Arthritis Research U.K. Epidemiology Unit, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PT, United Kingdom.
J Clin Endocrinol Metab. 2012 May;97(5):1508-16. doi: 10.1210/jc.2011-2513. Epub 2012 Mar 14.
Late-onset hypogonadism (LOH) has been defined as a syndrome in middle-aged and elderly men reporting symptoms in the presence of low testosterone (T).
The objective of the study was to seek objective biochemical and end-organ evidence of androgen deficiency in men classified as having LOH according to our previously published criteria.
DESIGN, SETTING, AND PARTICIPANTS: The design of the study included cross-sectional data from the European Male Aging Study on 2966 community-dwelling men aged 40-79 years in eight European countries.
MAIN OUTCOME MEASURE(S): Waist circumference, body mass index, muscle mass, estimated heel bone mineral density (eBMD), hemoglobin, insulin sensitivity, physical activity, metabolic syndrome, insulin resistance index, and cardiovascular disease were measured.
Sixty-three men (2.1%) were classified as having LOH: 36 moderate and 27 severe. They were older and more obese than eugonadal men and had, in proportion to the graded T deficiency, lower muscle mass, eBMD, and hemoglobin, with poorer general health. Both moderate and severe LOH was associated with lower hemoglobin, mid-upper arm circumference, eBMD, physical function (measured by the Short Form-36 questionnaire), slower gait speed and poorer general health. Only men with severe LOH showed significant associations with larger waist circumference (β=1.93 cm; 0.04-3.81), insulin resistance (β=2.81; 1.39-4.23), and the metabolic syndrome (odds ratio 9.94; 2.73-36.22) after adjustments for confounders. Men with low testosterone only (irrespective of symptoms) showed lesser magnitudes of association with the same end points.
LOH is associated with multiple end-organ deficits compatible with androgen deficiency. These data support the existence of a syndrome of LOH in only a minority of aging men, especially those with T below 8 nmol/liter.
迟发性性腺功能减退症（LOH）被定义为中年和老年男性出现低睾酮（T）症状的综合征。
本研究的目的是在根据我们先前发表的标准分类为患有 LOH 的男性中，寻求雄激素缺乏的客观生化和终末器官证据。
设计、地点和参与者：该研究的设计包括来自欧洲男性衰老研究的横断面数据，该研究纳入了 8 个欧洲国家的 2966 名年龄在 40-79 岁的社区居住男性。
腰围、体重指数、肌肉量、估计跟骨骨密度（eBMD）、血红蛋白、胰岛素敏感性、身体活动、代谢综合征、胰岛素抵抗指数和心血管疾病。
63 名男性（2.1%）被归类为患有 LOH：36 名中度和 27 名重度。与性腺功能正常的男性相比，他们年龄更大，更肥胖，并且随着 T 缺乏程度的分级，肌肉量、eBMD 和血红蛋白更低，整体健康状况更差。中度和重度 LOH 均与较低的血红蛋白、中上臂周长、eBMD、身体功能（通过简短形式 36 问卷测量）、较慢的步态速度和较差的整体健康状况相关。只有重度 LOH 男性与更大的腰围（β=1.93cm；0.04-3.81）、胰岛素抵抗（β=2.81；1.39-4.23）和代谢综合征（比值比 9.94；2.73-36.22）显著相关，这些关联在调整混杂因素后仍然存在。仅患有低睾酮（无论有无症状）的男性与相同终点的关联程度较小。
LOH 与多种与雄激素缺乏相关的终末器官缺陷有关。这些数据支持只有少数衰老男性存在 LOH 综合征的存在，尤其是 T 低于 8nmol/L 的男性。
