Friedrich Nele, Völzke Henry, Rosskopf Dieter, Steveling Antje, Krebs Alexander, Nauck Matthias, Wallaschofski Henri
Institute for Community Medicine, Ernst Moritz Arndt University, Walther Rathenau Str 48, D-17487 Greifswald, Germany .
J Androl. 2008 Nov-Dec;29(6):610-7. doi: 10.2164/jandrol.108.005561. Epub 2008 Jul 3.
Dehydroepiandrosterone (DHEA) is the main adrenal androgen, which mostly exists in a sulfated version (DHEAS). Both DHEA and DHEAS are metabolic intermediates in the biosynthesis of the male sex hormone testosterone. In men, testosterone is involved in the regulation of fertility, libido, and muscle mass and is valuable for the assessment of gonadal, adrenal, and pituitary function and for the diagnosis of hypogonadism. The objective of the present study was to calculate age-specific reference ranges for serum DHEAS and serum testosterone using 1) linear regression and the mean +/- 1.96 standard deviation concept and 2) quantile regression. From the cross-sectional Study of Health in Pomerania a total of 1078 men aged 20-79 years were included in the analyses. Serum DHEAS and testosterone levels were quantified using IMMULITE 2500 immunoassays. Linear and quantile regression were performed to calculate age-specific reference ranges. Both statistical methods generated different results: The reference ranges based on linear regression identified 17 men (1.6%) with DHEAS levels and 45 men (4.2%) with serum testosterone levels outside the reference range. Using quantile regression, 54 men (5.0%) and 50 men (4.6%) with serum DHEAS and testosterone levels outside the range were detected, respectively. The present study established age-specific reference ranges for serum DHEAS and testosterone levels for men. Quantile regression should be preferred to calculate reference ranges; a better concordance with original data is possible because no distribution assumption is required and the robustness against outliers is given.
脱氢表雄酮（DHEA）是主要的肾上腺雄激素，大多以硫酸化形式（DHEAS）存在。DHEA和DHEAS都是男性性激素睾酮生物合成过程中的代谢中间体。在男性中，睾酮参与生育能力、性欲和肌肉量的调节，对性腺、肾上腺和垂体功能的评估以及性腺功能减退的诊断具有重要价值。本研究的目的是使用1）线性回归和均值±1.96标准差概念以及2）分位数回归来计算血清DHEAS和血清睾酮的年龄特异性参考范围。从波美拉尼亚健康横断面研究中，共有1078名年龄在20至79岁的男性纳入分析。使用IMMULITE 2500免疫测定法定量血清DHEAS和睾酮水平。进行线性回归和分位数回归以计算年龄特异性参考范围。两种统计方法产生了不同的结果：基于线性回归的参考范围确定有17名男性（1.6%）的DHEAS水平以及45名男性（4.2%）的血清睾酮水平超出参考范围。使用分位数回归，分别检测到54名男性（5.0%）和50名男性（4.6%）的血清DHEAS和睾酮水平超出范围。本研究建立了男性血清DHEAS和睾酮水平的年龄特异性参考范围。计算参考范围时应优先选择分位数回归；由于无需分布假设且对异常值具有稳健性，所以可能与原始数据有更好的一致性。
