EPIDEMIOLOGY OF IMPOTENCE AND HORMONES IN NORMAL MEN

阳痿是一种常见的男性疾病，影响10-12万男性） 这对卫生和保健支出可能具有重大意义。 尽管它的流行，成本和对生活质量的影响 阳痿与内分泌功能的关系仍然知之甚少， 药物使用，生活方式，人体测量和行为（包括 饮酒、吸烟和营养） 中年人和老年人。没有明确的基于人口的 阳痿的研究一直在进行，尽管自 在社会态度上，可能的新原因，如化学物质， 危害和临床进展解决阳痿作为一种血管疾病。 NIH共识发展会议（1992年）遗憾地指出， 阳痿的流行病学研究，并得出结论，迫切需要 在这方面的工作。没有关于男性性行为的规范性数据。 功能 马萨诸塞州男性衰老研究（MMAS）的基线阶段（t1，1986- 90)收集了最大的基于人口的横截面数据库， 男性内分泌功能、健康状况、性功能，以及 心理社会相关性在全球范围内可用。MMAS的独特之处 包括 * 一个38岁自由生活、表面上健康男性的随机样本， 70; * 高产量（1709）的完整响应，允许精确 估计关键参数，同时控制混杂因素， 亚组分析 * 包括性行为， 健康状况、药物使用以及生理、人体测量， 社会人口统计学和心理社会变量综合激素， 营养和血脂谱; * 家庭方案，包括早期- 早晨采血和访谈者管理的工具; * 质量控制活动和验证子研究， 数据的质量。 拟议的纵向跟踪旨在检查两个主要的 终点-阳痿和激素谱-在相同的MMAS受试者6 基线研究（t2，1993- 1997年）后10年，以解决：（1） 阳萎发病率（t1和t2之间每年每1000名男子的新病例） 激素谱发生了什么变化？(2)是什么 主要终点和各种类别的 干预变量，即社会人口统计学;健康状况和 医疗保健;心理社会因素;和行为因素？十字架 t1和t2之间的截面关系是否不同？是否发生了变化 干预变量中的受试者与激素变化相关 阳痿？(3)阳痿的患病率是多少（每1000例 男性）在自由生活的正常人群中，明显健康的男性？ 数据收集方法将与基线相同 MMAS经过培训的技术人员将重新联系并重新访问原始MMAS 样本（预计仍有75%可用）。研究提出， 将提供迄今为止最全面的阳痿情况， 激素及其生理、心理和行为相关因素 在正常人身上。

Sexual impotence is a common male disorder affecting 10-12 million men) that can have great significance for health and health-care expenditures. Despite its prevalence, costs, and implications for quality of life impotence remains poorly understood in relation to the endocrine function, medication usage, lifestyles, anthropometrics and behavior (including alcohol consumption, smoking, and nutrition) in the susceptible populations of middle-aged and older men. No definitive population-based study of impotence has been conducted since, despite major changes since that time in social attitudes, possible new causes such as chemical hazards and clinical advances addressing impotence as a vascular disorder. An NIH Consensus Development Conference (1992) lamented the absence of epidemiologic studies of impotence and concluded there is an urgent need for work in this area. There are no normative data on male sexual functioning. The Massachusetts Male Aging Study (MMAS) in its baseline phase (t1, 1986- 90) assembled the largest population-based, cross-sectional database on male endocrine function, health status, sexual functioning, and psychosocial correlates available worldwide. Unique aspects of MMAS include * a random sample of free-living, apparently healthy men aged 38- 70; * a high yield (1709) of complete responses, permitting precise estimation of key parameters while controlling for confounders through subgroup analyses * a wide range of measures including sexual behavior, health status, medication usage, and physiologic, anthropometric, sociodemographic, and psychosocial variables comprehensive hormone, nutritional and lipid profiles; * an in-home protocol, including early- morning blood sampling and interviewer-administered instruments; * quality-control activities and validation substudies ensuring the high quality of the data. The proposed longitudinal follow-up is designed to examine two principal endpoints- impotence and hormone profiles - in the same MMAS subjects six years after the baseline study (t2, 1993-97) to address :(1) What was the incidence of impotence (new cases per year per 1000 men between t1 and t2? What changes occurred in the hormone profiles? (2) What was the relationship between the principal endpoints and the various classes of intervening variables, namely, sociodemographics; health status and medical care;psychosocial factors; and behavioral factors? Did the-cross- sectional relationship differ between t1 and t2? Did changes within subject in the intervening variables correlate with changes in hormones and impotence? (3) What is the prevalence of impotence (cases per 1000 men) in a normal population of free-living, apparently healthy men? The methods for data collection will be identical to those of the baseline MMAS. Trained technicians will recontact and re visit-the original MMAS sample (75 % are expected to be still available). The research proposed will provide the most comprehensive picture to date of impotence, hormones, and their physiological, psychosocial, and behavioral correlates in normal men.