Paediatric and adult-onset male hypogonadism
Paediatric and adult-onset male hypogonadism
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DOI：
10.1038/s41572-019-0087-y
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发表时间：
2019-05-30
影响因子：
81.5
通讯作者：
Maggi, Mario
中科院分区：
文献类型：
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作者：
Salonia, Andrea;Rastrelli, Giulia;Maggi, Mario
下丘脑-垂体-性腺轴与男性发育、成熟和衰老相关的许多过程有关。通过该轴，进行一系列协调活动，导致持续的睾丸内分泌功能（包括性腺睾酮的产生）以及外分泌功能（包括精子发生）。儿童或青春期期间损害下丘脑-垂体-性腺轴的疾病可能会导致青春期延迟。晚发性性腺功能减退症是老年男性的一种临床病症，结合了低浓度的循环睾酮和与激素产生受损相关的特定症状。对先天性性腺功能减退症的睾酮治疗必须是终生的，而对迟发性性腺功能减退症的睾酮治疗仍然存在争议，因为替代适应症不明确、疗效不确定和潜在风险。本入门书侧重于重新评估睾酮的生理作用，重点是对男性个体整个生命周期中性腺机能减退状况的批判性解释，但先天性发育障碍引起的性腺机能减退状态除外。
The hypothalamic-pituitary-gonadal axis is of relevance in many processes related to the development, maturation and ageing of the male. Through this axis, a cascade of coordinated activities is carried out leading to sustained testicular endocrine function, with gonadal testosterone production, as well as exocrine function, with spermatogenesis. Conditions impairing the hypothalamic-pituitary-gonadal axis during paediatric or pubertal life may result in delayed puberty. Late-onset hypogonadism is a clinical condition in the ageing male combining low concentrations of circulating testosterone and specific symptoms associated with impaired hormone production. Testosterone therapy for congenital forms of hypogonadism must be lifelong, whereas testosterone treatment of late-onset hypogonadism remains a matter of debate because of unclear indications for replacement, uncertain efficacy and potential risks. This Primer focuses on a reappraisal of the physiological role of testosterone, with emphasis on the critical interpretation of the hypogonadal conditions throughout the lifespan of the male individual, with the exception of hypogonadal states resulting from congenital disorders of sex development.