Cunningham Glenn R, Stephens-Shields Alisa J, Rosen Raymond C, Wang Christina, Ellenberg Susan S, Matsumoto Alvin M, Bhasin Shalender, Molitch Mark E, Farrar John T, Cella David, Barrett-Connor Elizabeth, Cauley Jane A, Cifelli Denise, Crandall Jill P, Ensrud Kristine E, Fluharty Laura, Gill Thomas M, Lewis Cora E, Pahor Marco, Resnick Susan M, Storer Thomas W, Swerdloff Ronald S, Anton Stephen, Basaria Shehzad, Diem Susan, Tabatabaie Vafa, Hou Xiaoling, Snyder Peter J
Division of Diabetes, Endocrinology and Metabolism (G.R.C.), Baylor College of Medicine and Baylor St. Luke's Medical Center, Houston, Texas 77030; Center for Clinical Epidemiology & Biostatistics (A.J.S., J.T.F., D.C., L.F.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; New England Research Institutes, Inc. (R.C.R.), Watertown, Massachusetts 02472; Division of Endocrinology (C.W., R.S.S.), Harbor-University of California at Los Angeles Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90502; Department of Biostatistics and Epidemiology (S.S.E., X.H.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Puget Sound Health Care System (A.M.M.), and Division of Gerontology and Geriatric Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington 98108; Research Program in Men's Health, Aging and Metabolism (S.B., S.B.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115; Division of Endocrinology, Metabolism and Molecular Medicine (M.E.M.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611; Department of Medical Social Sciences (D.C.), Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611; Division of Epidemiology, Department of Family and Preventative Medicine (E.B.), University of California San Diego School of Medicine, La Jolla, California 92093; Department of Epidemiology (J.A.C.), University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania 15261; Divisions of Endocrinology and Geriatrics (J.P.C., V.T.), Albert Einstein College of Medicine, Bronx, New York 10461; Department of Medicine (K.E.E., S.D.), Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota 55415; Minneapolis
J Clin Endocrinol Metab. 2015 Mar;100(3):1146-55. doi: 10.1210/jc.2014-3818. Epub 2014 Dec 30.
The prevalence of sexual dysfunction, low vitality, and poor physical function increases with aging, as does the prevalence of low total and free testosterone (TT and FT) levels. However, the relationship between sex hormones and age-related alterations in older men is not clear.
To test the hypotheses that baseline serum TT, FT, estradiol (E2), and sex hormone-binding globulin (SHBG) levels are independently associated with sexual function, vitality, and physical function in older symptomatic men with low testosterone levels participating in the Testosterone Trials (TTrials).
Cross-sectional study of baseline measures in the TTrials.
The study was conducted at 12 sites in the United States.
The 788 TTrials participants were ≥ 65 years and had evidence of sexual dysfunction, diminished vitality, and/or mobility disability, and an average of two TT < 275 ng/dL.
None.
Question 4 of Psychosocial Daily Questionnaire (PDQ-Q4), the FACIT-Fatigue Scale, and the 6-minute walk test.
Baseline serum TT and FT, but not E2 or SHBG levels had small, but statistically significant associations with validated measures of sexual desire, erectile function, and sexual activity. None of these hormones was significantly associated within or across trials with FACIT-Fatigue, PHQ-9 Depression or Physical Function-10 scores, or gait speed.
FT and TT levels were consistently, independently, and positively associated, albeit to a small degree, with measures of sexual desire, erectile function, and sexual activity, but not with measures of vitality or physical function in symptomatic older men with low T who qualified for the TTrials.
性功能障碍、活力低下和身体功能不佳的患病率随年龄增长而增加，总睾酮（TT）和游离睾酮（FT）水平降低的患病率也是如此。然而，老年男性性激素与年龄相关变化之间的关系尚不清楚。
检验以下假设：在参与睾酮试验（TTrials）的有症状且睾酮水平低的老年男性中，基线血清TT、FT、雌二醇（E2）和性激素结合球蛋白（SHBG）水平与性功能、活力和身体功能独立相关。
对TTrials中的基线测量进行横断面研究。
该研究在美国的12个地点进行。
788名TTrials参与者年龄≥65岁，有性功能障碍、活力下降和/或行动不便的证据，且平均两次TT<275 ng/dL。
无。
心理社会日常问卷（PDQ-Q4）的问题4、FACIT疲劳量表和6分钟步行试验。
基线血清TT和FT，但E2或SHBG水平与性欲、勃起功能和性活动的有效测量指标有小但具有统计学意义的关联。这些激素在试验内或试验间均与FACIT疲劳、PHQ-9抑郁或身体功能-10评分或步速无显著关联。
在符合TTrials条件的有症状且睾酮水平低的老年男性中，FT和TT水平始终、独立且呈正相关，尽管程度较小，与性欲、勃起功能和性活动的测量指标相关，但与活力或身体功能的测量指标无关。
