Department of Psychiatry, University of Groningen / University Medical Center Groningen, 9700 RB, PO Box 30.001 (CC 43), Groningen, The Netherlands.
Leiden University Medical Center, Department of Psychiatry, 2300 RC B1-P, Leiden, The Netherlands.
Psychoneuroendocrinology. 2021 Aug;130:105278. doi: 10.1016/j.psyneuen.2021.105278. Epub 2021 May 19.
Hypoandrogenic men showed a higher prevalence of major depressive disorder (MDD), which could be ascribed to overlapping symptoms such as sexual dysfunction, or additionally to core emotional symptoms such as sadness and anhedonia. We examined whether androgen levels 1) differ between men with and without MDD cross-sectionally, 2) are associated with an elevated risk for onset of MDD prospectively, and 3) associate with all individual MDD symptoms, or only with hypogonadism overlapping symptoms.
In 823 men (mean age 43.5 years), baseline plasma levels of total testosterone, 5α-dihydrotestosterone (5α-DHT), and androstenedione were determined with liquid chromatography-tandem mass spectrometry, and dehydroepiandrosterone-sulphate (DHEAS) and sex hormone binding globulin with radioimmunoassay, whereas free testosterone was calculated. MDD status was assessed at baseline and after two years using structured interviews and individual MDD symptoms were self-rated at baseline, and after one and two years.
None of the androgen levels were associated with current or onset (incidence or recurrence) of MDD. Free testosterone was only inversely associated with interest in sex. Also, androstenedione and DHEAS were positively associated with some individual MDD symptoms, and 5α-DHT levels showed non-linear associations (both with low and high levels) with MDD symptom severity and several individual MDD symptoms.
These results support the idea that circulating androgens synthesised by the testes are of limited clinical relevance to MDD in adult men, but levels of androstenedione, DHEAS and 5α-DHT may be associated with some individual MDD symptoms.
低雄激素男性表现出更高的重性抑郁障碍（MDD）患病率，这可能归因于重叠的症状，如性功能障碍，或者另外归因于核心情绪症状，如悲伤和快感缺失。我们研究了雄激素水平 1）是否在横断面的 MDD 男性和非 MDD 男性之间存在差异，2）是否与前瞻性 MDD 发病风险增加相关，以及 3）是否与所有个体 MDD 症状相关，或者仅与重叠的低雄激素症状相关。
在 823 名男性（平均年龄 43.5 岁）中，使用液相色谱-串联质谱法测定总睾酮、5α-二氢睾酮（5α-DHT）和雄烯二酮的基础血浆水平，用放射免疫法测定脱氢表雄酮硫酸盐（DHEAS）和性激素结合球蛋白，而游离睾酮则通过计算得出。在基线和两年后使用结构化访谈评估 MDD 状态，并且在基线、一年和两年后使用自我评估评估个体 MDD 症状。
没有任何雄激素水平与当前或发病（发生率或复发）的 MDD 相关。游离睾酮仅与性兴趣呈负相关。此外，雄烯二酮和 DHEAS 与一些个体 MDD 症状呈正相关，5α-DHT 水平与 MDD 症状严重程度和一些个体 MDD 症状呈非线性关联（均与低水平和高水平相关）。
这些结果支持循环睾丸激素对成年男性 MDD 的临床相关性有限的观点，但雄烯二酮、DHEAS 和 5α-DHT 的水平可能与某些个体 MDD 症状相关。
