2018年上半年某城区中老年男性迟发性性腺功能减退症的流行病学调查

Epidemiological survey on late-onset hypogonadism of mid-and elder man in urban area of Nanchong City(The first half of 2018 year)

目的对南充市城区中老年男性迟发性性腺功能减退症(LOH)的流行病学进行调查。方法2018年1月—7月在南充市城区中随机选取的9个社区为研究区域,采用年龄分层抽样选取40~80岁的中老年男性为调查对象,应用中老年男子雄激素缺乏(ADAM)问卷、老年男子症状(AMS)问卷和性腺激素水平测定方法来调查南充城区LOH患病率,同时对比不同年龄组中老年男性性腺激素水平和LOH的患病率。结果729名中老年男性完成调查,量表筛查LOH阳性率:ADAM量表阳性率为74.49%,而AMS量表阳性率为36.76%。不同年龄组的睾酮(TT)和游离睾酮(FT)水平存在统计学差异,随着年龄的增加,TT和FT水平有明显下降趋势,LH和FSH水平在不同年龄组中并无明显差异;196例TT<300 ng/dl(26.89%),105例TT<300 ng/dl且FT<50 pg/ml(14.4%),以量表结果阳性结合TT<300 ng/dl为LOH诊断标准,筛查LOH患病率分别是23.46%(ADAM)和20.71%(AMS),不同年龄分组之间比较LOH阳性率均存在统计学差异(P<0.05),随年龄增加LOH发病率有明显上升趋势。结论南充城区中老年男性LOH的患病率相比国内大型城市调查结果偏低,但高于一些农村地区调查结果,可能与城市经济发展水平、人群生活习惯、地域有一定的相关性,其深层次原因仍待进一步研究和讨论。

Objective To investigate the epidemiological status of late-onset hypogonadism(LOH)in middle-aged and elderly men in urban areas of Nanchong City.Methods From January to July 2018,9 communities were randomly selected as the research areas in the urban of Nanchong City.By using age-stratified sampling middle-aged and elderly men aged 40-80 years were selected as subjects.The androgen deficiency in aging males(ADAM)questionnaire,aging male symptoms(AMS)questionnaire and the method of measuring gonadal hormone levels were used to investigate the prevalence of LOH in Nanchong City,and to compare the gonadal hormone levels and prevalence of LOH in the different age groups of these middle-aged and elderly men.Results A total of 729 middle-aged and elderly men received the complet survey.The prevalence of LOH was measured by the questionnaires:the positive rate of the ADAM questionnaire was 74.49%,and AMS questionnaire was 36.76%.There were statistical differences in testosterone(TT)and free testosterone(FT)levels between different age groups.TT and FT levels decreased significantly with age,and LH and FSH levels did not differ significantly among the different age groups;The 196 cases of TT<300ng/dl(26.89%),105 cases of TT<300ng/dl and FT<50pg/ml(14.4%)were recognized the questionnaires results positive combined with the TT<300ng/dl as the LOH diagnostic criteria,the prevalence were 23.46%(ADAM)and 20.71%(AMS),respectively.There was a statistically significant difference in LOH prevalence between different age groups(P<0.05).The incidence of LOH increased with age.Conclusion The prevalence of LOH in middle-aged and elderly men in Nanchong City is lower than that in large cities in China,but higher than that in some rural areas,it might have a certain correlation with urban economic development level,people's living habits and geography.The reasons of that are worth to be further studied and discussed.