Survey for late-onset hypogonadism among old anti middle-aged males in Shanghai communities

This study sought to investigate late-onset hypogonadism （LOH） in old and middle-aged males in Shanghai communities, using symptom score evaluation systems and measurements of sex hormone levels. One thousand cases of males aged 40-70 years were investigated. The aging male symptoms （AMS） scale and androgen deficiency in aging males （ADAM） questionnaire were used at the beginning of the investigation, followed by measurement of the sex hormone-related factors （total testosterone （TT）, free testosterone （fT）, sex hormone-binding globulin （SHBG） and bioavailability of testosterone （Bio-T））. There were 977 valid questionnaires. The LOH-positive rates shown by AMS and ADAM were 59.88% and 84.65%, respectively; values increased with the age of the patients. There were 946 results related to sex hormone measurements, which showed the following results： TT was not related to aging （P〉O.05）; levels of SHBG increased with age; and fT and Bio-T decreased with age. There was a significant difference in fT between LOH-positive and LOH-negative patients, as shown by the ADAM. In summary, TT levels were not related to aging, even though SHBG did increase while fT and Bio-T decreased with aging. Clinically, the diagnosis of LOH cannot be based on serum TT level.

Prevalence of late-onset hypogonadism among middle-aged and elderly males in China:results from a national survey

This study aimed to propose an operational definition of late-onset hypogonadism(LOH)that incorporates both clinical symptoms and serum testosterone measurements to evaluate the prevalence of LOH in aging males in China.A population-based sample of 6296 men aged 40 years-79 years old was enrolled from six representative provinces in China.Serum total testosterone(TT),sex hormone-binding globulin(SHBG),and luteinizing hormone(LH)were measured and free testosterone(cFT)was calculated.The Aging Males’Symptoms(AMS)scale was used to evaluate the LOH symptoms.Finally,5078 men were included in this analysis.The TT levels did not decrease with age(P=0.59),and had no relationship with AMS symptoms(P=0.87 for AMS total score,P=0.74 for≥3 sexual symptoms).The cFT levels decreased significantly with age(P<0.01)and showed a negative association with the presence of≥3 sexual symptoms(P=0.03).The overall estimated prevalence of LOH was 7.8%(395/5078)if a cFT level<210 pmol l−1 combined with the presence of≥3 sexual symptoms was used as the criterion of LOH.Among them,26.1%(103/395)and 73.9%(292/395)had primary and secondary hypogonadism,respectively.After adjustment for confounding factors,primary and secondary hypogonadism was positively related to age and comorbidities.Body mass index was an independent risk factor for secondary hypogonadism.The results suggest that the AMS total score is not an appropriate indicator for decreased testosterone,and that the cFT level is more reliable than TT for LOH diagnosis.Secondary hypogonadism is the most common form of LOH.

《素问·阴阳类论》“一阳为游部”渊源考释

目的:探讨《黄帝内经》"一阳为游部"与古代圭表测景的内在联系。方法:通过对"游"的来源、内涵、演变的考证,深入分析"一阳为游部"在人体生理活动中的重要作用。结果:"游"的本义是指旗帜的飘带,它可以用来区别贵族王公身份的等级;"游"的引申义有"不固定"之意,因此古代的人口流动也称作"游";"游"在中国古代的典籍中还被用来形容能使光线发生反射或折射或散射现象的事物,如"游云""游气"。而"游"的所有这些意义均来源于甲骨文卜辞中的"立中"———上古的圭表测景。结论:古人对圭表测景意义的认识是"一阳为游部"的理论渊源,同时《黄帝内经》中的"胆者,中正之官""凡十一脏取决于胆"及五运六气学说"少阳相火""相火以位"理论亦与之有关。

驻福州某部队中青年干部脂肪肝检出率与相关因素分析

目的探讨部队中青年干部脂肪肝的患病率与体质量指数、年龄、血脂、血清酶等因素的关系,为脂肪肝的预防提供依据。方法对驻福州某部663名男性中青年干部健康体检报告的脂肪肝、体质量指数、年龄、血脂、血清酶水平进行分析。结果 663名受检者中检出脂肪肝患者157例,占23.68%。脂肪肝患者的年龄、体质量指数、血脂、血清酶均显著高于非脂肪肝者,两者上述项目比较,差异有统计学意义(P<0.05)。结论脂肪肝的发生与年龄、体质量指数、血脂密切相关。脂肪肝可对肝功能造成一定的损伤,改变饮食结构,纠正不良的生活方式是防治脂肪肝的重要措施。

Sonographic fatty liver, overweight and ischemic heart disease

AIM: To demonstrate the prevalence of sonographic fatty liver, overweight and ischemic heart disease (IHD) among the male workers in Taiwan, and to investigate the possible association of these three factors.METHODS: From July to September 2003, a total of 2 088 male aircraft-maintenance workers aged from 22to 65 years (mean 40.5) underwent an annual health examination, including anthropometrical evaluation, blood pressure measurement, personal medical history assessment,biochemical blood analysis, abdominal ultrasonographic examination and digital electrocardiography (ECG). The Student's t-test, x2 test and multivariate logistic regression analysis were utilized to evaluate the relationship between IHD and salient risk factors.RESULTS: The all-over prevalence of overweight was 41.4%, and that of fatty liver was 29.5% (mild, moderate and severe fatty liver being 14.5%, 11.3%, and 3.7%,respectively); while the prevalence of ischemic changes on ECG was 17.1% in this study. The abnormal rates for conventional IHD risk factors including hypertension,dyslipidemia, hyperglycemia and overweight increased in accordance with the severity of fatty liver. Overweight and severity of fatty liver were independently associated with increased risks for developing IHD. Overweight subjects had a 1.32-fold (95%CI: 1.01-1.73) increased IHD risk. Participants with mild, moderate, and severe fatty liver had a 1.88-fold (95%CI: 1.37-2.6), 2.37-fold (95%CI: 1.66-3.37) and 2.76-fold (95%CI: 1.62-4.72)increased risk for developing IHD. The prevalence of ischemic ECG for the fatty liver-affected subjects with or without overweight was 30.1% and 19.1%, while that of overweight subjects free from fatty liver was 14.4%.Compared to the subjects without fatty liver nor overweight,IHD risk for the three subgroups above was as follows:OR: 2.95 (95%CI:2.31-4.09), OR: 1.60 (95%CI: 1.07-2.39)and OR: 1.11 (95%CI: 0.78-1.56), respectively.CONCLUSION: The presence of fatty liver and its severity should be carefully considered as independent risk factors for IHD. Results of the study suggest the synergistic effect between fatty liver and overweight for developing IHD.Abdominal sonographic examination may provide valuable information for IHD risk assessment in addition to limited report about liver status, especially for overweight males.

Identification of late-onset hypogonadism in middle-aged and elderly men from a community of China

In this study, we investigated the essential criteria for late-onset hypogonadism （LOH） syndrome based on the presence of symptoms associated with low testosterone levels in Han Chinese men. Blood tests for total testosterone （TT） and sex hormone-binding globulin （SHBG） were performed, and the aging male symptoms （AMS） questionnaire was conducted in a randomly selected cohort composed of 944 Chinese men aged 40 to 79 years from nine urban communities. Three sexual symptoms （decreased ability/frequency of sexual activity, decreased number of morning erections, and decreased libido） were confirmed to be related to the total and free testosterone levels. The thresholds for TT were approximately 12.55 nmol l^-1 for a decreased ability/frequency to perform sex, 12.55 nmol l^-1 for decreased frequency of morning erections, and 14.35 nmol l^-1 for decreased sexual desire. The calculated free testosterone （CFT） thresholds for these three sexual symptoms were 281.14, 264.90, and 287.21 pmol l^-1, respectively. TT 〈13.21 nmol l^-1 （OR =1.4, 95%Ch 1.0-1.9, P= 0.037） or CFT 〈268.89 pmol l^-1 （OR - 1.5, 95%Ch 1.1-20, P=0.020） was associated with an increase in the aforementioned three sexual symptoms. The prevalence of LOH was 9.1% under the criteria, including all three sexual symptoms with TT levels 〈13.21 nmol l^-1 and CFT levels 〈268.89 pmol l^-1. Our results may improve the diagnostic accuracy of LOH in older men.

探讨运动量不同的人群UA水平与TG、TC、HDL-C、LDL-C水平的相关性

目的 :探讨运动量不同的人群UA水平与TG、TC、HDL-C、LDL-C水平的相关性。方法 :选取近期来我院体检的1165名男性官兵和1212名男性职工作为研究对象。将1165名男性官兵作为1组,将1212名男性职工作为2组。检测这些研究对象TC、TG、HDL-C、LDL-C、GLU、UA的水平,并分析两组研究对象UA水平与TG、TC、HDL-C、LDL-C水平的相关性。结果 :经检测发现,1组研究对象TG、TC、HDL-C、LDL-C、GUL的水平均明显低于2组研究对象,差异显著,具有统计学意义(P<0.05);1组研究对象UA的水平明显高于2组研究对象,差异显著,具有统计学意义(P<0.05)。1组研究对象UA的水平与其TC的水平呈正相关,与其HDL-C的水平呈负相关;2组研究对象UA的水平与其TG、TC、LDL-C的水平呈正相关,与其HDL-C的水平呈负相关。结论 :人体UA的水平与TG、TC、LDL-C的水平呈正相关。人们加强运动锻炼可降低其血糖及血脂的水平,但运动量过大则会使其血尿酸的水平升高,导致其发生运动性肾损害。

某部中年男性军官体脂率、腰臀比与血脂水平的相关性研究

[目的]研究某部中年男性军官体脂率、腰臀比与血脂水平的相关性。[方法]35～45岁男性军官562例，根据体脂率（FAT％）、腰臀比值（waist hip ratio，WHR）分为4组：A组（体脂率、腰臀比值均超标）：FAT％≥25且WHR≥0．9；B组（单纯体脂率超标）：FAT％≥25且WHR〈0．9；C组（单纯腰臀比值超标）：FAT％〈25且WHR≥0．9；D组（正常对照）：FAT％〈25且WHR〈0．9。血脂指标包括：血浆甘油三酯（TG）、总胆崮醇（TC）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）。[结果]（1）FAT％、WHR异常的军官占总检测人数的32％，血脂异常以TG升高所占比例最高。（2）FAT％、WHR与TG、TC、LDL-C呈正相关，与HDL-C呈负相关；（3）组间比较：A与B组、A与D组、B与C组、B与D组、C与D组TG、TC、LDL-C、HDL-C比较差异有统计学意义（P〈O．05），A组与C组比较上述指标差异无统计学意义（P〉0．05），WHR对上述指标的影响程度超过FAT％。[结论]某部中年男性军官身体脂肪含量增加和脂肪的腹型分布对血脂各指标均有影响，其中脂肪的腹型分布影响更为显著。

特勤疗养男性官兵全血细胞计数的检测分析

目的检测特勤疗养中心男性官兵全血细胞计数相关4项指标,了解特勤官兵的血细胞相关参数特点,为构建比较合理的特勤官兵全血细胞计数相关的标准参考区间提供依据。方法选择2019-01~12月某特勤疗养中心疗养的18~56岁特勤疗养男性官兵900例,于早晨空腹采集静脉血2 ml,采用日本Sysmex XN-1000全自动血细胞分析仪进行全血细胞计数检测,并进行统计分析。结果从事不同作业特勤疗养男性官兵的全血细胞计数结果显示,除白细胞计数(white blood cell,WBC)无统计学差异外,其它3项指标均有统计学差异(P<0.05)。900例特勤疗养男性官兵全血细胞计数4项指标95%参考区间和《全国临床检验操作规程》第4版存在一定差异;各年龄组间红细胞计数(red blood cell,RBC)、血红蛋白(hemoglobin,HGB)、血小板计数(platelet,PLT)随年龄增长而逐渐降低。结论由于特勤官兵工作、训练和生活环境等因素的影响,《全国临床检验操作规程》第4版的全血细胞计数参考区间不适合该群体;而全血细胞计数参考区间的准确性、可靠性、适用性与临床疾病的诊断效率密切相关。因此有必要根据检测情况,为该特殊群体建立合适的标准参考区间。