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接受保守治疗的慢性肾脏病男性的性功能与睾酮水平

Sexual Function and Testosterone Level in Men With Conservatively Treated Chronic Kidney Disease.

作者信息

Fugl-Meyer Kerstin S, Nilsson Marie, Hylander Britta, Lehtihet Mikael

机构信息

1 Karolinska Institute, Stockholm, Sweden.

2 Karolinska University Hospital, Stockholm, Sweden.

出版信息

Am J Mens Health. 2017 Jul;11(4):1069-1076. doi: 10.1177/1557988317703207. Epub 2017 Apr 19.

Abstract

Sexual dysfunctions are common, but underrecognized, in patients with chronic kidney disease (CKD) and are inversely associated with the glomerular filtration rate (GFR). Sexual dysfunctions may affect quality of life in males with CKD. The aim of this study was to analyze the relationship among sex hormones, sexual function, and sexual satisfaction in a group of men between 18 and 50 years of age with CKD Stages 1 to 5 not treated with hemodialysis or peritoneal dialysis. Fasting blood samples for hemoglobin, testosterone, prolactin, and luteinizing hormone and questionnaire surveys (Sexual Complaints Screener for Men, International Index of Erectile Function, and Aging Male Symptom scale) were evaluated in 100consecutive men. Higher CKD stage (i.e., lower renal function) had a statistically significant ( p < .01) correlation with lower total testosterone, free testosterone, and hemoglobin levels, and higher luteinizing hormone and prolactin levels. Sexual function/dysfunctions were not significantly associated with CKD stage, even after adjustment for age and serum testosterone. The results indicate that CKD stage is a factor affecting testosterone levels in combination with age in men between 18 and 50 years of age at different stages of CKD but not treated with hemodialysis or peritoneal dialysis. Sexual dysfunctions are common but not strongly correlated to testosterone levels, prolactin levels, and survey (Sexual Complaints Screener for Men, International Index of Erectile Function, and Aging Male Symptom scale) responses in patients with CKD.

摘要

性功能障碍在慢性肾脏病(CKD)患者中很常见,但却未得到充分认识,且与肾小球滤过率(GFR)呈负相关。性功能障碍可能会影响CKD男性患者的生活质量。本研究的目的是分析一组年龄在18至50岁之间、处于CKD 1至5期且未接受血液透析或腹膜透析治疗的男性患者的性激素、性功能和性满意度之间的关系。对100名连续入选的男性进行了血红蛋白、睾酮、催乳素和黄体生成素的空腹血样检测以及问卷调查(男性性问题筛查量表、国际勃起功能指数和老年男性症状量表)。更高的CKD分期(即更低的肾功能)与更低的总睾酮、游离睾酮和血红蛋白水平以及更高的黄体生成素和催乳素水平具有统计学显著相关性(p <.01)。即使在对年龄和血清睾酮进行校正后,性功能/性功能障碍与CKD分期也无显著相关性。结果表明,在18至50岁、处于不同CKD阶段且未接受血液透析或腹膜透析治疗的男性中,CKD分期是一个与年龄共同影响睾酮水平的因素。性功能障碍很常见,但与CKD患者的睾酮水平、催乳素水平以及问卷调查(男性性问题筛查量表、国际勃起功能指数和老年男性症状量表)结果没有强烈相关性。

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本文引用的文献

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Effects of Testosterone Treatment in Older Men.睾酮治疗对老年男性的影响。
N Engl J Med. 2016 Feb 18;374(7):611-24. doi: 10.1056/NEJMoa1506119.
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Chronic kidney disease: global dimension and perspectives.慢性肾脏病:全球维度与展望。
Lancet. 2013 Jul 20;382(9888):260-72. doi: 10.1016/S0140-6736(13)60687-X. Epub 2013 May 31.

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