Kupelian Varant, Shabsigh Ridwan, Travison Thomas G, Page Stephanie T, Araujo Andre B, McKinlay John B
New England Research Institutes, 9 Galen Street, Watertown, MA 02472, USA.
J Urol. 2006 Dec;176(6 Pt 1):2584-8. doi: 10.1016/j.juro.2006.08.020.
The prevalence of erectile dysfunction increases as men age. Simultaneously, age related changes occur in male endocrine functioning. We examined the association between erectile dysfunction and total testosterone, bioavailable testosterone, sex hormone-binding globulin and luteinizing hormone.
Data were obtained from the Massachusetts Male Aging Study, a population based cohort study of 1,709 men. Self-reported erectile dysfunction was dichotomized as moderate or severe vs none or mild. Odds ratios and 95% CI were used to assess the association between sex hormone levels and erectile dysfunction. Multiple logistic regression models were used to adjust for potential confounders including age, body mass index, partner availability, phosphodiesterase type 5 inhibitor use, depression, diabetes and heart disease.
Using data from the most recent followup, analyses were conducted on 625 men with complete data. A moderate decrease in erectile dysfunction risk was observed with increasing total testosterone and bioavailable testosterone levels. However, this effect was not apparent after controlling for potential confounders. Increased luteinizing hormone levels (8 IU/l or greater) were associated with a higher risk of erectile dysfunction (adjusted OR 2.91, 95% CI 1.55-5.48) compared to luteinizing hormone levels less than 6 IU/l. A significant interaction between luteinizing hormone and total testosterone levels showed that increased testosterone levels were associated with a decrease in risk of erectile dysfunction among men with luteinizing hormone levels greater than 6 IU/l.
In this large population based cohort of older men we found no association among total testosterone, bioavailable testosterone, sex hormone-binding globulin and erectile dysfunction. Testosterone levels were associated with a decrease in risk of erectile dysfunction only in men with increased luteinizing hormone levels.
勃起功能障碍的患病率随男性年龄增长而增加。同时，男性内分泌功能也会出现与年龄相关的变化。我们研究了勃起功能障碍与总睾酮、生物可利用睾酮、性激素结合球蛋白和促黄体生成素之间的关联。
数据来自马萨诸塞州男性衰老研究，这是一项基于人群的队列研究，共有1709名男性参与。自我报告的勃起功能障碍被分为中度或重度与无或轻度。比值比和95%置信区间用于评估性激素水平与勃起功能障碍之间的关联。多元逻辑回归模型用于调整潜在的混杂因素，包括年龄、体重指数、伴侣情况、5型磷酸二酯酶抑制剂的使用、抑郁、糖尿病和心脏病。
利用最近一次随访的数据，对625名有完整数据的男性进行了分析。随着总睾酮和生物可利用睾酮水平的升高，勃起功能障碍风险有适度降低。然而，在控制潜在混杂因素后，这种效应并不明显。与促黄体生成素水平低于6 IU/l相比，促黄体生成素水平升高（8 IU/l或更高）与勃起功能障碍风险更高相关（调整后的比值比为2.91，95%置信区间为1.55 - 5.48）。促黄体生成素和总睾酮水平之间存在显著交互作用，表明在促黄体生成素水平大于6 IU/l的男性中，睾酮水平升高与勃起功能障碍风险降低相关。
在这个基于人群的大型老年男性队列中，我们发现总睾酮、生物可利用睾酮、性激素结合球蛋白与勃起功能障碍之间无关联。仅在促黄体生成素水平升高的男性中，睾酮水平与勃起功能障碍风险降低相关。
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