Department of Urology, Korea University Medical Center and Korea University Institute of Regenerative Medicine, Seoul 136-705, Korea.
Asian J Androl. 2011 Jul;13(4):563-8. doi: 10.1038/aja.2010.124. Epub 2011 May 16.
Testosterone levels in men older than 40 years can decrease at a rate of 1%-2% per year, and reports show that more than 50% of 80-year-old men have testosterone levels consistent with hypogonadism. Late-onset hypogonadism (LOH) is a clinical and biochemical syndrome associated with advancing age and characterized by typical symptoms of serum testosterone deficiency. In recent decades, the concept of LOH in ageing men has become familiar in European countries and the United States. It is also a topic of interest and debate throughout Korea. However, most of the data regarding advantages or disadvantages of testosterone replacement therapy (TRT) as treatment for LOH have been primarily obtained from studies on Western populations; therefore, studies of the effects of TRT in Asian men, who may have different serum testosterone compared to Western men, are needed. TRT is commonly prescribed in Korea, despite the paucity of studies on the effects of TRT in Asian populations. Data from various TRT studies based on Korean have shown its efficacy in increasing serum testosterone levels and improving subjective symptoms as assessed by questionnaires. Currently, patches and short-acting intramuscular injections are displaced by gels and long-acting formulations. However, to prevent overdiagnosis and overtreatment, indication for TRT should include both low testosterone levels and symptoms and signs of hypogonadism.
男性 40 岁以后，血清睾酮水平每年以 1%-2%的速度下降，有报道称 80 岁以上男性中超过 50%的人存在符合性腺功能减退症的睾酮水平。迟发性性腺功能减退症（LOH）是一种与年龄增长相关的临床和生化综合征，其特征是血清睾酮缺乏的典型症状。近几十年来，LOH 在老年男性中的概念在欧洲国家和美国已广为人知。在韩国，它也是一个备受关注和争议的话题。然而，作为 LOH 治疗的睾酮替代疗法（TRT）的优势或劣势的数据主要来自对西方人群的研究；因此，需要对亚洲男性进行 TRT 影响的研究，因为亚洲男性的血清睾酮水平可能与西方男性不同。尽管亚洲人群中 TRT 的研究较少，但在韩国，TRT 仍被广泛应用。基于韩国的各种 TRT 研究的数据表明，它可以有效提高血清睾酮水平，并通过问卷调查改善主观症状。目前，贴片和短效肌内注射已被凝胶和长效制剂取代。然而，为了防止过度诊断和过度治疗，TRT 的适应证应包括低睾酮水平和性腺功能减退的症状和体征。
