【摘要】 目的 探讨睡眠不足与中青年男性性功能减退及血清睾酮(T)水平的关系。方法 选取2023年4月至2024年1月中国中医科学院广安门医院收治的225例中青年男性性功能减退患者作为研究对象，根据睡眠时长分为睡眠不足组(n=77)和睡眠正常组(n=148)。两组均填写问卷，并检测性激素水平。比较两组基线数据，采用Spearman法分析睡眠时长、血清T水平、性激素结合球蛋白(SHBG)水平、体重指数(BMI)与国际勃起功能指数-5(IIEF-5)评分及精简版中老年男性症状积分量表(c-AMS)性功能症状评分的相关性，进行睡眠时长、血清T水平与IIEF-5评分和c-AMS性功能症状评分的单因素与多因素回归分析，采用Bootstrap抽样法进行中介作用检验。结果 睡眠不足组BMI、c-AMS性功能症状评分高于睡眠正常组，IIEF-5评分、血清T水平、SHBG水平低于睡眠正常组(P<0.05)。睡眠时长与IIEF-5评分呈弱度正相关，与c-AMS性功能症状评分呈弱度负相关，与血清T水平呈中等强度正相关(P<0.01);血清T水平与IIEF-5评分呈弱度正相关，与c-AMS性功能症状评分呈弱度负相关(P<0.01)。与睡眠正常组比较，睡眠不足组IIEF-5评分更低、c-AMS性功能症状评分更高(P<0.05);血清T水平与IIEF-5评分和c-AMS性功能症状评分显著相关(P<0.05)。血清T水平在睡眠时长影响IIEF-5评分、c-AMS性功能症状评分过程中发挥部分中介作用，效应占比分别为25.017%和23.250%。结论 睡眠不足会导致中青年男性性功能减退，血清T水平下降是内在机制。更多还原

【Abstract】 Objective To investigate the correlation of sleep deprivation with reduced sexual function and serum testosterone(T) level in young and middle-aged men. Methods A total of 225 young and middle-aged male patients with reduced sexual function admitted to Guang′anmen Hospital, China Academy of Chinese Medical Sciences between April 2023 to January 2024 were selected as research subjects, and were divided into sleep deprivation group(n=77) and normal sleep group(n=148) according to sleep duration. Both groups filled out questionnaires and underwent sex hormone levels testing. The baseline data of the two groups were compared. Spearman method was used to analyze the correlation between sleep duration, serum T level, sex hormone binding globulin(SHBG) level, body mass index(BMI) and international index of erectile function-5(IIEF-5) score and simplified version of the middle-aged and elderly men′s symptom score scale(c-AMS) sexual function symptom score. Univariate and multivariate regression analysis were performed between sleep duration, serum T level and IIEF-5 score and c-AMS sexual function symptom score, and Bootstrap sampling method was used for mediation effect test. Results The BMI and c-AMS sexual dysfunction symptom score of the sleep-deprived group were higher than those of the normal sleep group, while the IIEF-5 score, serum T level, and SHBG level were lower than those of the normal sleep group(P<0.05). Sleep duration was weakly positively correlated with IIEF-5 score, weakly negatively correlated with c-AMS sexual function symptom score and moderately positively correlated with serum T level(P<0.01), Serum T level was weakly positively correlated with IIEF-5 score and weakly negatively correlated with c-AMS sexual function symptom score(P<0.01). The sleep deprivation group had lower IIEF-5 score and higher c-AMS score than the normal sleep group(P<0.05). Serum T level was significantly correlated with IIEF-5 score and c-AMS sexual function symptom score(P<0.05). Serum T level played a mediating effect in the influence of sleep duration on IIEF-5 score and c-AMS sexual function symptom score, with the effect proportions of 25.017% and 23.250%, respectively. Conclusions Sleep deprivation will lead to reduced sexual function in young and middle-aged men, and decreased serum T level is an intrinsic mechanism.更多还原