河北某地社区中老年健康男性血清生殖激素水平变化研究

Changes of Serum Reproductive Hormones with Aging Among Healthy Males in a Community Population of Hebei Province

目的:以社区人群为基础,研究中老年健康男性血清生殖激素水平随增龄的变化规律以及比较不同年龄组之间或同年龄组在城镇与农村居民之间的差异。方法:采用整群及年龄分层抽样方法,抽取了社区健康中老年男性434例,年龄分布40～69岁;其中城镇居民198例、农村居民236例,分别测定血清总睾酮(tT)、黄体生成素(LH)、性激素结合球蛋白(SHBG)浓度,计算得出游离睾酮(fT)浓度、生物可利用睾酮(Bio-T)浓度、睾酮分泌指数(TSI)、游离睾酮指数(fTI)。同时测定同一地区59例20～39岁男性生殖激素水平作为对照组。结果:中老年男性血清tT水平随增龄没有明显变化,而LH、SHBG水平逐渐增高,fT、Bio-T、TSI、fTI则逐步降低。采用Kruskal-WallisH检验,4个年龄组(20～39岁、40～49岁、50～59岁、60～69岁)之间,tT没有统计学差异(P>0.05),其他参数均有显著性差异(P<0.01)。tT水平与年龄、LH均没有相关性(P>0.05);LH和SHBG与年龄、SHBG与LH呈显著正相关(P<0.01),而fT、Bio-T、TSI、fTI与年龄、LH呈显著负相关(P<0.01)。按年龄配对Wilcoxon符号秩和检验,40～49岁组城镇与农村居民之间LH、TSI、fTI有显著性差异(P<0.05),fT、Bio-T有极显著性差异(P<0.01);对照组、50～59岁和60～69岁组,城镇与农村居民之间7项参数均无统计学差异(P>0.05)。40～49岁组LH、SHBG的升高率及fT、Bio-T、TSI、fTI的下降率,农村大于城镇居民;相反,在50～59岁和60～69岁组,城镇则大于农村居民。结论:中老年男性血清tT水平随增龄没有明显改变,而LH、SHBG、fT、Bio-T、TSI、fTI则随年龄呈现梯度性变化。许多参数在不同年龄组之间或城镇与农村居民之间存在着统计学差异。

Objective： To investigate the changes of serum reproductive hormones with male aging and to compare the differences in the hormone levels among different age groups or between township and rural males of the same age group. Methods： Using cluster and stratified sampling, we recruited 434 healthy old and middle-aged （40 -69 years） males, 198 from the township and 236 from the rural communities. We determined the concentrations of serum total testosterone （tT）, lnteinizing hormone （LH） and sex hormone binding globulin （SHBG） , free testosterone （fT）, bio-available testosterone （Bio-T）, and obtained the testosterone secretion index （TSI） and free testosterone index （fTI）. Meanwhile, we included fifty-nine 20 -39 years old males from the same communities in a control group. Results ： With the increase of age, the serum tT levels did not change significantly, while the levels of serum LH and SHBG increased, and those of fT, Bio-T, TSI and fTI decreased gradually. Statistically significant differences were found among the four different age groups in all the parameters of reproductive hormones （P 〈0. 01 ）, except in the serum tT level （P 〉 0.05 ）. The serum tT level was not significantly correlated with aging and LH （ P 〉 0.05 ）. Serum LH and SHBG had a marked positive correlation with aging, and SHBG with LH （ P 〈 0.01 ）, while fT, Bio-T, TSI and fTI were negatively correlated with aging and the LH level （ P 〈 0.01 ）. Serum LH, TSI and fTI showed statistical differences （P 〈 0.05 ）, while fT and Bio-T exhibited extremely significant differences （P 〈 0.01 ） between the township and rural males in the 40 -49 yr group, and in the same age group, the increase rates of serum LH and SHBG and reduction rates of fT, Bio-T, TSI and fTI were higher in the rural men than in the township residents. However, the results were just the opposite in the 50 - 59 and 60 - 69 yr groups. Conclusion ： The levels of serum LH, SHBG, fT, Bio-T, TSI and fTI changed with aging in a gradientmanner in the old and middle-aged males, but no significant changes were observed in the level of serum tT. There were statistical differences in many parameters of serum reproductive hormones among different age groups or between township and rural males.