Aging and declining testosterone: past, present, and hopes for the future.
Aging and declining testosterone: past, present, and hopes for the future.
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DOI：
10.2164/jandrol.112.017160
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发表时间：
2012-11
影响因子：
--
通讯作者：
Tenover JL
中科院分区：
文献类型：
--
作者：
Zirkin BR;Tenover JL
随着男性年龄的增长，血清睾酮(T)水平下降，而血清黄体生成素(LH)水平有所上升或保持不变。与年龄相关的T水平降低可能与身体成分、能量水平、肌肉力量、身体、性和认知功能以及情绪的变化有关。血清T水平下降的主要原因是衰老的睾丸产生T的能力下降，与人类一样，棕色挪威大鼠在血清LH水平不变或略有上升的情况下，表现出与年龄相关的血清T水平下降。在这种大鼠模型中，衰老的间质细胞，即睾丸中终末分化的T产生细胞，对促黄体生成素刺激的反应产生T的能力显著降低。这篇综述首先讨论了已知的T合成随着间质细胞衰老而下降的分子机制。文章最后总结了T替代疗法的简史、目前的指导方针、与老年男性T替代疗法相关的争议，并提出了未来的临床方向。
As men age, serum testosterone (T) levels decline, whereas serum luteinizing hormone (LH) levels increase somewhat or remain unchanged. Age-related reductions in T levels may be associated with alterations in body composition; energy level; muscle strength; physical, sexual, and cognitive functions; and mood. The predominant contributor to the decline in serum T levels is the decreased ability of the aging testes to make T. As in humans, the Brown Norway rat demonstrates age-related reductions in serum T levels in the setting of unchanged or modestly increased serum LH levels. In this rat model, the ability of aged Leydig cells, the terminally differentiated T-producing cells of the testis, to produce T in response to LH stimulation is significantly diminished. This review begins with a discussion of what is known of the molecular mechanisms by which T synthesis declines with Leydig cell aging. It concludes with a brief history of T replacement therapy, current guidelines, controversies related to T replacement therapy in older men, and proposed future clinical directions.
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发表时间：
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期刊：
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