ABSTRACT
Objective@#To investigate the values of serum calculated free testosterone (cFT), testosterone secretion index (TSI), and free testosterone index (FTI) in the diagnosis of ED with androgen deficiency by observing their changes in the patient.@*METHODS@#We conducted this study among 185 men complaining of ED and 35 20－40 years old healthy males presenting at the clinic for premarital medical checkup. We asked them about their medical history, to fill in the International Index of Erectile Function (IIEF-5) Questionnaire, and to complete the nocturnal penile tumescence (NPT) test. According to the data obtained, 150 of the complainants were diagnosed as ED patients and 25 of the healthy examinees were included in the control group. We determined the levels of total serum testosterone (TT), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), serum albumin (ALB), cFT, bio-available testosterone (bio-T), TSI, and FTI in the two groups of subjects. Using cFT ≤0.3 nmol/L, TSI ≤2.8, and FTI ≤0.4 as the critical values and TT ≤11.5 nmol/L as the gold standard for androgen deficiency, we calculated cFT-, TSI-, and FTI-related rates of missed diagnosis, misdiagnosis, and diagnostic coincidence.@*RESULTS@#With TT ≤11.5 nmol/L as the criterion, the cFT-, TSI-, and FTI-related rates of coincidence in the diagnosis of androgen deficiency in the ED patients were 90.8%, 85.8%, and 80.8%, those of missed diagnosis were 4.0%, 33.3%, and 44.0%, and those of misdiagnosis were 10.5%, 19.4%, and 12.6%, with the Kappa of values 0.755, 0.564, and 0.427, respectively (P <0.05). The levels of serum TT, cFT, Bio-T, TSI, and FTI were decreased with increased age of the 20－40 years old ED patients, with statistically significant differences among different age groups except the serum TT level. However, no statistically significant differences were found in the levels of TT, cFT, Bio-T, TSI, and FTI among the patients with different IIEF-5 scores.@*CONCLUSIONS@#The level of cFT has a higher value than those of TT, TSI, and TSI in the diagnosis of ED with androgen deficiency in 20－40 years old men.
Subject(s)
Adult , Humans , Male , Young Adult , Androgens , Case-Control Studies , Erectile Dysfunction , Blood , Diagnosis , Luteinizing Hormone , Blood , Serum Albumin , Sex Hormone-Binding Globulin , Testosterone , BloodABSTRACT
<p><b>Objective</b>To determine the stability of androgen indexes by analyzing the relationship of androgen indexes with the results of late-onset hypogonadism (LOH) questionnaire investigations, and offer some reference for the application of the diagnostic criteria for LOH released by The Chinese Society of Andrology in 2009.</p><p><b>METHODS</b>This study included 1 003 males aged 40 years or older who had accomplished the questionnaires of Androgen Deficiency in Aging Males (ADAM), Aging Males' Symptoms Scale (AMS), and International Index of Erectile Function-5 (IIEF-5). We evaluated the correlation of androgen indexes with the results of the questionnaire investigation, repeated the examination of androgen indexes for the subjects with total testosterone (TT) ≤11.5 nmol/L after an average of 1.5 years, and analyzed the factors inducing changes of androgen indexes.</p><p><b>RESULTS</b>Free testosterone index (FTI) ≤ 0.42 (OR, 1.369) and calculated free testosterone (cFT) ≤ 0.3 nmol/L (OR, 1.302) were considered as the risk factors of LOH in AMS, and so were testosterone secretion index (TSI) ≤ 2.8 nmol/IU (OR, 1.679) and cFT ≤ 0.3 nmol/L (OR, 1.371) in IIEF-5. Paired t-test on the results of the examination performed twice showed significant differences in the levels of TT, TSI, cFT, and FT (P<0.05).</p><p><b>CONCLUSIONS</b>Decreased testosterone may cause the diversity of LOH symptoms and hence the fluctuation of androgens. Therefore, the diagnosis of LOH depends on androgen indexes, varied symptoms in the questionnaires, and relief of the symptoms after testosterone therapy.</p>
ABSTRACT
Introduction: With the average longevity in men and women, sexual health concerns have become more and more important and demands for help are far more common than in the past. The percentage of aging population is increasing also. A metabolic and hormonal change occurs in male during aging.The level of total, free and bioavailable testosterone decline with aging and it leads to decrease in sexual activities, metabolism and also the life quality.The aim of this initial study was the determination of free testosterone and bioavailable testosterone and it was the novelty of our study. Data obtained from our research can be used as basic information for hormone replacement therapy in late onset hypogonadism.Research goal: To study the free testosterone and bioavailable testosterone level in aging malesMaterials and Methods: This study is a part of study: “Androgen status of aging males” which was supported by Asian Research Center, Korean Foundation for Advanced Studies. The study was approved by IRB of MoH and written consent was obtained from all participants.Fasting blood samples were collected in the morning between 8.00-10.00 AM. We used commercial ELISA kits from Magiwel CoLtd (USA) for determining the total testosterone, sex hormone binding globulin levels. Bromcresol green method was used in determination of serum albumin level. Bioavailable and free testosterone were calculated by Alex Vermeulen, Lieve Verdonk and M. Kaufman’s formula, which was recommended by International Society for the Study of Aging Male.We studied 114 healthy males aged above 40 years old, all undergone the General and Urological examination.Result and discussion: The average age was 57.48±10.48 years in our study participants. In group of 40-49 years were 29% (n=33), in 50-59 age group 23% (n=26), in 60-69 age group 27% (n=38) and in age group over 70-s were 15% (n=17).Mean total testosterone was 6.04±1.83 ng/ml, in 40-49 age group it was 6.14±1.65 ng/ml, in 50-59 age group 6.04±2.36 ng/ml, in 60-69 age group 6.05±1.80 ng/ml, and over 70’s it was 5.85±1.43 ng/ml.Mean sex hormone binding globulin was 50.22±29.97 nmol/l, in 40-49 age group 37.60±23.03 nmol/l, in 50-59 age group 47.08±29.61 nmol/l, in 60-69 age group 57.24±33.91 nmol/l, and over 70’s it was 59.22±25.38 nmol/l.Mean albumin was 40.86±6.89 g/l, in 40-49 age group 44.55±5.93 g/l, in 50-59 age group 41.85±6.93 g/l, in 60-69 age group 38.92±6.85 g/l, and over 70’s was 36.55±4.77 g/l.Mean free testosterone was 0.112±0.064 ng/ml, in 40- 49 age group 0.124±0.058 ng/ml, in 50-59 age group0.114±0.077 ng/ml, in 60-69 age group 0.107±0.072 ng/ml, and over 70’s it was 0.097±0.044 ng/ml.Mean bioavailable testosterone was 2.53±1.48 ng/ ml, in 40-49 age group 2.76±1.37 ng/ml, in 50-59 age group 2.60±1.70 ng/ml, in 60-69 age group 2.51±1.56 ng/ml, and over 70’s it was 2.04±1.05 ng/ml.Conclusion:1. In our participants aged above 40 years old, the average mean of free testosterone was 0.112±0.066 ng/ml, free testosterone index was 16.95±11.82. Free testosterone had inverse correlation with aging (r=-0.168, p=0.03) and had peer decline among aging groups.2. The average mean of bioavailable testosterone was 2.53±1.48 ng/ml, and had age related inverse correlation (r=-0.169, p=0.037), which decline was deeper in men aged over 70 years.Key words:Aging, total, free, bioavailable testosterone,free testosterone index