Effects of transdermal testosterone on cognitive function and health perception in older men with low bioavailable testosterone levels
Effects of transdermal testosterone on cognitive function and health perception in older men with low bioavailable testosterone levels
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DOI：
10.1093/gerona/57.5.m321
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发表时间：
2002-05-01
影响因子：
5.1
通讯作者：
Prestwood, KM
中科院分区：
文献类型：
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作者：
Kenny, AM;Bellantonio, S;Prestwood, KM
背景许多50岁以上的男性生物可利用的睾酮水平低于年轻成年男性的参考范围。雄激素水平下降对认知和健康感知的影响很少受到关注。将67名生物可利用睾酮水平低于128 ng/dl（成人正常范围下限）的男性（平均年龄76 ± 4岁，范围65-87）随机接受经皮睾酮（2-2.5 mg贴剂/d）或安慰剂贴剂治疗1年。所有男性均接受500 mg补充钙和400 IU维生素D。结果测量包括性激素[睾酮、生物可利用睾酮、性激素结合球蛋白（SHBG）、雌二醇和雌酮]、认知测试（数字符号、数字跨度、线索A和B）、健康感知（医学结果调查简表36或SF-36）、下肢肌肉力量和力量。和钙摄入量。23名男性（34%）退出研究; 44名男性完成试验。在12个月时，睾酮组（n = 24）的生物可利用睾酮水平从93 +/- 34（SD）增加到162 +/- 100 ng/dl（p <0.002），而对照组（n = 20）没有发生变化。虽然两组的雌二醇水平没有变化，但睾酮组的雌酮水平增加（28 +/- 7至32 +/- 9 pg/dl，p = 0.017）。睾酮组和安慰剂组的数字符号测试分数都有所改善。在接受睾酮治疗的男性中，Trailmaking B的评分有所改善（p <0.005），尽管这种变化与安慰剂组的变化没有统计学差异。整个组的Trailmaking B评分与12个月的睾酮水平相关（p = 0.016）。通过SF-36测量的健康感知评分没有显著变化，尽管在12个月的干预期间，两组的心理和一般健康评分都有所下降。10个月的生物可利用睾酮评分与身体角色评分（p = .022）、活力评分（p = .036）和身体综合评分（p = .010）直接相关。在生物可利用睾酮水平低的男性中，经皮睾酮治疗不会损害并可能改善认知功能。治疗没有改善健康感知，但这可能是由于睾酮和安慰剂组中类似反应所提示的皮肤刺激副作用。
Background. Many men older than 50 years have bioavailable testosterone levels below the reference range for young adult men. The impact of the decreased androgen levels oil cognition and health perception has received little attention.Methods. Sixty-seven men (mean age 76 +/- 4 years, range 65-87) with bioavailable testosterone levels below 128 ng/dl (lower limit for adult normal range) were randomized to receive transdermal testosterone (2-2.5 mg patches/d) or placebo patches for I year. All men received 500 mg Supplemental calcium and 400 IU vitamin D. Outcome measures included sex hormones [testosterone, bioavailable testosterone, sex hormone binding globulin (SHBG), estradiol, and estrone], cognitive tests, (Digit Symbol, Digit Span, Trailmaking A and B), health perception (Medical Outcome Survey Short-form 36 or SF-36), lower extremity muscle strength and power. and calcium intake.Results. Twenty-three men (34%) withdrew from the Study; 44 men completed the trial. Bioavailable testosterone levels increased from 93 +/- 34 (SD) to 162 +/- 100 ng/dl (p < .002) at 12 months in the testosterone group (n = 24) while no change occurred in the control group (n 20). While there was no change in estradiol levels in either group, estrone levels increased in the testosterone group (28 +/- 7 to 32 +/- 9 pg/dl, p = .017). Scores oil the Digit Symbol test improved in both the testosterone and placebo groups. Scores on Trailmaking B improved in men treated with testosterone (p < .005), although the changes were not statistically different from the changes seen in the placebo group. Twelve-month scores on Trailmaking B for the entire group were correlated with 12-month testosterone levels (p = .016). Scores for health perception measured by SF-36 did not change significantly, though scores of mental and general health declined in both groups during the 12-month intervention. Twelve-month bioavailable testosterone scores were directly correlated with scores for physical role (p = .022), vitality (p = .036), and the physical composite score (p = .010).Conclusions. Transdermal testosterone treatment in men with low bioavailable testosterone levels does not impair and may improve cognitive function. Treatment did not improve health perception but this may have been due to the side effects of skin irritation suggested by similar reactions in both the testosterone and placebo groups.