van den Beld A W, Lamberts S W
Department of Internal Medicine III, Erasmus University Hospital, Rotterdam, The Netherlands.
Prostate Suppl. 2000;10:2-8. doi: 10.1002/1097-0045(2000)45:10+<2::aid-pros2>3.0.co;2-y.
Frailty is characterized by generalized weakness, impaired mobility and balance, and poor endurance. Loss of muscle strength is an important factor in the process of frailty, and is the limiting factor for an individual's chances of living an independent life until death. In men, several hormonal systems show a decline in activity during aging. Serum bioavailable testosterone (T) and estradiol (E2), dehydroepiandrosterone (DHEA) and its sulfate (DHEAS), and growth hormone (GH) and insulin-like growth factor (IGF)-I concentrations all decrease during aging in men. Physical changes during aging have been considered physiologic, but there is evidence that some of these changes are related to this decline in hormonal activity. In a cross-sectional study performed among 403 independently living elderly men, positive independent associations were observed between serum bioavailable T and muscle strength and bone mineral density (BMD). Serum T was negatively associated with fat mass. Serum luteinizing hormone (LH) increased with age and was inversely associated with T. Independent of T, LH was negatively related with muscle strength and positively with the number of problems in activities of daily living. Further, a positive relation was present between serum E2 and BMD. A positive association between DHEAS and BMD was dependent on T and E2 concentrations. Finally, in the same study, men with the highest E2 concentrations were significantly more satisfied with life, measured with a questionnaire developed by Herschbach and Huber, compared to men with the lowest E2 concentrations. In conclusion, these findings are in agreement with other studies, which suggest that the maintenance of a good physical functional ability and quality of life is related to serum T, E2, and DHEA(S) concentrations.
衰弱的特征是全身虚弱、行动和平衡能力受损以及耐力差。肌肉力量的丧失是衰弱过程中的一个重要因素，并且是个体独立生活直至死亡几率的限制因素。在男性中，几种激素系统在衰老过程中活性会下降。血清生物可利用睾酮（T）和雌二醇（E2）、脱氢表雄酮（DHEA）及其硫酸盐（DHEAS）、生长激素（GH）和胰岛素样生长因子（IGF）-I的浓度在男性衰老过程中均会降低。衰老过程中的身体变化一直被认为是生理性的，但有证据表明其中一些变化与激素活性的这种下降有关。在一项对403名独立生活的老年男性进行的横断面研究中，观察到血清生物可利用T与肌肉力量和骨矿物质密度（BMD）之间存在正相关的独立关联。血清T与脂肪量呈负相关。血清黄体生成素（LH）随年龄增长而升高，且与T呈负相关。独立于T之外，LH与肌肉力量呈负相关，与日常生活活动中的问题数量呈正相关。此外，血清E2与BMD之间存在正相关关系。DHEAS与BMD之间的正相关关系取决于T和E2的浓度。最后，在同一研究中，与E2浓度最低的男性相比，E2浓度最高的男性使用Herschbach和Huber编制的问卷测量时对生活的满意度明显更高。总之，这些发现与其他研究一致，表明维持良好身体功能能力和生活质量与血清T、E2和DHEA（S）浓度有关。
