成都市社区中老年男性迟发性性腺功能减退症的年龄切点研究  

Age-specific Cut-off Point for the Determination of Populations of Late-onset Hypogonadism:a Study Conducted in Community-dwelling Middle-aged and Older Males in Chengdu

作　　者：杨帆[1] 蒋小波[2] 曹洪义[1] 唐毅[1] 杨婧[1] 任欣[1] 亢君[1] 万海艳[1] YANG Fan;JIANG Xiaobo;CAO Hongyi;TANG Yi;YANG Jing;REN Xin;KANG Jun;WAN Haiyan(Endocrinology and Metabolism Department,Chengdu Fifth People's Hospital,Chengdu 611130,China;Cardiovascular Department,Chengdu Fifth People's Hospital,Chengdu 611130,China)

机构地区：[1]四川省成都市第五人民医院内分泌代谢科,611130 [2]四川省成都市第五人民医院心血管内科,611130

出　　处：《中国全科医学》2019年第24期2996-2999,共4页Chinese General Practice

基　　金：四川省卫生和计划生育委员会科研项目(16PJ054)

摘　　要：背景男性迟发性性腺功能减退症(LOH)是一种与男性年龄增长相关的临床和生物化学综合征,严重影响患者的生活质量,并给多器官功能带来不良影响。目前国内外均没有较为统一的诊断标准,不同地区LOH发病率也存在一定差异。目的了解成都市社区中老年男性LOH的患病情况,并研究其LOH高危年龄切点。方法2017年5—8月采用分层抽样的方法在成都市温江区成都印钞公司社区固定人群中选取30~70岁的中老年男性800例,按照排除标准筛选出709例进行中老年男性雄激素缺乏(ADAM)量表调查,同时测定其血清总睾酮(TT)。采用χ^2检验比较不同年龄段中老年男性筛查阳性率,Spearman秩相关分析研究中老年男性筛查阳性情况与年龄之间的关系,受试者工作特征曲线(ROC曲线)确定LOH高危中老年男性年龄切点。结果709例研究对象中30~39岁231例(32.6%),40~49岁168例(23.7%),50~59岁178例(25.1%),60~69岁132例(18.6%)。ADAM量表、血清TT、ADAM量表联合血清TT筛查阳性率分别为67.1%、19.0%、17.9%。不同年龄段中老年男性ADAM量表、血清TT、ADAM量表联合血清TT筛查阳性率比较,差异有统计学意义(P<0.05)。ADAM量表、ADAM量表联合血清TT筛查阳性情况与年龄相关(rs=0.238、0.231,P<0.05)。ADAM量表、血清TT、ADAM量表联合血清TT筛查LOH的年龄切点分别为42.5、50.5、53.5岁。结论成都市社区中老年男性LOH患病率较高,且与年龄有一定的相关性,其LOH年龄切点范围为40~55岁。Background Male late-onset hypogonadism (LOH)is a clinical and biochemical syndrome associated with aging.It will severely affect the quality of life and bring adverse effects on multiple organs .At present,there is no unified diagnostic criteria at home and abroad,and the incidence of LOH varies in different regions.Objective To investigate the prevalence of LOH and identify age-specific cut-off point for the determination of LOH among community-dwelling middleaged and older males in Chengdu.Methods By use of stratified sampling,we selected 800 males aged 30-70 from the fixed populations living in Chengdu Banknote Printing Company Community in Chengdu's Wenjiang District during May to August 2017,and 709 of them including 231(32.6%) aged 30-39,168(23.7%) aged 40-49,178(25.1%) aged 50-59,and 132(18.6%) aged 60-69 were finally enrolled according to the exclusion criteria.The Androgen Deficiency in Aging Male(s ADAM) questionnaire was used to screen LOH.Serum total testosterone was measured to identify LOH.Chi-square test was used to compare the prevalence of LOH among different age groups.Spearman rank correlation analysis was used to explorethe relationship between age and the prevalence of LOH.ROC curve analysis was performed to determine the age-specific cut-off point for the determination of high risk population of LOH.Results The prevalence of LOH in all participants assessed by ADAM score,serum TT level, and ADAM score combined with serum TT level was 67.1%,19.0%,17.9%,respectively.The prevalence of LOH assessed by ADAM score,serum TT level,and ADAM score combined with serum TT level differed significantly between the four age groups(P<0.05).The prevalence of LOH in all participants assessed by ADAM score,or ADAM score combined with serum TT level increased with age(rs=0.238,0.231,P<0.05).The optimal age-specific cut-off points for the identification of LOH by ADAM score,serum TT level,and ADAM score combined with serum TT level were 42.5,50.5,53.5,respectively. Conclusion The prevalence of LOH in community-

关 键 词：性腺功能减退症 年龄因素 中老年男性雄激素缺乏调查量表 血清总睾酮 

分 类 号：R588[医药卫生—内分泌]