Division of Gerontology & Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA; Geriatric Research, Education and Clinical Center, V.A. Puget Sound Health Care System, 1660 South Columbian Way (S-182-GRECC), Seattle, WA 98108, USA.
Endocrinol Metab Clin North Am. 2022 Mar;51(1):47-62. doi: 10.1016/j.ecl.2021.11.001. Epub 2022 Feb 8.
A systematic approach to diagnose hypogonadism initially establishes the presence of symptoms/signs of testosterone deficiency, considers other potential causes of manifestations, and excludes conditions that transiently suppress testosterone. Hypogonadism is confirmed by measuring fasting serum total testosterone in the morning on at least 2 separate days, or free testosterone by equilibrium dialysis or calculated free testosterone in men with conditions that alter sex hormone-binding globulin or serum total testosterone near lower limit of normal. To guide management, further evaluation is performed to identify the specific cause of hypogonadism and whether it is potentially reversible or an irreversible pathologic disorder.
一种系统性的诊断低睾丸激素血症的方法首先确定是否存在睾酮缺乏的症状/体征，考虑其他可能导致这些表现的潜在原因，并排除那些暂时抑制睾酮的情况。通过至少连续 2 天在早晨测量空腹血清总睾酮，或通过平衡透析法测量游离睾酮，或在改变性激素结合球蛋白或血清总睾酮接近正常值下限的情况下的男性中计算游离睾酮，来确认低睾丸激素血症。为了指导治疗，需要进一步评估以确定低睾丸激素血症的具体原因，以及它是否具有潜在的可逆转性或不可逆的病理障碍。
