背景:先前的横断面和纵向研究已经描述了男性的睾丸激素水平随着年龄的增长而降低,不考虑老年男性的获得性合并症。
目的:我们使用多元面板回归分析评估了年龄与睾酮水平之间的纵向关联以及几种合并症对这种关系的影响。
方法:参与者选自巴尔的摩纵向衰老研究。在每次随访期间获得了有关几种合并症和总睾酮水平的数据。进行了多变量面板回归分析,以确定年龄对睾丸激素水平的影响,同时控制个体合并症。
结果:主要结果是年龄和各种合并症之间的关联强度,和睾丸激素水平。
结果:本研究共纳入625名男性,平均年龄为65岁,平均睾酮水平为463ng/dL。在多变量调整面板回归分析中,年龄与睾酮下降没有显着相关,而贫血,糖尿病,心力衰竭,肥胖,外周动脉疾病,卒中与总睾酮水平呈负相关。我们报告癌症和总睾酮之间没有关联。
结论:这项研究表明,随着时间的推移,睾酮水平下降可能是由于各种合并症的存在,影响老年男性性腺机能减退的医疗管理。
UNASSIGNED:这项研究的优势包括睾丸激素测试的标准化获取和变量的统一收集,而局限性包括缺乏来自205例患者的随访数据以及队列中种族/民族多样性有限.
结论:在这项大型纵向研究中,我们发现,当调整伴随合并症的存在时,年龄并不能预测睾酮水平的显著下降。随着预期寿命的整体增加和糖尿病、血脂异常等合并症发病率的同时上升,我们的研究结果可能有助于优化有多种合并症的迟发性性腺功能减退症患者的筛查和治疗.
Previous cross-sectional and longitudinal studies have described decreasing testosterone levels with age in men, without consideration of acquired comorbidities in aging males.
We evaluated the longitudinal association between age and testosterone levels as well as the impact of several comorbidities on this relationship using multivariate panel regression analysis.
Participants were selected from the Baltimore Longitudinal Study of Aging. Data were obtained on the presence of several comorbidities and total testosterone level during each follow-up visit. A multivariate panel regression analysis was performed to determine the impact of age on testosterone level while controlling for individual comorbidities.
The primary outcomes were strength of association between age and various comorbidities, and testosterone level.
A total of 625 men were included in this study, with a mean age of 65 years and a mean testosterone level of 463 ng/dL. On multivariable-adjusted panel regression analysis, age was not significantly associated with testosterone decline, while anemia, diabetes mellitus, heart failure, obesity, peripheral artery disease, and stroke were inversely associated with total testosterone level. We report no association between cancer and total testosterone.
This study indicates that a decline in testosterone levels over time may be due to the presence of various comorbidities, which affects the medical management of hypogonadism in aging men.
The strengths of this study include the standardized acquisition of testosterone tests and uniform collection of variables, while limitations include the lack of follow-up data from 205 patients and the limited racial/ethnic diversity in the cohort.
In this large longitudinal study, we found that when adjusted for the presence of concomitant comorbidities, age does not predict a significant decline in testosterone level. With the overall increase in life expectancy and the simultaneous rise in the incidence of comorbidities such as diabetes and dyslipidemia, our findings may help optimize screening and treatment for late-onset hypogonadism in patients with multiple comorbidities.