Hamanoue Nobuya, Tanabe Makito, Tanaka Tomoko, Akehi Yuko, Murakami Junji, Nomiyama Takashi, Yanase Toshihiko
Department of Endocrinology and Diabetes Mellitus, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan.
Department of Bioregulatory Science of Life-related Diseases, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan.
Endocr J. 2017 May 30;64(5):521-530. doi: 10.1507/endocrj.EJ16-0619. Epub 2017 Mar 30.
An age-associated androgen decrease and its pathological conditions are defined as late-onset hypogonadism (LOH). Among the various symptoms associated with LOH, a visceral fat increase is strongly associated with relatively low levels of testosterone. However, few studies have investigated the relationship between the Aging Males' Symptoms (AMS) scores and metabolic abnormalities. Thus, we aimed to clarify this relationship by investigating the relationship between AMS scores and various markers in blood. During routine health examinations in 241 middle-aged males (52.7±7.5 years of age, mean±SD), 150 males (62.2%) displayed higher AMS values than normal. No statistical association was observed between total AMS scores and any testosterone value. All mental, physical and sexual AMS subscales were significantly positively correlated with insulin levels and HOMA-IR. Only sexual subscale scores were significantly inversely associated with free or bioavailable testosterone level. Males with insulin resistance (HOMA-IR≥2.5) demonstrated significantly higher AMS scores than those with normal insulin sensitivity (HOMA-IR<2.5). AMS values were positively correlated with fasting blood glucose, insulin and HOMA-IR values. Interestingly, univariate and multivariate analyses revealed that HOMA-IR≥2.5 was a significant predictor for detection of moderately severe AMS values (AMS≥37), whereas AMS≥37 was not a predictor of metabolic syndrome by International Diabetes Federation (IDF) criterion. In conclusion, almost 60% of healthy male subjects displayed abnormal AMS scores. AMS values were not associated with testosterone values but rather were related to insulin resistance, particularly in subjects with moderately severe AMS values. Insulin resistance-related general unwellness might be reflected by AMS values.
与年龄相关的雄激素减少及其病理状况被定义为迟发性性腺功能减退（LOH）。在与LOH相关的各种症状中，内脏脂肪增加与相对较低的睾酮水平密切相关。然而，很少有研究调查老年男性症状（AMS）评分与代谢异常之间的关系。因此，我们旨在通过研究AMS评分与血液中各种标志物之间的关系来阐明这种关系。在对241名中年男性（年龄52.7±7.5岁，均值±标准差）进行常规健康检查期间，150名男性（62.2%）的AMS值高于正常水平。总AMS评分与任何睾酮值之间均未观察到统计学关联。所有精神、身体和性方面的AMS子量表均与胰岛素水平和HOMA-IR显著正相关。只有性方面的子量表评分与游离或生物可利用睾酮水平显著负相关。胰岛素抵抗（HOMA-IR≥2.5）的男性的AMS评分显著高于胰岛素敏感性正常（HOMA-IR<2.5）的男性。AMS值与空腹血糖、胰岛素和HOMA-IR值呈正相关。有趣的是，单因素和多因素分析显示，HOMA-IR≥2.5是检测中度严重AMS值（AMS≥37）的重要预测指标，而按照国际糖尿病联盟（IDF）标准，AMS≥37并不是代谢综合征的预测指标。总之，近60%的健康男性受试者的AMS评分异常。AMS值与睾酮值无关，而是与胰岛素抵抗有关，特别是在中度严重AMS值的受试者中。与胰岛素抵抗相关的全身不适可能通过AMS值反映出来。
