Porav-Hodade Daniel, Gherasim Raul Dumitru, Kosovski Irina Bianca, Voidazan Toader Septimiu, Crisan Nicolae, Bogdan Petrut, Galis Radu, Feciche Bogdan Ovidiu, Ilona Mártha Orsolya Katalin, Todea-Moga Ciprian
Department of Urology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania.
Department of Urology, Clinical County Hospital Mures, 540136 Târgu Mures, Romania.
Diagnostics (Basel). 2025 Jan 27;15(3):294. doi: 10.3390/diagnostics15030294.
: The aim of this study was to investigate the relationship between age, the severity of erectile dysfunction (ED), and the various hormones that may influence erectile function. : A multicenter cross-sectional study was conducted between January 2015 and December 2023. The study assessed age, sexual function using the IIEF-15 questionnaire, and the levels of total testosterone (TT), free testosterone (FT), FSH, LH, estradiol, prolactin (PRL), and SHBG. : A total of 411 patients were included in the study. The mean age of the patients was 63.19 years. The vast majority (91.73%) exhibited some degree of ED. The severity of ED increases with age, ranging from 56.26 years for patients without ED to 73.12 years for those with severe ED. A statistically significant negative correlation was observed between IIEF and age, while a positive correlation was observed between IIEF and serum levels of TT and FT ( < 0.05). Age was significantly correlated with all evaluated hormones ( < 0.01), except estradiol and prolactin. Total testosterone levels progressively decreased with the increase in the severity of erectile dysfunction, from a median of 7.05 ng/mL in patients with normal erectile function to 3.56 ng/mL in those with severe symptoms, remaining above the normal minimum threshold across all groups, whereas free testosterone (FT) levels also declined progressively. All erectile dysfunction groups had median FT levels below the normal minimum threshold. FSH, LH, and SHBG showed an increase with each progressive severity of erectile dysfunction. The multivariate linear regression revealed that IIEF scores are significantly associated with age, TT, and FT levels, while FSH did not present a statistically significant association in this model. : Age shows a significant statistical correlation with both the severity of erectile dysfunction and the levels of total testosterone, free testosterone, LH, FSH, and SHBG. Total and free testosterone levels are significantly associated with the severity of erectile dysfunction, with free testosterone median values remaining above the normal minimum threshold in all patients with erectile dysfunction. Therefore, free testosterone should be considered a routine test, alongside total testosterone. In contrast, LH, estradiol, SHBG, and prolactin do not demonstrate any statistical correlation with erectile dysfunction and should not be recommended as routine investigations.
本研究的目的是调查年龄、勃起功能障碍（ED）的严重程度以及可能影响勃起功能的各种激素之间的关系。
2015年1月至2023年12月期间进行了一项多中心横断面研究。该研究评估了年龄、使用IIEF-15问卷评估的性功能以及总睾酮（TT）、游离睾酮（FT）、促卵泡生成素（FSH）、促黄体生成素（LH）、雌二醇、催乳素（PRL）和性激素结合球蛋白（SHBG）的水平。
共有411名患者纳入本研究。患者的平均年龄为63.19岁。绝大多数（91.73%）表现出一定程度的ED。ED的严重程度随年龄增加而增加，无ED患者的年龄为56.26岁，重度ED患者的年龄为73.12岁。观察到IIEF与年龄之间存在统计学显著负相关，而IIEF与TT和FT的血清水平之间存在正相关（<0.05）。年龄与所有评估的激素均显著相关（<0.01），但雌二醇和催乳素除外。随着勃起功能障碍严重程度的增加，总睾酮水平逐渐下降，勃起功能正常的患者中位数为7.05 ng/mL，症状严重的患者为3.56 ng/mL，所有组均保持在正常最低阈值以上，而游离睾酮（FT）水平也逐渐下降。所有勃起功能障碍组的FT中位数水平均低于正常最低阈值。随着勃起功能障碍严重程度的逐渐增加，FSH、LH和SHBG均升高。多元线性回归显示，IIEF评分与年龄、TT和FT水平显著相关，而在该模型中FSH未呈现统计学显著相关性。
年龄与勃起功能障碍的严重程度以及总睾酮、游离睾酮、LH、FSH和SHBG的水平均存在显著的统计学相关性。总睾酮和游离睾酮水平与勃起功能障碍的严重程度显著相关，所有勃起功能障碍患者的游离睾酮中位数均保持在正常最低阈值以上。因此，游离睾酮应与总睾酮一起被视为常规检查项目。相比之下，LH、雌二醇、SHBG和催乳素与勃起功能障碍无任何统计学相关性，不应推荐作为常规检查项目。
