Aggrawal Kamal, Madhu S V, Aggrawal Kireet, Kannan A T
Department of Community Medicine, University College of Medical Sciences, Dilshad Garden, Delhi-110095.
J Commun Dis. 2005 Sep;37(3):219-25.
Hypogonadism in male patients with Leprosy is common and may identify patients with future risk for bone loss and osteoporosis. In the present study, we evaluated gonadal function in 71 male patients with Leprosy both clinically and by estimation of serum testosterone levels. The patients belonged to selected rural areas of Uttar pradesh, with majority aged less than 50 yrs (74.6%), Hindus (66.7%), illiterate (60.9%), and of low socioeconomic status (58% with per capita income < Rs.500 per month). Most patients had multibacillary Leprosy (83.1%), duration less than 2 years (75.4%) and had received antileprosy drugs for less than a year (95.6 %). Seven patients (9.9%) had clinical features of hypogonadism such as gynaecomastia, decreased sexual hair and infertility. Serum testosterone levels, estimated in 31 of the patients, revealed low values in 25.8% (8/31) patients (Mean 4.65+/-3.37 ng/ml). Age, duration of Leprosy and socioeconomic status but not type of Leprosy or treatment duration affected hypogonadism significantly. The results of the present study indicate a high frequency of hypogonadism among rural male Leprosy patients that warrants routine screening to identify patients at risk for osteoporosis and possible prevention with testosterone replacement therapy.
男性麻风病患者性腺功能减退很常见,这可能预示着患者未来有骨质流失和骨质疏松的风险。在本研究中,我们通过临床评估和血清睾酮水平测定,对71例男性麻风病患者的性腺功能进行了评估。这些患者来自北方邦选定的农村地区,大多数年龄小于50岁(74.6%),为印度教徒(66.7%),文盲(60.9%),社会经济地位较低(58%的人均收入<每月500卢比)。大多数患者患有多菌型麻风病(83.1%),病程小于2年(75.4%),接受抗麻风病药物治疗少于1年(95.6%)。7例患者(9.9%)有性腺功能减退的临床特征,如男性乳房发育、性毛减少和不育。对31例患者进行血清睾酮水平测定,结果显示25.8%(8/31)的患者睾酮水平较低(平均4.65±3.37 ng/ml)。年龄、麻风病程和社会经济地位对性腺功能减退有显著影响,而麻风类型或治疗时间则无明显影响。本研究结果表明,农村男性麻风病患者中性腺功能减退的发生率较高,因此有必要进行常规筛查,以确定有骨质疏松风险的患者,并可能采用睾酮替代疗法进行预防。