摘要
目的:探究基于我国社区人口资料的迟发性性腺功能减退症(LOH)患病率以及ADAM问卷和AMS量表(分别简称ADAM和AMS)在我国人群的敏感性、特异性及适用性。方法:1498例中老年健康男性研究对象填写了ADAM和AMS,其中434例进行了生殖激素浓度测定,利用血清总睾酮(tT)和计算的游离睾酮(fT)切点计算LOH的筛查阳性率、雄激素水平低下率、LOH临床患病率、筛查量表的敏感性和特异性等。利用ROC曲线优选AMS评分症状评价的切点值。结果:研究对象中仅有5例曾经不规范地补充过雄激素,调查时没有研究对象补充或主动寻求激素治疗。利用ADAM或AMS筛查40～69岁人群,LOH的平均筛查阳性率分别为80.77%和32.34%;以tT或fT为切点计算出的40～69岁人群平均雄激素水平低下率分别为14.02%和43.69%,ADAM阳性或者AMS阳性研究对象的平均LOH临床患病率分别为37.85%和15.42%;使用fT切点评定的ADAM、AMS的敏感性分别为86.63%和35.29%,特异性分别为24.48%和63.49%。ROC曲线优选的AMS评分症状评价的切点值为19.5分。结论:基于我国人群的ADAM、AMS的敏感性、特异性与国际上的多数研究结论基本一致,LOH筛查阳性率、雄激素水平低下率和临床患病率则明显高于其他研究报道。对于我国人群来说,两个筛查量表具有较好的适用性;ADAM敏感性高,省时、易操作,可作为筛查量表使用,而AMS可作为疗效监测量表使用。
Objective：To investigate the incidence of late onset of hypogonadism（LOH） in males as well as the sensitivity, specificity and applicability of the androgen deficiency in aging males（ADAM） questionnaire and the aging males＇symptoms（AMS） scale in Chinese males based on the community population data.Methods：A total of 1 498 old and middle-aged healthy males attended the ADAM and AMS investigations,of whom 434 received the measurement of the concentration of serum reproductive hormones, the positive rate of LOH screening,the rate of androgen deficiency,the clinical incidence of LOH,and the sensitivity and specificity of ADAM and AMS by tT and fT cut-off.The symptom evaluation cut-off value of the AMS score was optimized using the ROC curve. Results：Although 5 of the subjects had previously received irregular testosterone supplement,none of them was given or actively sought for androgen therapy at the time of the investigation.Among the 40-69 years old males,the mean positive rates of LOH screening by ADAM and AMS were 80.77%and 32.34%,and the mean androgen deficiency rates obtained by tT and fT cut-off were 14.02%and 43.69%.The mean clinical incidences of LOH in the ADMA- and AMS-positive subjects were 37.85%and 15.42%.According to the fT cut-off,the sensitivities of ADAM and AMS were 86.63%and 35.29%,and their specificities were 24.48%and 63.49%,respectively. The symptom evaluation cut-off value of the AMS score optimized by the ROC curve was 19.5.Conclusion：The sensitivity and specificity of ADAM and AMS in the Chinese population are basically consistent with the results of most studies abroad,while the positive rate of LOH screening,the rate of androgen deficiency and the clinical incidence of LOH obviously higher in the former than those reported in other studies.Both ADAM and AMS are applicable to the Chinese population.The former is advantageous for its high sensitivity,time saving and easy operation,and therefore suitable for screening LOH,while the latter can be used for monitoring ther
出处
《中华男科学杂志》
CAS
CSCD
北大核心
2010年第2期106-111,共6页
National Journal of Andrology
基金
中央级公益性科研院所基本科研业务费专项(2007计生所JZ01)~~
关键词
中老年男性
迟发性性腺功能减退症
筛查量表
ADAM问卷
AMS量表
验证
aging male
late onset of hypogonadism
screening scale
androgen deficiency in aging males questionnaire
aging males＇symptoms
validation
