Psychobiologic correlates of the metabolic syndrome and associated sexual dysfunction
Psychobiologic correlates of the metabolic syndrome and associated sexual dysfunction
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DOI：
10.1016/j.eururo.2006.02.053
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发表时间：
2006-09-01
期刊：
影响因子：
23.4
通讯作者：
Maggi, Mario
中科院分区：
文献类型：
--
作者：
Corona, Giovanni;Mannucci, Edoardo;Maggi, Mario
目的：低睾酮水平和勃起功能障碍（艾德）与代谢综合征（MS）的关系日益受到关注。本研究确定了与MS相关的性功能障碍（SD）的心理生物学特征（如由国家胆固醇教育计划的成人治疗小组III标准定义的）在一系列的803名连续男性门诊患者中。几种激素，生化，和仪器（阴茎多普勒超声[PDU]）参数进行了研究，沿着一般精神病理学评分（米德尔塞克斯医院问卷修改[MHQ]）。结果：在236例（29.4%）诊断为MS的患者中，96.5%的患者报告艾德，39.6%的患者报告性欲减退（HSD），22.7%的患者报告早泄，4.8%的患者报告延迟射精。MS患者的特点是更大的主观（如SIEDY评估）和客观（如PDU评估）艾德和更大的躯体化焦虑比其余的样本。MS患者明显的性腺功能减退症（总睾酮< 8 nM）的患病率显著较高。在MS组分中，腰围和高睾酮血症是性腺功能减退症的最佳预测因子。患有MS的性腺功能减退患者表现出较高的促性腺激素和较低的游离睾酮水平，提示原发性性腺功能减退。在MS患者中，性腺功能减退症是目前在11.9%和3.8%，其余的样本（p < 0.0001），并与典型的性腺功能减退症相关的症状，如性欲减退，性交频率低，抑郁症状。结论：我们的数据表明，MS与更严重的艾德和诱导体化。此外，在SD患者中，MS与性腺功能减退症的患病率较高相关。性腺功能减退的存在可进一步加重MS相关性功能障碍，增加典型的性腺功能减退相关症状（包括HSD，66.7%）。认识到与性腺功能减退症相关的MS对性健康和一般健康及其严重的潜在相关风险都很重要。(c)2006年欧洲泌尿外科协会。Elsevier B.V.出版，保留所有权利。
Objectives: The association of low testosterone level and erectile dysfunction (ED) with metabolic syndrome (MS) is receiving increasing attention. The present study determined the psychobiologic characteristics of sexual dysfunction (SD) associated with MS (as defined by the National Cholesterol Education Program's Adult Treatment Panel III criteria) in a series of 803 consecutive male outpatients.Methods: Several hormonal, biochemical, and instrumental (penile Doppler ultrasound [PDU]) parameters were studied, along with general psychopathology scores (Middlesex Hospital Questionnaire modified [MHQ]). The Structured Interview on Erectile Dysfunction (SIEDY) was also applied.Results: Among the 236 patients (29.4%) diagnosed as having a MS, 96.5% reported ED, 39.6% hypoactive sexual desire (HSD), 22.7% premature ejaculation, and 4.8% delayed ejaculation. Patients with MS were characterised by greater subjective (as assessed by SIEDY) and objective (as assessed by PDU) ED and by greater somatised anxiety than the rest of the sample. The prevalence of overt hypogonadism (total testosterone < 8 nM) was significantly higher in patients with MS. Among MS components, waist circumference and hyperglycaemia were the best predictors of hypogonadism. Hypogonadal patients with MS showed higher gonadotropin and lower free testosterone levels, suggesting a primary hypogonadism. Among patients with MS, hypogonadism was present in 11.9% and 3.8% in the rest of the sample (p < 0.0001) and was associated with typical hypogonadism-related symptoms, such as hypoactive sexual desire, low frequency of sexual intercourse, and depressive symptoms.Conclusions: Our data suggest that MS is associated with a more severe ED and induces somatisation. Furthermore, MS is associated with a higher prevalence of hypogonadism in patients with SD. The presence of hypogonadism can further exacerbate the MS-associated sexual dysfunction, adding the typical hypogonadisin-related symptoms (including HSD, 66.7%). Recognising MS associated with hypogonadism is important for both sexual and general health and its serious potential associated risks. (c) 2006 European Association of Urology. Published by Elsevier B.V. All rights reserved.