【摘要】 目的:了解南京城区中老年男性生殖健康的基本情况。方法:随机对南京玄武区884例55~89岁的中老年男性进行常规体检,实验室检测血常规、肝肾功能、血糖、血脂及总前列腺特异性抗原(T-PSA)等指标,用放射免疫法测定血清总睾酮(TT)、游离睾酮(fT)、性激素结合球蛋白(SHBG)及黄体生成素(LH)等生殖激素指标。并收集119例20~39岁青年男性血清生殖激素指标作为对照。结果:中老年男性的生殖激素中除TT及E2之外,其他6项生殖激素及相关参数(LH、FSH、fT、SHBG、TSI、fTI)的中位数(50%位数)随年龄增加均呈现梯度性变化,LH、FSH及SHBG水平逐渐增高,而fT、TSI、fTI则逐渐降低。采用Mann-Whitney U法比较5个年龄组(20~39岁,55~59岁,60~69岁,70~79岁,≥80岁)两两之间的生殖激素或相关参数水平差异后发现:①TT水平,除了对照组与≥80岁年龄组、60~69岁组与≥80岁组间有统计学差异外(P<0.05),其他各组间均无统计学差异(P均>0.05);②E2水平,各组间均无统计学差异;③LH、FSH水平,除了55~59岁与60~69岁组间及FSH水平70~79岁与≥80岁组间无统计学差异外,其他各组间均有统计学差异;④fT、TSI水平,除了55~59岁组与60~69岁组间无统计学差异,其他各组间均有统计学差异;⑤SHBG及fTI水平,所有组间均有显著性差异。而对生殖激素及相关指标与年龄、LH等因素进行相关性分析后发现:fT、TSI、fTI与年龄、LH显著负相关(P<0.01,|r|>0.4),而与胆固醇、血糖及血红蛋白呈相对较弱的正相关(P<0.01,r<0.4);SHBG及LH与年龄呈显著正相关(P<0.01,r>0.4),SHBG与血糖及血红蛋白呈相对较弱的负相关(P<0.01,|r|<0.4),LH与血红蛋白呈相对较弱的负相关(P<0.01,|r|<0.4);TT与年龄呈相对较弱的负相关(P<0.01,|r|<0.4),而与血红蛋白呈相对较弱的正相关(P<0.01,r<0.4)。结论:随着年龄增长,中老年男性血清TT(fT更为明显)水平下降,并可能引起脂质代谢异常、血红蛋白降低及血糖升高。更多还原

【Abstract】 Objective: To investigate the status of male reproductive health among middle-aged and older men in the urban area of Nanjing. Methods: We collected the laboratory results of 884 middle-aged and older men aged 55- 89 years from the Xuanwu District of Nanjing present for routine physical examinations,including those of blood routine tests,liver and kidney function,blood glucose,blood lipid,and total prostate specific antigen( TPSA),as well as such reproductive hormone indexes as total serum testosterone( TT),free serum testosterone( fT),and sex hormone binding globulin( SHBG). We also obtained the above reproductive hormone indexes from 119 young and middle-aged men aged 20- 39 years as controls. Results: Aging-related changes were found in the 50 percentiles of all the reproductive hormones and relevant parameters but those of TT and E2,with gradual increases in LH,FSH and SHBG and decreases in fT,TSI and fTI. Comparison of reproductive hormones and relevant parameters by Mann-Whitney U test did not show any statistically significant differences in the TT level between any two of the five age groups( 20- 39,55- 59,60- 69,70-79,and ≥80 yr)( P > 0. 05) except between the control and ≥80 yr groups and the 60- 69 and ≥80 yr groups( P < 0. 05),nor in the E2 level between any two groups,nor in the levels of LH and FSH except between the 55- 59 and 60- 69 yr groups and the 70-79 and ≥80 yr groups,and nor in the levels of fT and TSI except between the 55- 59 and 60- 69 yr groups. However,there were significant differences in the levels of SHBG and fTI between any two age groups. Spearman correlation analysis revealed that fT,TSI, and fTI were correlated negatively with aging and LH( P < 0. 05,| r | > 0. 5) but weakly positively with cholesterol,blood glucose and hemoglobin( P < 0. 05,| r | < 0. 5),SHBG and LH positively with aging,SHBG weakly negatively with blood glucose and hemoglobin,LH weakly negatively with hemoglobin,and TT weakly negatively with aging but positively with hemoglobin. Conclusion: The levels of serum testosterone,particularly that of fT,declined with aging in middle-aged and older men in the urban area of Nanjing,which may contribute to abnormal lipid metabolism,low hemoglobin and high blood glucose.更多还原