上海市某社区中老年男性勃起功能障碍与性激素的关系研究

目的:探索中老年男性勃起功能障碍(erectile dysfunction,ED)与多种性激素之间的关系。方法:对上海市某社区928名40~70岁中老年男性进行问卷调查,采用"勃起功能国际问卷-5(IIEF-5)"量表进行评估,并抽取空腹静脉血,采用免疫学方法测定血清总睾酮(TT)、游离睾酮(FT)、催乳素(PRL)、黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)及性激素结合球蛋白(SHBG)水平。按照各激素的四分位数点将对象分为4组(P0~P24组、P25~P49组、P50~P74组和P75~P100组),比较不同水平激素ED的患病风险。结果:40~50岁、51~60岁、61~70岁组的ED患病率分别为52.34%、73.14%、90.18%。调整潜在混杂因素后,FT水平的P0~P24组、P25~P49组、P50~P74组ED的患病危险性,比P75~P100组高,aOR分别为1.54、1.42、1.52,但其95%可信区间(95%CI)下限略小于1。PRL和FSH水平低的对象,患病风险较低;PRL水平在P0~P24组、P25~P49组、P50~P74组的aOR分别为0.61、0.79、0.58,除P25~P49组外,关联均有统计学意义;FSH水平在P0~P24组、P25~P49组、P50~P74组的aOR分别为0.55、0.48、0.60,除P50~P74组95%CI上限稍大于1外,关联均有统计学意义。而ED与TT、SHBG、LH、E2等的关联没有统计学意义。以上各激素与重度ED的关联均无统计学意义。结论:调整年龄及其他混杂因素后,ED与血清PRL、FSH水平存在统计学关联,与FT水平的关联较弱,与TT、LH、SHBG、E2水平的关联没有统计学意义。就现有研究结果,尚不能认为激素水平的变化对中老年人ED的发生起主要作用。

Relationship between Erectile Dysfunction and Sex Hormones in Middle-aged and Older Men in A Community in Shanghai

Objective: To investigate the relationship between erectile dysfunction(ED) and sex hormones in middle-aged and older men.Methods: A cross-sectional study was conducted among men aged 40-70 years old in a community in Shanghai.Participants’sexual function was assessed by international index of erectile function 5(IIEF-5),and their blood samples were collected.Total levels of testosterone(TT),free testosterone(FT),prolactin(PRL),luteinizing hormone(LH),follicle stimulating hormone(FSH),estradiol(E2) and sex hormone-binding globulin(SHBG) were measured by immunological methods.Results: The prevalence rate of ED was high in middleaged and older men,which were 52.34%,73.14%,90.18% for those aged 40-50 years,51-60 years and 61-70 years.After potential confounders were adjusted,men in the first three quartiles of FT level had higher risk of ED than those in the last quartile,the adjusted odds ratios(aOR) were 1.54,1.42 and 1.52,respectively,but the lower end of their 95% confidence intervals were slightly less than 1.Men with lower PRL or FSH had lower risk of ED: aORs for men in the first three quartiles of PRL level were 0.61,0.79 and 0.58,respectively,but the aOR for those in the second quartile was not signficant;aORs for men in the first three quartiles of FSH level were 0.55,0.48,0.60,respectively.But no statistically significant association was found among TT,SHBG,LH,E2 and ED.Conclusion: Lower level of FT and higher level of PRL,FSH were statistically associated with higher risk of ED,but no association between ED and hormones including TT,SHBG,LH,E2was observed.