2022年 新着論文 42 糖尿病診療分野から論文が発表されました

A simple questionnaire for the detection of testosterone deficiency in men with late-onset hypogonadism

Endocr J. 2022 Nov 28;69(11):1303-1312. doi: 10.1507/endocrj.EJ22-0073. Epub 2022 Jul 14.

Authors

Yuko Akehi  1   2 Makito Tanabe  2 Hiromi Yano  3 Yuichi Takashi  2 Daiji Kawanami  2 Takashi Nomiyama  2   4 Toshihiko Yanase  2   5

Affiliations

  • 1 Diabetes Therapeutics and Research Center, Institute of Advanced Medical Sciences, Tokushima University, Tokushima 770-8503, Japan.
  • 2 Department of Endocrinology and Diabetes Mellitus, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan.
  • 3 Department of Preventive Medicine, Iizuka Hospital, Iizuka 820-8505, Japan.
  • 4 Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare Ichikawa Hospital, Ichikawa 272-0827, Japan.
  • 5 Muta Hospital, Fukuoka 814-0163, Japan.

Free article

Abstract

The Aging Males’ Symptoms (AMS) score, developed to screen for late-onset hypogonadism (LOH), contains 17 questions regarding mental, physical, and sexual parameters. In the Japanese guidelines, a free testosterone (FT) <8.5 pg/mL is recommended for testosterone treatment. However, previous studies have shown no correlation between total AMS scores and testosterone concentration. We aimed to develop a better questionnaire for the detection of testosterone deficiency in men, for the diagnosis of LOH. In 234 Japanese men, aged 40-64 years, we analyzed the relationships of AMS with serum total testosterone (TT), FT, calculated FT (cFT), and calculated bioavailable testosterone (cBT), and identified useful questions for the detection of testosterone deficiency. Four scores, a decrease in muscular strength, a decrease in ability to perform sexually or the frequency, a decrease in the number of morning erections, and a decrease in sexual desire/libido, were negatively associated with two or more of the above four testosterone parameters, and the sum of these four scores (named the selective score) correlated with TT and cFT, independent of age. Statistical analysis revealed an association between insulin resistance and testosterone deficiency, and a higher selective score in smokers than non-smokers. Cubic function model analysis and logistic regression analysis revealed that selective scores ≥10 corresponded with the testosterone concentrations recommended for the diagnosis of LOH, including FT <8.5 pg/mL, independent of age, insulin resistance, and smoking. Thus, the selective score represents a simple and useful means for screening of testosterone deficiency in Japanese men, as an indicator of LOH.

Keywords: Late-onset hypogonadism; Questionnaire; Testosterone deficiency.

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