Reference Ranges for Testosterone in Men Generated Using Liquid Chromatography Tandem Mass Spectrometry in a Community-Based Sample of Healthy Nonobese Young Men in the Framingham Heart Study and Applied to Three Geographically Distinct Cohorts
Reference Ranges for Testosterone in Men Generated Using Liquid Chromatography Tandem Mass Spectrometry in a Community-Based Sample of Healthy Nonobese Young Men in the Framingham Heart Study and Applied to Three Geographically Distinct Cohorts
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DOI：
10.1210/jc.2010-3012
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发表时间：
2011-08-01
影响因子：
5.8
通讯作者：
Vasan, Ramachandran S.
中科院分区：
文献类型：
--
作者：
Bhasin, Shalender;Pencina, Michael;Vasan, Ramachandran S.
背景：参考范围对于将睾酮水平划分为低水平或正常水平以及诊断雄激素缺乏至关重要。我们在以社区为基础的男性样本中建立了总睾酮（TT）和游离睾酮（FT）的参考范围。方法：采用液相色谱串联质谱法测量弗雷明汉心脏研究第3代19-40岁非肥胖健康男性的TT；计算FT。低于参考样本的第2.5个百分位数的值被认为是低的。我们在三个队列中确定了低TT和FT与身体功能障碍、性症状（仅欧洲男性衰老研究（EMAS））和糖尿病的关联：弗雷明汉心脏研究第2代和第3代、EMAS和男性骨质疏松性骨折研究。结果：在456名男性的参考样本中，TT和141的平均（SD）、中位数（四分位数）和第2.5个百分点值分别为723.8（221.1）、698.7（296.5）和348.3 ng/dl。FT分别为8（45.0）、134.0（60.0）和70.0 pg/ml。在所有三个样本中，TT和FT较低的男性比正常水平的男性更有可能出现走路速度慢、爬楼梯困难、身体虚弱和糖尿病。在EMAS中，TT和FT较低的男性比正常水平的男性更容易出现性症状。TT和FT较低的男性更有可能出现以下至少一种症状：性症状（仅限EMAS）、身体功能障碍或糖尿病。结论：在以社区为基础的男性样本中产生的参考范围为睾酮水平的低或正常分类提供了合理的基础。根据这些标准，TT或FT较低的男性有较高的身体功能障碍、性功能障碍和糖尿病患病率。这些参考限度应与事件结果和随机试验进行前瞻性验证。[J] .中华临床内分泌杂志，2011,31(2):393 - 393。
Context: Reference ranges are essential for partitioning testosterone levels into low or normal and making the diagnosis of androgen deficiency. We established reference ranges for total testosterone (TT) and free testosterone (FT) in a community-based sample of men.Methods: TT was measured using liquid chromatography tandem mass spectrometry in nonobese healthy men, 19-40 yr old, in the Framingham Heart Study Generation 3; FT was calculated. Values below the 2.5th percentile of reference sample were deemed low. We determined the association of low TT and FT with physical dysfunction, sexual symptoms [European Male Aging Study (EMAS) only], and diabetes mellitus in three cohorts: Framingham Heart Study generations 2 and 3, EMAS, and the Osteoporotic Fractures in Men Study.Results: In a reference sample of 456 men, mean (SD), median (quartile), and 2.5th percentile values were 723.8 (221.1), 698.7 (296.5), and 348.3 ng/dl for TT and 141. 8 (45.0), 134.0 (60.0), and 70.0 pg/ml for FT, respectively. In all three samples, men with low TT and FT were more likely to have slow walking speed, difficulty climbing stairs, or frailty and diabetes than those with normal levels. In EMAS, men with low TT and FT were more likely to report sexual symptoms than men with normal levels. Men with low TT and FT were more likely to have at least one of the following: sexual symptoms (EMAS only), physical dysfunction, or diabetes.Conclusion: Reference ranges generated in a community-based sample of men provide a rational basis for categorizing testosterone levels as low or normal. Men with low TT or FT by these criteria had higher prevalence of physical dysfunction, sexual dysfunction, and diabetes. These reference limits should be validated prospectively in relation to incident outcomes and in randomized trials. (J Clin Endocrinol Metab 96: 2430-2439, 2011)