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首页> 外文期刊>The journal of sexual medicine >The Determination of Total Testosterone and Free Testosterone (RIA) are not Applicable to the Evaluation of Gonadal Function in HIV-infected Males
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The Determination of Total Testosterone and Free Testosterone (RIA) are not Applicable to the Evaluation of Gonadal Function in HIV-infected Males

机译：总睾丸激素和游离睾丸激素（RIA）的测定不适用于艾滋病毒感染男性的性腺功能评估

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Introduction. Hypogonadism is common in human immunodeficiency virus (HIV)-infected men; the high concentration of sex hormone binding globulin (SHBG) in this population, induces a "false increase" in total testosterone (TT) values. Aims. To validate the determination of TT and measured free testosterone (FT [radioimmunoassay {RIA} ]) for hypogonadism diagnosis in an HIV-infected population using calculated free testosterone (CFT) as reference method; and also to determine the prevalence and identify the risks factors of hypogonadism. Methods. Cross-sectional, observational study. Ninety HIV-infected males (42 +-8.2 years), not HCV coinfected, antiretroviral therapy (ART)-naive (14 patients), on current ART with enhanced protease inhibitor (PI) (39 patients), or patients on Pi-naive ART (NN) (37 patients). Main Outcome Measures. CFT was calculated by determining TT, SHBG, and albumin (Vermeulen's formula); hypogonadism was defined as CFT <0.22 nmol/L (reference range for young healthy males in our laboratory); sensitivity of TT and FT (RIA) for hypogonadism diagnosis was calculated. Results. Twelve patients (13.3%, 95% confidence interval [CI] 7.8-21.9) by CFT presented hypogonadism. TT and FT (RIA) presented a sensitivity of less than 30% in the diagnosis of hypogonadism. Logistic regression multivariate analysis confirmed an independent association between hypogonadism, the patient's age per decade, odds ratio (OR) 6.9 (CI 1.9-24.8; P= 0.003), and longer duration of HIV infection per decade, OR 13.1 (CI 1.3-130.6; P= 0.02). Hypogonadism was associated with erectile dysfunction. Conclusions. TT and FT (RIA) are not useful in the differential diagnosis of hypogonadism in HIV-infected males. There is a significant prevalence of hypogonadism in HIV-infected males, with the patient's age and duration of the disease being the only identifiable risk factors.
机译：介绍。性腺机能减退在感染人类免疫缺陷病毒（HIV）的男性中很常见;在该人群中，高浓度的性激素结合球蛋白（SHBG）导致总睾丸激素（TT）值“虚假增加”。目的使用计算的游离睾丸激素（CFT）作为参考方法，验证用于HIV感染人群性腺功能低下诊断的TT和测得的游离睾丸激素（FT [放射免疫分析{RIA}]）的测定;并确定性腺功能低下的患病率并确定其危险因素。方法。横断面观察研究。九十名感染了HIV的男性（42岁至-8.2岁），未进行HCV合并感染，未进行过抗逆转录病毒治疗（ART）的患者（14例），目前接受增强蛋白酶抑制剂（PI）治疗的抗逆转录病毒疗法的患者（39例），或未进行过Pi的患者ART（NN）（37例）。主要观察指标。 CFT通过确定TT，SHBG和白蛋白（Vermeulen公式）计算得出;性腺功能减退定义为CFT <0.22 nmol / L（我们实验室中年轻健康男性的参考范围）;计算TT和FT（RIA）对性腺功能低下诊断的敏感性。结果。通过CFT的12例患者（13.3％，95％置信区间[CI] 7.8-21.9）表现为性腺功能减退。 TT和FT（RIA）诊断性腺功能减退的敏感性低于30％。 Logistic回归多元分析证实性腺机能减退，患者每十年的年龄，优势比（OR）6.9（CI 1.9-24.8; P = 0.003）和更长的每十年HIV感染持续时间之间的独立关联，即OR 13.1（CI 1.3-130.6） ; P ＝ 0.02）。性腺功能减退与勃起功能障碍有关。结论。 TT和FT（RIA）在HIV感染的男性性腺功能减退的鉴别诊断中无用。在艾滋病毒感染的男性中，性腺功能减退症的患病率很高，患者的年龄和病程是唯一可确定的危险因素。

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