Практические аспекты лабораторного мониторинга эстрогенов у мужчин

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Андрология и генитальная хирургия. 2023; 24: 37-48

Практические аспекты лабораторного мониторинга эстрогенов у мужчин

Тюзиков И. А., Греков Е. А., Емельянова И. В., Смирнов А. В.

https://doi.org/10.17650/2070-9781-2023-24-4-37-48

Аннотация

С момента открытия эстрогенов в 30-х годах XX в. научно-практический интерес к ним был связан исключительно с вопросами женской эндокринологии, а физиология и патофизиология эстрогенов у мужчин ввиду исторически сложившейся трактовки роли этих стероидов исключительно лишь как женских половых гормонов долгое время оставались практически не изученными. Однако согласно классической теории стероидогенеза эстрогены являются конечным продуктом данного биохимического процесса, а тестостерон, помимо своих известных самостоятельных функций в мужском организме, выступает также в роли их биохимического прекурсора. Поэтому нормальная эндокринология половых стероидов у мужчин в принципе невозможна без участия эстрогенов, и в течение последних десятилетий накоплены убедительные научные данные, свидетельствующие о важных физиологических функциях эстрогенов в мужском организме.

В обзорной статье на основе данных литературы последних лет кратко рассматриваются ключевые аспекты клинической эндокринологии эстрогенов у мужчин и более подробно – современные возможности методов лабораторного мониторинга эстрогенов в сыворотке крови у мужчин и некоторые диагностические инструменты, позволяющие более полноценно и объективно интерпретировать результаты лабораторных методов определения эстрогенов, в частности соотношение тестостерон/эстрадиол. Показано, что расчет этого соотношения является более надежным методом оценки нарушений обмена эстрогенов в рутинной клинической практике, чем раздельное определение уровней половых стероидов в сыворотке крови, и может рассматриваться как важный маркер различных заболеваний у мужчин.

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Andrology and Genital Surgery. 2023; 24: 37-48

Practical aspects of laboratory monitoring of estrogens in men

Tyuzikov I. A., Grekov E. A., Emelyanova I. V., Smirnov A. V.

https://doi.org/10.17650/2070-9781-2023-24-4-37-48

Abstract

Since the discovery of estrogens in the 30s of the XX century, scientific and practical interest in them has been concentrated exclusively from the standpoint of female endocrinology, and the physiology and pathophysiology of estrogens in men, due to the historically established interpretation of the role of these steroids exclusively as female sex hormones, have remained practically unexplored for a long time. However, according to the classical theory of steroidogenesis, estrogens are the end product of this biochemical process, and testosterone, in addition to its well-known independent functions in the male body, also acts as their biochemical precursor. Therefore, normal endocrinology of sex steroids in men is in principle impossible without the participation of estrogens, and over the past decades, convincing scientific data have been accumulated indicating important physiological functions of estrogens in the male body. The review article, based on the literature of recent years, briefly examines the key aspects of clinical endocrinology of estrogens in men and describes in more detail the modern possibilities of methods for laboratory monitoring of estrogens in blood serum in men and some diagnostic tools that allow a more complete and objective interpretation of the results of laboratory methods for determining estrogens, in particular, testosterone/estradiol ratio. It is shown that the calculation of this ratio is a more reliable method for assessing estrogen metabolism disorders in routine clinical practice than the separate determination of serum levels of sex steroids, and can be considered as an important marker of various diseases in men.

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