Corona G, Petrone L, Paggi F, Lotti F, Boddi V, Fisher A, Vignozzi L, Balercia G, Sforza A, Forti G, Mannucci E, Maggi M
Andrology Unit and Endocrinology Department of Clinical Physiopathology, University of Florence, 50139 Florence, Italy.
Int J Androl. 2010 Aug 1;33(4):574-80. doi: 10.1111/j.1365-2605.2009.00986.x. Epub 2009 Sep 25.
While the association of Klinefelter's Syndrome (KS) with infertility is well-known, very few investigations have evaluated the prevalence of sexual dysfunction in KS. The aim of the present study was to systematically analyse the prevalence of KS in a consecutive series of adult male patients consulting for sexual problems and to investigate its specific correlates. Among a consecutive series of 1386 men (mean age 48.9 +/- 12.7 years old), 23 (1.7%) subjects with KS were found. Patients with KS were younger and more often hypogonadal when compared with the rest of the sample. Among patients with KS, five (22.7%) subjects reported severe erectile dysfunction, 14 (60.9%) hypoactive sexual desire (HSD), two (9.5%) premature and two (9.5%) delayed ejaculation. Only the association between KS and HSD was confirmed after adjustment for age [HR = 3.2 (1.37-7.5)], however, when patients with KS were compared with age, smoking habit, and testosterone matched controls, even the association between KS with HSD disappeared. In comparison to matched hypogonadal controls, subjects with KS had lower levels of education, a higher frequency of cryptorchidism and poorer pubertal progression. In conclusion, our results indicate that sexual dysfunction present in KS is not specifically associated with the syndrome but is caused by the underlying hypogonadal state. Further studies are needed to evaluate the efficacy of testosterone substitution in ameliorating the hypoactive sexual desire often reported in subjects with KS.
虽然克氏综合征（KS）与不育症之间的关联广为人知，但很少有研究评估KS患者性功能障碍的患病率。本研究的目的是系统分析一系列因性问题前来咨询的成年男性患者中KS的患病率，并调查其具体相关因素。在连续的1386名男性（平均年龄48.9±12.7岁）中，发现了23名（1.7%）患有KS的受试者。与其余样本相比，KS患者更年轻，性腺功能减退的情况更常见。在KS患者中，5名（22.7%）受试者报告有严重勃起功能障碍，14名（60.9%）性欲减退（HSD），2名（9.5%）早泄，2名（9.5%）射精延迟。在对年龄进行调整后，仅证实了KS与HSD之间的关联[风险比（HR）=3.2（1.37 - 7.5）]，然而，当将KS患者与年龄、吸烟习惯和睾酮水平相匹配的对照组进行比较时，即使KS与HSD之间的关联也消失了。与匹配的性腺功能减退对照组相比，KS患者的教育水平较低，隐睾症发生率较高，青春期发育较差。总之，我们的结果表明，KS患者存在的性功能障碍并非与该综合征特异性相关，而是由潜在的性腺功能减退状态引起的。需要进一步研究来评估睾酮替代疗法在改善KS患者常报告的性欲减退方面的疗效。
