Zhou Shan-Jie, Lu Wen-Hong, Yuan Dong, Li Hong, Shu Ru-Ming, Di Guan, Gu Yi-Qun
Department of Male Clinical Research, National Research Institute for Family Planning, Beijing 100081, China.
Zhonghua Nan Ke Xue. 2010 Feb;16(2):106-11.
To investigate the incidence of late onset of hypogonadism (LOH) in males as well as the sensitivity, specificity and applicability of the androgen deficiency in aging males (ADAM) questionnaire and the aging males' symptoms (AMS) scale in Chinese males based on the community population data.
A total of 1 498 old and middle-aged healthy males attended the ADAM and AMS investigations, of whom 434 received the measurement of the concentration of serum reproductive hormones, the positive rate of LOH screening, the rate of androgen deficiency, the clinical incidence of LOH, and the sensitivity and specificity of ADAM and AMS by tT and fT cut-off. The symptom evaluation cut-off value of the AMS score was optimized using the ROC curve.
Although 5 of the subjects had previously received irregular testosterone supplement, none of them was given or actively sought for androgen therapy at the time of the investigation. Among the 40 - 69 years old males, the mean positive rates of LOH screening by ADAM and AMS were 80.77% and 32.34%, and the mean androgen deficiency rates obtained by tT and fT cut-off were 14.02% and 43.69%. The mean clinical incidences of LOH in the ADMA- and AMS-positive subjects were 37.85% and 15.42%. According to the fT cut-off, the sensitivities of ADAM and AMS were 86.63% and 35.29%, and their specificities were 24.48% and 63.49%, respectively. The symptom evaluation cut-off value of the AMS score optimized by the ROC curve was 19.5.
The sensitivity and specificity of ADAM and AMS in the Chinese population are basically consistent with the results of most studies abroad, while the positive rate of LOH screening, the rate of androgen deficiency and the clinical incidence of LOH obviously higher in the former than those reported in other studies. Both ADAM and AMS are applicable to the Chinese population. The former is advantageous for its high sensitivity, time saving and easy operation, and therefore suitable for screening LOH, while the latter can be used for monitoring therapeutic efficacy.
基于社区人群数据，调查男性迟发性性腺功能减退（LOH）的发生率，以及衰老男性雄激素缺乏症（ADAM）问卷和衰老男性症状（AMS）量表在中国男性中的敏感性、特异性和适用性。
共有1498名中老年健康男性参加了ADAM和AMS调查，其中434人接受了血清生殖激素浓度测定、LOH筛查阳性率、雄激素缺乏率、LOH临床发生率以及通过总睾酮（tT）和游离睾酮（fT）临界值评估ADAM和AMS的敏感性和特异性。利用ROC曲线优化AMS评分的症状评估临界值。
虽然有5名受试者之前接受过不规律的睾酮补充，但在调查时均未接受或主动寻求雄激素治疗。在40 - 69岁男性中，ADAM和AMS筛查LOH的平均阳性率分别为80.77%和32.34%，通过tT和fT临界值获得的平均雄激素缺乏率分别为14.02%和43.69%。ADMA和AMS阳性受试者中LOH的平均临床发生率分别为37.85%和15.42%。根据fT临界值，ADAM和AMS的敏感性分别为86.63%和35.29%，特异性分别为24.48%和63.49%。通过ROC曲线优化的AMS评分症状评估临界值为19.5。
ADAM和AMS在中国人群中的敏感性和特异性与国外大多数研究结果基本一致，而前者的LOH筛查阳性率、雄激素缺乏率和LOH临床发生率明显高于其他研究报道。ADAM和AMS均适用于中国人群。前者具有高敏感性、省时且操作简便的优势，因此适用于LOH筛查，而后者可用于监测治疗效果。
