Time for international action on treating testosterone deficiency syndrome.
Time for international action on treating testosterone deficiency syndrome.
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DOI：
10.1080/13685530802699067
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发表时间：
2009-03
期刊：
影响因子：
--
通讯作者：
Carruthers M
中科院分区：
文献类型：
--
作者：
Carruthers M
由于全球老龄化、肥胖率升高、糖尿病和代谢综合征以及压力异雌激素和抗雄激素等不利环境因素，睾酮缺乏对男性健康的影响越来越大。所讨论的问题是关于睾酮治疗的益处和安全性的大量证据在多大程度上应用于临床实践。我们将世界不同地区 50 岁以上男性的人口统计数据与根据销售数据估计的该年龄段接受睾酮治疗的男性人数进行了比较。据估计，每个地区总人口中 50 岁以上的男性中，有 20% 可能出现睾酮缺乏症状，而在大多数欧洲国家，平均只有这些男性 (0.69%) 正在接受治疗。英国（1.00%）和德国（1.89%）的比例较高，但法国（0.49%）、意大利（0.51%）和俄罗斯（0.54%）的比例较低。有趣的是，尽管国家对雄激素的使用采取了严格的控制措施，但澳大利亚的数字更高（1.64%）。美国的治疗率最高（7.96%），并且这一数字正在迅速增加。如果诊断的基础是更常规的症状组合加上总睾酮和游离睾酮水平低的生化证据，则预计 50 岁以上男性中至少有 5% 会缺乏雄激素，因此治疗率百分比会高出四倍。然而，即便如此，也只有美国的比例超过 10%。迫切需要采取国际行动，提高各国医疗界对睾酮治疗水平极低的认识。这方面的改进需要对医生和医疗保健系统监管人员进行教育和激励。需要开展公众宣传活动，让男性了解睾酮缺乏的症状及其对健康的影响。
Testosterone deficiency is having an increasing impact on men's health because of global aging, higher levels of obesity, diabetes and metabolic syndrome and adverse environmental factors such as stress xenoestrogens and anti-androgens. The question addressed is to what extent the large body of evidence on the benefits and safety of testosterone therapy is applied in clinical practice. Demographic data for men over the age of 50 from different regions of the world have been compared with the number of men in that age group estimated from sales figures to be receiving testosterone treatment. On the basis of estimate that 20% of men over 50 in the general population of each region could be expected to have testosterone deficiency symptoms, on average only these men (0.69%) in most European countries were receiving treatment. Proportion was higher in the UK (1.00%) and Germany (1.89%), but lower in France (0.49%), Italy (0.51%) and Russia (0.54%). Interestingly, Australia had higher figures (1.64%), in spite of tight state control measures on androgen use. The USA has the highest treatment rate (7.96%) and this is increasing rapidly. If the basis for the diagnosis was the more conventional combination of symptoms plus biochemical evidence of low total and free testosterone levels, androgen deficiency would be expected in at least 5% of men over 50, and percentage treatment rates therefore four times higher. However, even on that basis, only in the USA do these exceed 10%. International action is urgently needed to raise awareness in the medical profession in the various countries of these remarkably low levels of testosterone treatment. Improvement in this requires education and motivation of doctors and those regulating the healthcare systems. A public awareness campaign is needed to educate men about the symptoms of testosterone deficiency and its impact on their health.
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