Clin. Endocrinol. Metab., 2009, 94(7), 2353–2359.

  • Akishita, M., Hashimoto, M., Ohike, Y., et al.: Low testosterone level as a predictor of cardiovascular events in Japanese men with coronary risk factors. Atherosclerosis, 2010, 210(1), 232–236.

  • Haring, R., Teng, Z., Xanthakis, V., et al.: Association of sex steroids, gonadotrophins, and their trajectories with clinical cardiovascular disease and all-cause mortality in elderly men from the Framingham Heart Study. Clin. Endocrinol. (Oxf.), 2013, 78(4), 629–634.