Department of Clinical Biochemistry, Black Country Pathology Services, Walsall Manor Hospital, Walsall, United Kingdom; School of Medicine and Clinical Practice, Faculty of Science & Engineering, The University of Wolverhampton, United Kingdom.
School of Health and Life Sciences, Aston University, Birmingham, England, United Kingdom.
Clin Chim Acta. 2021 Oct;521:64-69. doi: 10.1016/j.cca.2021.06.026. Epub 2021 Jun 25.
As circulating testosterone may be suppressed in the post-prandial state, it has been recommended that measurements are carried out with the patient fasted.
In this regard, we assessed the effect of fasting/non-fasting status on total testosterone (T) levels in men.
Data was collected in a single UK Hospital in men with two serum T requests taken within a 6-month period of each other and sampled at a time of day ≤ 2 h apart. Three groups were established, with T levels compared via signed-rank test in men with both a fasting and non-fasting sample (Group 1; n = 69), and in men with paired non-fasting (Group 2; n = 126) and paired fasting (Group 3; n = 18) samples. The differences in T levels between the paired samples was compared between the three groups using the rank-sum test and also via multiple regression analysis with the groups factorised.
Median (Interquartile Range, IQR) age did not vary significantly between Groups 1, 2 and 3 at 49 (38-56), 51.5 (42-60) and 51.5 (40-59) years, respectively. No significant difference (p = 0.89) was found between the T levels in Group 1 with non-fasting (median (IQR) T = 11.1 (9.3-13.6) nmol/L) versus fasting samples T = 10.8 (8.9-14.1) nmol/L). Paired T levels did not significantly differ in each of the other two groups (2 and 3). There was no significant association between the differences in paired T levels between the three groups, even when the model was adjusted for age and time, with Group 1 (as reference) versus Group 2 (p = 0.79) and versus Group 3 (p = 0.63).
We found no significant differences between fasting and non-fasting T levels. A definitive confirmatory study is required to determine whether fasting status is necessary to diagnose hypogonadism.
Non-requirement of fasting status when checking testosterone levels would remove a major hurdle in the diagnosis of hypogonadism.
由于循环睾酮在餐后状态下可能会受到抑制，因此建议在患者空腹时进行测量。
在这方面，我们评估了禁食/不禁食状态对男性总睾酮（T）水平的影响。
在英国的一家单一医院中收集数据，在 6 个月内对两名男性进行了两次血清 T 请求，并在一天内 ≤ 2 小时的时间间隔内进行了采样。通过符号秩检验比较了三组中既有空腹样本又有非空腹样本的男性（第 1 组；n=69）、既有配对非空腹样本（第 2 组；n=126）和配对空腹样本（第 3 组；n=18）的 T 水平。使用秩和检验比较了三组之间配对样本之间 T 水平的差异，并通过多因素回归分析将组因素化。
第 1 组、第 2 组和第 3 组的中位（四分位距，IQR）年龄分别为 49（38-56）、51.5（42-60）和 51.5（40-59）岁，差异无统计学意义。第 1 组非空腹（中位数（IQR）T=11.1（9.3-13.6）nmol/L）与空腹样本 T=10.8（8.9-14.1）nmol/L）之间的 T 水平无显著差异（p=0.89）。其他两组（第 2 组和第 3 组）的配对 T 水平也无显著差异。即使调整了年龄和时间，三组之间配对 T 水平差异之间也没有显著关联，第 1 组（作为参考）与第 2 组（p=0.79）和第 3 组（p=0.63）之间也没有显著关联。
我们发现禁食和非禁食 T 水平之间没有显著差异。需要进行一项明确的验证性研究来确定是否需要禁食状态来诊断性腺功能减退症。
在检查睾酮水平时不需要禁食状态，可以消除诊断性腺功能减退症的主要障碍。
