EPIDEMIOLOGY OF IMPOTENCE AND HORMONES IN NORMAL MEN

性阳萎是一种常见的男性疾病，影响1000-1200万男性) 这可能会对医疗和医疗保健支出产生重大影响。 尽管它的流行、成本和对生活质量的影响 阳萎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)在易感人群中 中老年男性群体。没有明确的以人口为基础 对阳萎的研究自那以来一直在进行，尽管自 当时在社会态度上，可能出现了新的原因，如化学物质 将阳萎作为一种血管疾病处理的危害和临床进展。 美国国立卫生研究院共识发展会议(1992)哀叹没有 对阳萎的流行病学研究得出的结论是，迫切需要 在这方面的工作。目前还没有关于男性性行为的标准数据 功能正常。 马萨诸塞州男性老龄化研究(MMAS)处于基线阶段(1986年T1- 90)收集了最大的基于人口的横断面数据库 男性内分泌功能、健康状况、性功能和 心理社会关联可在全球范围内使用。MMA的独特之处 包括随机抽样的自由生活的、表面上健康的38岁男性- 70；*完整回复的高产量(1709)，允许精确 控制混杂因素时关键参数的估计 分组分析*广泛的衡量标准，包括性行为， 健康状况，用药情况，生理，人体测量， 社会人口和心理社会变量综合荷尔蒙， 营养和血脂状况；*家庭方案，包括早期- 晨间采血和采访者使用的仪器；* 质量控制活动和验证子研究确保高 数据的质量。 拟议的纵向跟踪旨在检查两项主要原则 相同MMA受试者的6个终点-阳萎和荷尔蒙特征 基线研究(T2,1993-97)几年后要解决的问题：(1)什么是 阳萎发病率(T1至T2期间每年每1000名男性新增病例？ 激素谱发生了什么变化？(2)什么是 主端点和不同类别的 中间变量，即社会人口学；健康状况和 医疗保健；心理社会因素；以及行为因素？有没有-有没有- T1和T2的截面关系不同？是否在内部进行了更改 受试者的中间变量与荷尔蒙的变化相关 和阳萎？(3)阳萎的流行率是多少(每1000例病例 在一个自由生活的、表面上健康的正常人群中)？ 数据收集的方法将与基线的方法相同 MMA。训练有素的技术人员将重新联系并再次访问-原始MMA 样本(预计仍有75%)。这项研究建议 将提供迄今为止最全面的阳萎图景， 荷尔蒙及其生理、心理和行为的相关性 在普通人身上。

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.