中国全科医学2017，Vol.20Issue(33)：4130-4135,6.DOI:10.3969/j.issn.1007-9572.2017.00.061
老年男性症状量表评分预测社区中老年男性血清睾酮相关指标异常的价值研究
Value of the Aging Males' Symptoms Scale Score in Predicting the Abnormality of Serum Testosterone-related Markers in Community-dwelling Middle-aged and Elderly Men
摘要
Abstract
Objective To explore the value of the Aging Males' Symptoms Scale (AMS) score in predicting the abnormality of serum testosterone-related markers [total testosterone (TT),sex hormone binding globulin (SHBG),luteinizing hormone (LH),calculated free testosterone (cFF),free testosterone index (FTI) and testosterone secretion index (TSI)] in community-dwelling middle-aged and elderly men,in order to provide a reference for clinical screening and diagnosis of LOH.Methods According to the economic characteristics and people's way of life,the communities in Zunyi City,China were divided into three layers:urban communities,township communities and rural communities.From each layer,7 communities/neighborhood committees/villages were randomly selected as the sampling places at a ratio of 1 ∶ 10 from August to September 2013 by stratified and cluster sampling.And from these places,a total of 1 166 qualifying data were collected from male residents aged 20 or over.Based on the serum testosterone-related markers levels of 227 20-39-year-old residents,the abnormal cut-off points of male serum testosterone-related markers were established.The data of 939 males aged 40 or over were employed to evaluate the value of AMS sore in predicting the abnormality of serum testosterone-related markers.The residents were surveyed by a self-developed questionnaire consisting of demographic data,family medical history,medical history,and AMS score (LOH symptoms were identified by AMS score ≥27,and residents with AMS score ＜27 were considered to have no LOH symptoms).The serum TT,SHBG,LH were measured,and cFT,FTI and TSI were calculated.Results Of the 939 males aged 40 or over,628 (66.9％) had LOH symptoms,36 (3.8％) had abnormal TT (25 were accompanied by concomitant LOH symptoms),203 (21.6％) had abnormal SHBG (155 were accompanied by concomitant LOH symptoms),57 (6.1％) had abnormal LH (53 were accompanied by concomitant LOH symptoms),136 (14.5％) had abnormal cFT (110 were accompanied by concomitant LOH symptoms),271 (28.9％) had abnormal FTI (213 were accompanied by concomitant LOH symptoms),249 (26.5％) had abnormal TSI (200 were accompanied by concomitant LOH symptoms).There was no significant difference in TT between residents with LOH symptoms and those without (P ＞ 0.05).Residents with LOH symptoms had higher SHBG and LH,but lower cFT,FTI and TSI compared with those without (P ＜ 0.05).The prevalence of abnormal TT did not differ significantly between residents with LOH symptoms and those without (P ＞ 0.05).The prevalence of abnormal SHBG,LH,cFT,FTI and TSI was found to be higher in residents with LOH symptoms (P ＜ 0.05).The accuracy of AMS score (≥27) for predicting abnormal TT was low (34.61％),and the accuracy of AMS score (≥27) for predicting abnormal FTI and TSI were high (49.63％,49.20％ respectively).The Kappa value of AMS score for predicting abnormal TT was 0.003 (P =0.739).And its Kappa value for predicting the abnormal SHBG,LH,cFT,FTI and TSI were respectively 0.069,0.049,0.065,0.118,0.123 (all P ＜ 0.01).Conclusion The AMS score is less valuable in predicting TT abnormalities,but it is good for predicting FTI and TSI abnormalities.关键词
睾酮/雄激素类/中年人/老年人/男人/性腺功能减退症/老年男性症状量表Key words
Testosterone/Androgens/Middle aged/Aged/Men/Hypogonadism/Aging Males' Symptoms Scale分类
医药卫生引用本文复制引用
熊世敏,刘方苇,史勇军,余琴,余纳,申旭波,李红钢,熊承良,周远忠..老年男性症状量表评分预测社区中老年男性血清睾酮相关指标异常的价值研究[J].中国全科医学,2017,20(33):4130-4135,6.基金项目
“十二五”国家科技支撑计划课题(2012BAI32B03) （2012BAI32B03）
