Rabijewski Michał, Papierska Lucyna, Kuczerowski Roman, Piątkiewicz Paweł
Department of Internal Diseases, Diabetology and Endocrinology, Medical University of Warsaw, Poland.
Department of Endocrinology, Medical Centre for Postgraduate Education, Warsaw, Poland.
Clin Interv Aging. 2015 Aug 20;10:1381-91. doi: 10.2147/CIA.S88499. eCollection 2015.
Andropausal and depressive symptoms are common in aging males and may be associated with hormone deficiency. We investigated the severity of andropausal and depressive symptoms, as well as their hormonal determinants, in 196 middle-aged and elderly men (age range: 40-80 years) with prediabetes (PD) and in 184 healthy peers. PD was diagnosed according to the definition of the American Diabetes Association. The severity of andropausal and depressive symptoms was assessed using the Aging Males' Symptoms Rating Scale and the Self-Rating Depression Scale. Total testosterone (TT), calculated free testosterone (cFT), dehydroepiandrosterone sulfate (DHEAS), and insulin-like growth factor 1 (IGF-1) were measured. The prevalence of andropausal syndrome in men with PD was significantly higher than that in healthy men (35% vs 11%, respectively). In men with PD aged 40-59 years, the severity of sexual, psychological, and all andropausal symptoms was greater than in healthy peers, while in elderly men (60-80 years), only the severity of psychological symptoms was greater than in healthy peers. The severity of depressive symptoms in the middle-aged men with PD was greater than in healthy peers, while the severity of depressive symptoms in elderly men with PD and healthy peers was similar. The higher prevalence of andropausal symptoms was independently associated with cFT and IGF-1 in middle-aged men and with TT and DHEAS in elderly men with PD. The more severe depression symptoms were associated with low TT and DHEAS in middle-aged men and with low cFT and DHEAS in elderly men with PD. In conclusion, the prevalence of andropausal symptoms, especially psychological, was higher in prediabetic patients as compared to healthy men, while the severity of depressive symptoms was higher only in middle-aged men with PD. Hormonal determinants of andropausal and depressive symptoms are different in middle-aged and elderly patients, but endocrine tests are necessary in all men with PD.
男性更年期症状和抑郁症状在老年男性中很常见，可能与激素缺乏有关。我们调查了196名患有糖尿病前期（PD）的中老年男性（年龄范围：40 - 80岁）和184名健康同龄人中男性更年期症状和抑郁症状的严重程度及其激素决定因素。根据美国糖尿病协会的定义诊断PD。使用男性更年期症状评定量表和自评抑郁量表评估男性更年期症状和抑郁症状的严重程度。测量总睾酮（TT）、计算游离睾酮（cFT）、硫酸脱氢表雄酮（DHEAS）和胰岛素样生长因子1（IGF - 1）。患有PD的男性中男性更年期综合征的患病率显著高于健康男性（分别为35%和11%）。在40 - 59岁患有PD的男性中，性、心理和所有男性更年期症状的严重程度高于健康同龄人，而在老年男性（60 - 80岁）中，只有心理症状的严重程度高于健康同龄人。患有PD的中年男性抑郁症状的严重程度高于健康同龄人，而患有PD的老年男性和健康同龄人抑郁症状的严重程度相似。男性更年期症状较高的患病率在中年男性中与cFT和IGF - 1独立相关，在患有PD的老年男性中与TT和DHEAS独立相关。更严重的抑郁症状在中年男性中与低TT和DHEAS相关，在患有PD的老年男性中与低cFT和DHEAS相关。总之，与健康男性相比，糖尿病前期患者中男性更年期症状的患病率，尤其是心理症状更高，而抑郁症状的严重程度仅在患有PD的中年男性中更高。男性更年期和抑郁症状的激素决定因素在中年和老年患者中有所不同，但所有患有PD的男性都需要进行内分泌检查。
