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目的:了解南京城区中老年男性生殖健康的基本情况。方法:随机对南京玄武区884例55~89岁的中老年男性进行常规体检,实验室检测血常规、肝肾功能、血糖、血脂及总前列腺特异性抗原(T-PSA)等指标,用放射免疫法测定血清总睾酮(TT)、游离睾酮(fT)、性激素结合球蛋白(SHBG)及黄体生成素(LH)等生殖激素指标。并收集119例20~39岁青年男性血清生殖激素指标作为对照。结果:中老年男性的生殖激素中除TT及E2之外,其他6项生殖激素及相关参数(LH、FSH、fT、SHBG、TSI、fTI)的中位数(50%位数)随年龄增加均呈现梯度性变化,LH、FSH及SHBG水平逐渐增高,而fT、TSI、fTI则逐渐降低。采用Mann-Whitney U法比较5个年龄组(20~39岁,55~59岁,60~69岁,70~79岁,≥80岁)两两之间的生殖激素或相关参数水平差异后发现:①TT水平,除了对照组与≥80岁年龄组、60~69岁组与≥80岁组间有统计学差异外(P<0.05),其他各组间均无统计学差异(P均>0.05);②E2水平,各组间均无统计学差异;③LH、FSH水平,除了55~59岁与60~69岁组间及FSH水平70~79岁与≥80岁组间无统计学差异外,其他各组间均有统计学差异;④fT、TSI水平,除了55~59岁组与60~69岁组间无统计学差异,其他各组间均有统计学差异;⑤SHBG及fTI水平,所有组间均有显著性差异。而对生殖激素及相关指标与年龄、LH等因素进行相关性分析后发现:fT、TSI、fTI与年龄、LH显著负相关(P<0.01,|r|>0.4),而与胆固醇、血糖及血红蛋白呈相对较弱的正相关(P<0.01,r<0.4);SHBG及LH与年龄呈显著正相关(P<0.01,r>0.4),SHBG与血糖及血红蛋白呈相对较弱的负相关(P<0.01,|r|<0.4),LH与血红蛋白呈相对较弱的负相关(P<0.01,|r|<0.4);TT与年龄呈相对较弱的负相关(P<0.01,|r|<0.4),而与血红蛋白呈相对较弱的正相关(P<0.01,r<0.4)。结论:随着年龄增长,中老年男性血清TT(fT更为明显)水平下降,并可能引起脂质代谢异常、血红蛋白降低及血糖升高。
Objective: To understand the basic situation of reproductive health of middle-aged men in Nanjing. Methods: A total of 884 middle-aged and elderly men aged 55-89 years old in Xuanwu District of Nanjing were randomly selected for routine physical examination. Blood samples were collected for routine examination of blood, liver and kidney function, blood glucose, blood lipids and total prostate specific antigen (T-PSA) Serum total testosterone (TT), free testosterone (fT), sex hormone binding globulin (SHBG) and luteinizing hormone (LH) were measured by immunoassay. And 119 cases of 20 to 39-year-old male reproductive hormone serum markers as a control. Results: The median (50%) of the other six reproductive hormones and related parameters (LH, FSH, fT, SHBG, TSI and fTI) Gradient changes were observed, LH, FSH and SHBG levels gradually increased, while fT, TSI, fTI decreased gradually. The Mann-Whitney U method was used to compare reproductive hormones or related parameters between five age groups (20-39, 55-59, 60-69, 70-79, ≥80 years) ①TT levels, except for the control group and ≥ 80 years old group, 60-69 years old group and ≥80 years old group were statistically different (P <0.05), the other groups were no significant difference (P> 0.05 ); ②E2 levels, no significant difference between the groups; ③LH, FSH levels, except 55 to 59 years old and 60 to 69 years old group and FSH levels 70 to 79 years old and ≥ 80 years old group no significant difference, There was no significant difference between the other groups except for 55-59 years old group and 60-69 years old group; ⑤The levels of SHBG and fTI in all groups were significantly different; Between the significant differences. Correlation analysis of reproductive hormones and related indicators with age, LH and other factors showed that fT, TSI and fTI had significant negative correlation with age and LH (P <0.01, | r |> 0.4) (P <0.01, r <0.4); SHBG and LH were positively correlated with age (P <0.01, r> 0.4); SHBG had a relatively weak negative correlation with blood glucose and hemoglobin (P < (P <0.01, | r | <0.4), LH was negatively correlated with hemoglobin (P <0.01, | r | <0.4) | <0.4), but a relatively weaker positive correlation with hemoglobin (P <0.01, r <0.4). CONCLUSIONS: As age increases, serum TT (fT is more pronounced) is lower in middle-aged and elderly men and may cause dyslipidemia, decreased hemoglobin and elevated blood glucose.