Физиологическая роль и клиническое значение глобулина, связывающего половые гормоны, у мужчин
Автор: Рыжков А.И., Соколова С.Ю., Шорманов И.С.
Журнал: Экспериментальная и клиническая урология @ecuro
Рубрика: Андрология
Статья в выпуске: 2 т.17, 2024 года.
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Основные физиологические функции глобулина, связывающего половые гормоны (ГСПГ), в мужском организме транспорт половых стероидов в гидрофильной крови и создание буферной системы, сглаживающей колебания концентрации свободного тестостерона. Кроме этого, ГСПГ может ограничивать биологическую активность половых стероидов за счет снижения концентрации свободной фракции гормона, но только при нефункционирующей или неадекватно функционирующей оси гипоталамус-гипофиз-яички. При корректной работе механизма отрицательной обратной связи концентрация ГСПГ будет определять уровень общего тестостерона, но не окажет влияния на свободную фракцию и, соответственно, биологическую активность половых стероидов. Вероятно, у ГСПГ есть и иные функции, на что указывает наличие рецепторов ГСПГ в некоторых тканях и механизма транспорта ГСПГ внутрь клетки посредством эндоцитоза, но физиологическая роль этих процессов на сегодняшний день не ясна и требует дальнейшего изучения. С практической точки зрения определение уровня ГСПГ необходимо прежде всего для расчета уровня свободного тестостерона, так как точные методы прямого измерения свободного тестостерона недоступны в клинической практике. Диагностика гипогонадизма только на основании уровня общего тестостерона ассоциирована с риском гипердиагностики, так как концентрация ГСПГ в крови может оказывать существенное влияние на уровень общего тестостерона, не меняя при этом уровень свободного тестостерона. Перспективным представляется применение ГСПГ в качестве биомаркера ряда заболеваний и патологических состояний. Более низкие концентрации ГСПГ ассоциированы с повышенным риском сахарного диабета, метаболического синдрома и неалкогольной жировой болезнью печени (НАЖБП), а более высокие с повышенным риском остеопороза и переломов у пожилых мужчин. При этом открытым остается вопрос: является ли ГСПГ всего лишь биомаркером или вовлечен в патогенез развития данных заболеваний?
Глобулин, связывающий половые гормоны, гспг, мужской гипогонадизм, свободный тестостерон
Короткий адрес: https://sciup.org/142242606
IDR: 142242606 | DOI: 10.29188/2222-8543-2024-17-2-45-51
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