Department of Cancer Epidemiology and Prevention, Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland.
Clin Endocrinol (Oxf). 2011 Aug;75(2):232-9. doi: 10.1111/j.1365-2265.2011.04043.x.
Physiologic processes during ageing leading to multi-morbidity and diseases that increase risk of premature death may be influenced by ageing-associated changes in endogenous hormone production.
To evaluate the decline in sex steroid hormone levels across age and estimate the number of US men 40+ years old who may have low hormone levels.
We measured serum testosterone, oestradiol and sex hormone binding globulin by immunoassay in 1351 men 20+ years old in Third National Health and Nutrition Examination Survey. We estimated free hormones by mass action.
Free testosterone declined most rapidly with age (a 2% decline in geometric mean concentration occurred after ageing 1·3 years), followed by total testosterone (2·4 years), free oestradiol (4·1 years) and total oestradiol (8·1 years). These hormone changes with age translated into 25·0% and 30·2% of men 70+ years old having low total (which we defined as <10·4 nm) and free (<0·17 nm) testosterone, respectively, and 8·3% and 23·9% having low total (<73·4 pm) and free (<2·2 pm) oestradiol. Using population size projections between the 2000 and 2010 Censuses, we estimated that 8·4 (95% CI 4·7-12·2), 6·2 (3·1-9·2) and 6·0 (3·1-9·0) million men 40+ years old may have low total testosterone, free testosterone and free oestradiol, respectively. The prevalences were only modestly lower in men without prevalent chronic diseases.
Although no consensus exists for defining low hormone levels in ageing men, a substantial number of US men may have low sex steroid hormone levels, possibly putting them at risk for adverse health consequences and premature death.
衰老过程中的生理变化导致多种疾病和增加过早死亡风险的疾病，可能受到与衰老相关的内源性激素产生变化的影响。
评估不同年龄段性激素水平的下降，并估计美国 40 岁以上男性中可能存在低激素水平的人数。
我们在第三次国家健康和营养检查调查中测量了 1351 名 20 岁以上男性的血清睾酮、雌二醇和性激素结合球蛋白，通过免疫测定法。我们通过质量作用估计游离激素。
游离睾酮随年龄下降最快（每增加 1.3 岁，几何平均浓度下降 2%），其次是总睾酮（2.4 岁）、游离雌二醇（4.1 岁）和总雌二醇（8.1 岁）。这些与年龄相关的激素变化导致 70 岁以上的男性中有 25.0%和 30.2%的人总睾酮（我们定义为<10.4nm）和游离睾酮（<0.17nm）水平较低，分别有 8.3%和 23.9%的人总雌二醇（<73.4pm）和游离雌二醇（<2.2pm）水平较低。根据 2000 年和 2010 年人口普查之间的人口规模预测，我们估计分别有 840 万（95%可信区间 470-1220 万）、620 万（310-920 万）和 600 万（310-900 万）40 岁以上的男性可能存在总睾酮、游离睾酮和游离雌二醇水平较低。在没有慢性疾病的男性中，患病率略低。
尽管目前对于定义衰老男性的低激素水平尚无共识，但相当数量的美国男性可能存在低性激素水平，这可能使他们面临不良健康后果和过早死亡的风险。
