Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
Unit of Endocrinology and Diabetes, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
Andrology. 2018 Sep;6(5):665-679. doi: 10.1111/andr.12506. Epub 2018 Jun 10.
Adult-onset hypogonadism is a syndrome often underdiagnosed, undertreated, or incompletely explored. There are various reasons for this: firstly, undefined age range of men in whom testosterone levels should be investigated and then no definitive serum cutoff point for the diagnosis of hypogonadism; and finally, variable and non-specific signs and symptoms; men and physicians do not pay adequate attention to sexual health. All these factors make the diagnostic criteria for hypogonadism controversial. The evaluation of the clinical features and causes of this syndrome, its link with age, the role of testosterone and other hormone levels, and the presence of any comorbidities are all useful factors in the investigation of this population. The purpose of this manuscript, after an accurate analysis of current literature, is to facilitate the diagnosis of hypogonadism in men through the use of the CATCH acronym and a checklist to offer a practical diagnostic tool for daily clinical practice. A narrative review of the relevant literature regarding the diagnosis of late-onset hypogonadism or adult-onset hypogonadism was performed. PubMed database was used to retrieve articles published on this topic. A useful new acronym CATCH (Clinical features [symptoms] and Causes, Age, Testosterone level, Comorbidities, and Hormones) and a practical checklist to facilitate the evaluation of hypogonadism in aging men were used. The evaluation of the clinical features and causes of hypogonadism, the link with age, the role of Testosterone and other hormones, and the evaluation of comorbidities are important in investigating adult-onset hypogonadism. The CATCH checklist could be helpful for clinicians for an early diagnosis of both hypogonadism and associated comorbidities. We suggest the use of this acronym to advocate the investigation of declining testosterone in aging men.
成人迟发性性腺功能减退症是一种经常被漏诊、治疗不足或未充分探索的综合征。造成这种情况的原因有很多:首先,没有明确应该检查哪些男性的睾丸激素水平,也没有明确的血清截断值来诊断性腺功能减退症;最后,症状和体征具有多变性和非特异性;男性和医生没有充分关注性健康。所有这些因素使得性腺功能减退症的诊断标准存在争议。评估这种综合征的临床特征和原因、它与年龄的关系、睾丸激素和其他激素水平的作用以及任何合并症的存在,都是对该人群进行调查的有用因素。本文通过使用 CATCH 缩写词和检查表,对当前文献进行了准确分析,旨在为男性性腺功能减退症的诊断提供便利,并提供一种实用的诊断工具,用于日常临床实践。对有关迟发性或成人性腺功能减退症诊断的相关文献进行了叙述性综述。使用 PubMed 数据库检索了关于该主题的文章。使用了一个有用的新缩写词 CATCH(临床特征[症状]和原因、年龄、睾丸激素水平、合并症和激素)和一个实用的检查表,以方便评估老年男性的性腺功能减退症。评估性腺功能减退症的临床特征和原因、与年龄的关系、睾丸激素和其他激素的作用以及合并症的评估在研究成人迟发性性腺功能减退症中非常重要。CATCH 检查表可以为临床医生提供帮助,以便早期诊断性腺功能减退症及其相关合并症。我们建议使用这个缩写词来倡导对老年男性睾丸激素下降的调查。