Cov koom haum ntawm Bioavailable Serum Testosterone Nrog Kev Paub Txog Kev Ua Haujlwm hauv cov txiv neej laus
Jun 24, 2024
Abstract
Keeb kwm:
Lub hnub nyoog-txog kev paub txog kev poob qis tuaj yeem cuam tshuam los ntawm testosterone xwm txheej. Txawm li cas los xij, kev tshawb fawb soj ntsuam qhov cuam tshuam ntawm bioavailable testosterone, qhov nquag, dawb testosterone, ntawm kev paub txog kev ua haujlwm tsis tshua muaj. Peb txoj kev tshawb fawb tau txiav txim siab txog kev sib raug zoo ntawm kev suav bioavailable testosterone thiab kev txawj ntse hauv cov txiv neej laus.
Thaum lawv muaj hnub nyoog, ntau tus neeg pom tias lawv lub cim xeeb deteriorates. Cov neeg feem coob yuav ntaus nqi qhov no rau qhov poob ntawm lawv lub peev xwm kev txawj ntse. Txawm li cas los xij, kev sib raug zoo ntawm kev txawj ntse poob thiab kev nco tsis yog qhov yooj yim.
Ua ntej tshaj plaws, kev txawj ntse tsis yog ib yam nkaus xwb tab sis suav nrog ntau yam. Piv txwv li, kev mloog, kev xav, kev muaj peev xwm hais lus, kev taw qhia spatial, thiab lwm yam, yog txhua yam kev paub txog kev txawj ntse. Ntawm cov kev tshwm sim no, kev nco tsuas yog ib qho ntawm lawv. Yog li ntawd, txawm tias kev txawj ntse poob qis, nco tsis tas yuav poob nrog nws.
Qhov thib ob, tib neeg lub cim xeeb muaj feem xyuam nrog ntau yam xws li kev noj qab haus huv ntawm lub cev, kev noj qab haus huv ntawm lub hlwb, thiab kev ua neej. Yog tias peb muaj peev xwm tswj hwm peb lub neej thiab kev noj qab haus huv, peb tuaj yeem txhim kho peb lub cim xeeb zoo, uas tsis tas yuav cuam tshuam nrog kev paub txog kev poob qis.
Thaum kawg, peb yuav tsum muaj kev ntseeg siab. Thaum peb muaj hnub nyoog, kev nco ploj yog ib txoj cai ntawm tib neeg txoj kev loj hlob, tiam sis tsis tau txhais hais tias peb yuav tsis nco qab tej yam los yog tias peb lub peev xwm kev txawj ntse yuav poob. Peb tuaj yeem txhim kho peb lub peev xwm thiab kev nco qab los ntawm peb txoj kev siv zog, xws li tswj kev tawm dag zog, pw tsaug zog zoo, noj zaub mov zoo thiab noj zaub mov zoo, tus cwj pwm zoo, thiab lwm yam.
Nyob rau hauv luv luv, tsis txhob xav txog kev poob qis thiab nco tsis zoo li tib lub tswv yim, thiab tsis txhob tso tseg sim vim koj laus dua. Tsuas yog los ntawm kev ua tau zoo tuaj yeem ua rau peb muaj kev noj qab haus huv, muaj kev ntseeg siab, thiab txawj ntse lub neej. Nws tuaj yeem pom tias peb yuav tsum txhim kho kev nco, thiab Cistanche deserticola tuaj yeem txhim kho kev nco zoo vim Cistanche deserticola yog cov khoom siv tshuaj hauv Suav teb uas muaj ntau yam teebmeem, ib qho ntawm kev txhim kho kev nco. Qhov kev ua tau zoo ntawm cov nqaij minced los ntawm nws cov khoom xyaw ntau yam, nrog rau cov kua qaub, polysaccharides, flavonoids, thiab lwm yam. Cov khoom xyaw no tuaj yeem txhawb lub hlwb kev noj qab haus huv ntau txoj hauv kev.
Nyem paub txoj hauv kev los txhim kho lub hlwb
Txoj kev:
Peb tau siv cov ntaub ntawv los ntawm US National Health and Nutrition Examination Survey (NHANES) thaum xyoo 2013 thiab 2014. Txoj kev tshawb no muaj 208 tus txiv neej uas muaj hnub nyoog ntau dua lossis sib npaug li 60 xyoo. Bioavailable serum Testosterone raug xam raws li tag nrho cov ntshav ntshav testosterone, kev sib deev hormone-binding globulin, thiab qib albumin, qhov kev paub txog kev txawj ntse tau raug soj ntsuam los ntawm Consortium los tsim Kev Sau Npe rau Alzheimer's Disease (CERAD) Lo Lus Sau Kev Kawm Test (WLLT), Lo Lus Sau Recall Test (WLRT), thiab Intrusion Word Count Test (WLLT-IC thiab WLRT-IC), Tsiaj Fluency Test (AFT), thiab Digit Symbol Hloov Test (DSST). Ntau qhov kev txheeb xyuas cov kab rov tav tau ua raws li kev hloov pauv rau hnub nyoog, haiv neeg, kev noj qab haus huv ntawm tib neeg, qib kev kawm, keeb kwm kev kho mob, lub cev qhov hnyav, lub zog, kev haus cawv, qib kev ua si, thiab sijhawm pw tsaug zog.
Cov txiaj ntsig:
Ib qho kev sib raug zoo tseem ceeb ntawm bioavailable testosterone thiab DSST ( : 0.049, p=.002) qhab nia tau kuaj pom, tsis muaj cov tsos mob tshwm sim ntawm toj siab. Tsis muaj kev koom tes tseem ceeb nrog CERAD WLLT (p=.132), WLRT (p=.643), WLLT-IC (p=.979), thiab WLRT-IC (p { {12}} .387), thiab AFT (p=.057) tau pom.
Xaus:
Muab xam bioavailable Testosterone tau nthuav tawm ib qho kev koom tes zoo nrog kev ua haujlwm ceev, kev mloog zoo, thiab kev nco ua haujlwm hauv cov txiv neej laus dua 60 xyoo. Kev tshawb fawb ntxiv tau lees paub los piav qhia qhov cuam tshuam ntawm qhov tsis muaj hnub nyoog cuam tshuam txog kev poob qis hauv testosterone ntawm kev paub txog kev ua haujlwm hauv cov txiv neej laus.
Ntsiab lus:
Kev laus, Bioavailable testosterone, Kev paub, Dementia, cov txiv neej laus.
Age-related cognitive decline can be a precursor of dementia, which currently remains a major public health challenge (1). An aging brain is characterized by a reduction in gray and white matter volume and is associated with decreased processing, attention, memory, and executive function (2). In the United States, ~5.1 million people are living with dementia (3), with an estimated financial impact projected at >$ 9 trillion thoob ntiaj teb los ntawm 2050 (4).
Tam sim no, muaj ntau yam kev pheej hmoo cuam tshuam nrog kev paub txog kev poob qis thoob plaws lub neej, suav nrog caj ces predisposition, tsis muaj zaub mov noj, lub cev tsis muaj zog, thiab androgen deficiency (5,6), yam uas sawv cev rau qhov tseem ceeb rau kev tshawb fawb yav tom ntej hauv kev sim kho thiab / lossis tswj kev paub txog kev poob qis hauv cov laus.
Cov pov thawj hais txog kev cuam tshuam ntawm cov txiv neej feem ntau cov tshuaj testosterone ntawm kev paub txog kev ua haujlwm tsis sib haum xeeb (7-13), thaum ob qho tag nrho thiab bioavailable qib ntawm testosterone tsis tu ncua nrog kev laus (14).
Tshwj xeeb, cov kev tshawb fawb yav dhau los tau pom muaj kev sib koom ua ke ntawm cov qib testosterone qis thiab txo qis kev txawj ntse (7,8) lossis dementia hnyav (9), tab sis lwm cov kev tshawb fawb tsis tau pom cov koom haum (10,13) lossis tsis muaj kev sib raug zoo ntawm cov kev sib txawv no (11,12). ). Cov kev tshawb pom no tau coj mus rau qhov tsis paub tseeb txog seb cov tshuaj testosterone puas cuam tshuam nrog kev pheej hmoo ntawm kev paub tsis meej ntawm cov txiv neej thaum laus.
Ib qho ntawm cov teeb meem hauv kev txhais cov ntaub ntawv luam tawm yog cov kev tshawb fawb sib txawv qhia tag nrho cov testosterone lossis bioavailable testosterone. Feem ntau ntawm testosterone nyob rau hauv tib neeg lub cev yog nruj nreem khi (~ 60% ntawm tag nrho cov testosterone) rau kev sib deev hormone-binding globulin (SHBG) thiab rau ib tug tsawg dua (~ 38%) khi rau albumin. Tsuas yog ib feem me me (~ 2%) ntawm tag nrho cov testosterone yog unbound los yog "dawb" thiab yog li "biologically active" thiab muaj nyob rau hauv cov ntaub so ntswg theem (15).
SHBG tuaj yeem sib txawv raws li ntau yam xws li kev noj zaub mov zoo, qhov hnyav, qib androgen, kev mob sib kis, thiab hnub nyoog (16,17). Cov kev cuam tshuam tom qab no muaj nyob rau hauv kev sib khi ntawm testosterone thiab yog li kev ua haujlwm ua rau bioavailable testosterone ib qho kev nyiam tshaj li tag nrho cov testosterone hauv kev sib cais. Tseeb, raws li tag nrho cov testosterone feem ntau txo nrog lub hnub nyoog, thaum SHBG feem ntau nce (18), tag nrho cov txiaj ntsig ntawm kev laus yuav muaj kev cuam tshuam ntau dua rau bioavailable, active testosterone. Yog li ntawd, txoj kev tshawb nrhiav ntu ntu tam sim no txhawm rau tshuaj xyuas lub koom haum ntawm bioavailable testosterone nrog kev paub txog kev ua haujlwm hauv cov txiv neej laus.
Txoj kev
Kawm Tsim thiab koom nrog
Peb tau muab cov ntaub ntawv tshaj tawm los ntawm cov neeg koom nrog hnub nyoog Ntau dua lossis sib npaug li 60 xyoo los ntawm ib lub voj voog kev soj ntsuam hauv National Health and Nutrition Examination Survey (NHANES): 2013–2014. NHANES yog ua los ntawm Lub Chaw Tiv Thaiv Kab Mob thiab Tiv Thaiv (CDC) thiab National Center for Health Statistics (NCHS) los saib xyuas kev noj qab haus huv hauv Asmeskas cov pej xeem.
Kev txiav tawm hnub nyoog ntau dua lossis sib npaug rau 60 xyoo tau siv raws li cov ntaub ntawv muaj rau tag nrho cov ntshav testosterone, SHBG, thiab albumin concentrations. Cov txheej txheem tsis suav nrog tsis muaj cov ntaub ntawv sau tseg rau tag nrho cov ntshav ntshav testosterone, SHBG, thiab albumin concentrations, cov ntaub ntawv tsis tiav rau kev ntsuam xyuas kev paub, lossis cov ntaub ntawv tsis muaj pej xeem. NHANES raws tu qauv tau pom zoo los ntawm NCHS Research Ethics Review Board, thaum txhua tus neeg koom tau sau ntawv tso cai.
Bioavailable Testosterone Kev Ntsuas
Bioavailable serum Testosterone tau xam raws li Vermeulen methodology (19) siv ntsuas qhov ntsuas ntawm tag nrho cov ntshav ntshav testosterone, SHBG, thiab albumin. Tag nrho cov ntshav testosterone los ntawm cov qauv yoo mov thaum hmo ntuj tau kwv yees los ntawm isotope dilution-kua chromatography-tandem mass spectrometry (ID-LC-MS/MS) txoj kev. SHBG tau hnov mob nrog lub cev tiv thaiv kab mob thiab kev ntsuas chemoluminescence ntawm microparticles thiab ntsuas los ntawm lub raj photomultiplier. Albumin concentration tau soj ntsuam siv DcX800 txoj kev siv biochromatic digital endpoint methodology nrog Bromcresol Purple.
Kev ntsuam xyuas kev paub
Kev paub txog kev ua haujlwm tau raug soj ntsuam los ntawm kev siv ntau yam kev xeem suav nrog Consortium los tsim Kev Sau Npe rau Alzheimer's Disease (CERAD) Word List Learning Test (WLLT), Word List Recall Test (WLRT), thiab Intrusion Word Count Test (WLLT-IC thiab WLRT- IC), Kev Ntsuas Tsiaj Tsiaj (AFT), thiab Kev Ntsuas Tus lej Cim Hloov (DSST). Cov kev ntsuam xyuas tau tswj hwm los ntawm cov neeg ua haujlwm tau txais kev cob qhia, cov neeg ua haujlwm tsim nyog thaum kawg ntawm kev xam phaj tus kheej hauv cov chaw kuaj mob mobile. Cov ntsiab lus tag nrho ntawm kev xam phaj ua haujlwm tau raug nthuav tawm rau lwm qhov (https://www.cdc.gov/ nchs/nhanes/index.htm).
Lub CERAD WLLT, WLLT-IC, WLRT, thiab WLRT-IC tshuaj xyuas qhov muaj peev xwm kawm tam sim thiab ncua sij hawm rau cov ntaub ntawv hais lus tshiab thiab muaj 3 qhov kev kawm nce qib tom qab los ntawm kev ncua ncua kev sib tw nrog ntau cov qhab nia nruab nrab ntawm 0 thiab 10. AFT ntsuam xyuas kev ua haujlwm los ntawm kev ntsuas cov lus hais lus zoo nrog cov qhab nia ntawm 3 txog 39.
DSST suav nrog kev sib tw ua haujlwm los ntawm Wechsler Adult Intelligence ScaleIII, uas tshuaj xyuas kev ua haujlwm nrawm, kev mloog zoo, thiab kev nco ua haujlwm, thiab tau qhab nia nruab nrab ntawm 0 thiab 105. Cov qhab nias siab dua qhia txog kev paub zoo dua. Cov neeg koom nrog yam tsis muaj lus teb rau ib qho ntawm cov kev xeem tau raug cais tawm.
Covariates
Hnub nyoog (xyoo), haiv neeg (haiv neeg), kev khwv nyiaj txiag hauv zej zog (tsev neeg cov nyiaj tau los rau cov neeg txom nyem piv txwv [FIPR]), qib kev kawm (tsev kawm ntawv tsim nyog), keeb kwm kho mob (nco-kev paub txog kev poob haujlwm thiab mob stroke), lub cev qhov ntsuas (BMI; kg / m2), sijhawm pw tsaug zog txhua hnub (teev pw tsaug zog siv thaum hmo ntuj ntawm hnub ua haujlwm lossis hnub ua haujlwm) thiab kev ua si lub cev (feeb siv ua kis las siv zog, qoj ib ce, lossis ua si ua si), noj zog txhua hnub (kcal), thiab haus cawv (g ) raug suav hais tias yog covariates. Tag nrho covariates tau txheeb xyuas tias muaj peev xwm confounders hauv kev sib raug zoo ntawm bioavailable testosterone thiab kev txawj ntse. Cov neeg koom nrog cov tshuaj kho mob tam sim no ntawm aromatase inhibitors thiab glucocorticoids raug cais tawm, txiav txim siab tias lawv tuaj yeem hloov pauv qib testosterone endogenous (20).
Cov hnub nyoog muaj cov neeg koom nrog ntau dua lossis sib npaug rau 60 xyoo thiab tau muab faib ua 60–69, 70–79, thiab Ntau dua lossis sib npaug rau 80 xyoo. Cov pab pawg neeg muaj xws li Mexican American, lwm haiv neeg Mev, tsis yog neeg Mev Dawb, tsis yog neeg Mev Dub, tsis yog neeg Mev Neeg Esxias, thiab lwm yam (ntau) haiv neeg. Kev lag luam hauv zej zog tau muab faib ua qis-nrab (FIPR <1) thiab nruab nrab-siab (FIPR Ntau dua lossis sib npaug rau 1). Qib kev kawm tau txhais tias tsis muaj daim ntawv kawm tiav high school, feem ntau kawm tiav high school lossis qib kawm qib siab tsawg kawg nkaus.
Kev kho mob keeb kwm raws li kev poob ntawm kev txawj ntse-nco muaj nuj nqi lossis mob stroke raug cais raws li Yog / Tsis muaj lus teb raws li cov xwm txheej yav dhau los qhia los ntawm kws kho mob lossis lwm tus kws kho mob. BMI tau txhais raws li tus neeg koom nrog qhov hnyav hauv kilograms muab faib los ntawm square ntawm qhov siab hauv meters. Lub cev ua haujlwm ntawm<150 min/wk was considered low-moderate and ≥150 min/wk was considered moderate-high. Energy and alcohol intake were calculated as averages of the 24-hour dietary recall and categorized into low, moderate, and high.
BMI ntawm<18 kg/m2 was considered low, 18–24.9 kg/m2 moderate, and ≥25 kg/m2 high. An energy intake of <2 000 kcal was considered as low, 2 000–3 000 kcal moderate, and >3 000 kcal high. Alcohol intake < 15 g was considered low, 15–30 g moderate, and >30 g high. Sleep duration of ≤6 hours was classified as low, 7–9 hours as moderate, and >9 hnu as.
Kev txheeb cais
Ntau qhov kev ntsuam xyuas kab rov tav tau ua los tshuaj xyuas kev sib koom ua ke ntawm bioavailable thiab tag nrho cov testosterone thiab kev paub txog kev ua haujlwm (tag nrho thiab kev ntsuam xyuas tshwj xeeb kev txawj ntse) nrog rau kev hloov kho ntawm tag nrho covariates.
Ib qho kev txwv cubic spline tau ua hauj lwm los ua qauv ntawm nonlinear thiab koob tshuaj tiv thaiv kev sib raug zoo ntawm kev suav bioavailable testosterone thiab kev txawj ntse siv 3 pob caus tom qab kho covariate. Kev txheeb xyuas qhov tseem ceeb tau tsim los ua p < .05. Kev txheeb cais tau ua tiav siv IBM SPSS cov ntaub ntawv txheeb cais (Version 28.0, IBM Corp., Armonk, NY).
Cov txiaj ntsig
Cov yam ntxwv ntawm cov neeg koom nrog kev kawm
Cov ntaub ntawv rau kev paub txog kev ua haujlwm thiab suav bioavailable testosterone muaj rau tag nrho ntawm 208 tus neeg koom (Daim duab 1). Cov ntaub ntawv keeb kwm yav dhau (piv txwv li, cov xwm txheej hauv zej zog, kev txheeb xyuas tus kheej, thiab cov yam ntxwv ntawm kev noj haus) ntawm txhua tus neeg koom nrog tau tshaj tawm hauv Table 1. Cov neeg kawm tau muaj hnub nyoog nruab nrab ntawm 69.4 (± 0.5) xyoo thiab feem ntau tsis yog neeg Mev dawb (53%) ntawm high socieconomic status (69%) nrog rau kev kawm ntawv qib siab tsawg kawg nkaus (67%). Lub sijhawm pw tsaug zog yog nruab nrab (63%) ntawm cov neeg koom thiab kev ua si lub cev yog siab (55.3%). Kev siv hluav taws xob qis dua qhov pom zoo siv (51%) lossis hauv cov lus pom zoo (42%).
Kev haus dej cawv tsawg (78%), thiab BMI siab (71%). Qhov nruab nrab suav bioavailable testosterone yog 185.7 (± 4.0) ng/dL. Qhov qhab nia nruab nrab rau CERAD WLLT yog 19.3 (± 0.3) ntawm 30, 6.1 (± 0.2) ntawm 10 rau CERAD WLRT, {{ 22}}.6 (± 0.1) ntawm 12 rau CERAD WLLT-IC, {{30}}.4 (± 0.1) ntawm 10 rau CERAD WLRT -IC, 18.3 (0.4) ntawm 40 rau AFT, thiab 49.0 (± 1.0) ntawm 100 rau DSST.
Xam Bioavailable Testosterone thiab Kev Paub Txog Kev Ua Haujlwm
Kev suav bioavailable testosterone tau zoo cuam tshuam nrog DSST (: 0.049, p=.002) qhab nia (Table 2). Tsis pom muaj kev koom tes tseem ceeb nrog CERAD WLLT (p=.132), WLRT (p=.643), WLLT-IC (p=.979), thiab WLRT-IC ( p=.387), thiab AFT (p=.057). Cubic spline modeling tsis pom muaj qhov tshwm sim ntawm cov nyhuv toj siab thoob plaws qhov kev faib tawm ntawm kev suav bioavailable testosterone qib tshawb fawb ntawm cov koom haum tseem ceeb tau pom (Daim duab 2).
Raws li peb cov qauv kev hloov pauv ntau yam, kev hloov pauv hauv bioavailable testosterone ntawm 100 ng / dL sib raug rau 5% kev txhim kho hauv DSST kev ua tau zoo. Thaum kawg, ib qho kev soj ntsuam zoo sib xws ntawm tib pawg raws li tag nrho cov testosterone concentrations pom tsis muaj kev koom tes tseem ceeb nrog kev paub txog kev ua haujlwm (CERAD WLLT p=.335, WLLRT p=.786, WLLT-IC p {{7 } } .612 thiab WLLRT-IC p=.7
Kev sib tham
Txoj kev tshawb fawb tam sim no tau tshawb fawb txog kev koom tes ntawm kev suav bioavailable testosterone thiab kev paub txog kev ua haujlwm hauv cov txiv neej laus nyob hauv Tebchaws Meskas. Peb cov txiaj ntsig tau pom tias muaj kev koom tes tseem ceeb ntawm kev suav bioavailable testosterone nrog DSST tus qhab nia, tom qab hloov kho rau ntau yam kev sib raug zoo, anthropometric, thiab khoom noj khoom haus covariates. Cov txiaj ntsig tsis tseem ceeb ntawm CERAD WLLT, WLLT-IC, WLRT WLRT-IC, thiab AFT cov qhab nia.
Peb txoj kev tshawb fawb ntxiv rau lub cev ntawm cov ntaub ntawv uas twb muaj lawm uas txhawb nqa lub luag haujlwm ntawm testosterone hauv kev tswj hwm kev txawj ntse hauv cov txiv neej. Piv txwv li, nws tau pom yav dhau los tias suav bioavailable testosterone hauv cov txiv neej noj qab haus huv 20-84 xyoo yog qhov cuam tshuam nrog kev txo qis hauv kev pom thiab kev mloog (21). Ib yam li ntawd, qhov tseem ceeb, txawm tias tsis muaj kev sib raug zoo tsis zoo (r=−.222) tau pom nyob rau hauv cov txiv neej laus hnub nyoog 55 xyoo thiab siab dua, ntawm kev ntsuas bioavailable testosterone thiab kev ua haujlwm ntawm kev sim B test (22).
Tsis tas li ntawd, Chu et al. nthuav tawm tias ntsuas bioavailable testosterone qib hauv Suav cov txiv neej laus uas muaj amnestic me ntsis kev paub tsis meej thiab Alzheimer's tus kab mob hnub nyoog 55-93 xyoo tau zoo cuam tshuam nrog qeeb Stroop lo lus rov qab kuaj thiab hais lus thiab pom kev nco (23). Tsis tas li ntawd, kev sib raug zoo ntxiv tau pom nyob rau hauv cov txiv neej nyob ntawm nws tus kheej hnub nyoog 40-80 nrog suav bioavailable testosterone thiab txhim kho kev ua haujlwm ceev thiab kev ua haujlwm (24). Ib yam li ntawd, nyob rau hauv cov txiv neej noj qab haus huv laus dua 65 xyoo, suav bioavailable testosterone yog txuam nrog kev sim B thiab cov lej cim kev ntsuas uas ntsuas ntau qhov ntsuas ntawm kev txawj ntse, suav nrog kev mloog, kev ua haujlwm nco, kev ua haujlwm ntawm lub hlwb, thiab lub koom haum perpetual (25).
Hauv kev sib piv rau peb qhov kev tshawb pom, ntau qhov kev tshawb fawb tsis qhia txog kev sib raug zoo ntawm testosterone thiab kev paub txog kev ua haujlwm. Geerlings et al. qhia tias nyob rau hauv cov txiv neej Nyij Pooj American laus hnub nyoog 71-93 xyoo tsis muaj dementia, suav bioavailable testosterone siv ntau qhov sib tw immunoassay-ib qho kev ntsuas qis dua piv rau LC-MS-thov cov ntshav concentration tertiles tsis muaj kev koom tes nrog Kev Txawj Ntse Kev Ntsuas Ntsuas Ntsuas Ntsuas (26 ). Qhov kawg yog qhov kev ntsuas ntau ntawm kev mloog, kev xav, kev taw qhia, kev nco luv luv thiab ntev, kev siv lus thiab kev pom, kev hais lus zoo, kev xav, thiab kev txiav txim siab (27).
Ib yam li ntawd, Alibhai et al. tau tshaj tawm tias qhov siab ntawm kev suav bioavailable testosterone hauv cov txiv neej laus uas muaj lossis tsis muaj mob qog noj ntshav prostate hnub nyoog 50-87 xyoo tsis tau txuas nrog kev ua haujlwm nrawm (kev sim A thiab Delis-Kaplan cov thawj coj ua haujlwm ua haujlwm xim-lo lus cuam tshuam), kev saib xyuas (tus lej thiab spatial. span rau pem hauv ntej qhab nia), kev hais lus zoo (tswj lub ncauj lus sib koom ua ke thiab kuaj tsiaj kom paub meej), visuospatial peev xwm (daim ntawv sib hloov thiab kev txiav txim siab ntawm kab kev taw qhia cov qhab nia nyoos), thiab kev ua haujlwm nco (kev sim ntsuas kev kawm ua ke) (28).
Cov ntaub ntawv pov thawj ntawm cov koom haum tsis tseem ceeb ntawm kev ntsuas bioavailable testosterone qib thiab kev ntsuas ntawm kev paub xws li tag nrho kev nco cuam tshuam hauv cov txiv neej hauv zej zog hnub nyoog 35-80 xyoo kuj tau tshaj tawm (29).
Peb qhov kev tshawb pom, ua ke nrog cov kev tshawb fawb yav dhau los, yuav tshwm sim tsis sib haum; Txawm li cas los xij, ntau txoj hauv kev tau txais kev pom zoo muaj peev xwm piav qhia rau qhov tsis sib xws. Piv txwv li, qhov sib txawv ntawm cov kev tshawb fawb, ib feem, tej zaum yuav piav qhia los ntawm qhov nyuaj ntawm cov kev txawj ntse sib txawv thiab cov cuab yeej ntsuas kev ntsuas uas siv rau kev ntsuas qhov ntsuas ntawm kev paub. Cov qhab nia rau ib qho kev xeem peb tau pom cov koom haum tseem ceeb nrog suav bioavailable Testosterone yog tus cwj pwm los ntawm nws cov brevity thiab siab rhiab heev rau kev txheeb xyuas cov tib neeg uas muaj kev paub tsis meej. DSST tau qhia tshwj xeeb kom paub txog kev kuaj pom ob qho tib si kev paub tsis meej nrog rau kev hloov pauv ntawm kev paub tsis meej hauv ntau qhov chaw kho mob (30). Tsis tas li ntawd, ntau txoj kev tshawb fawb nrhiav cov neeg koom nrog ntau yam kev laus uas yuav yog ib qho kev sib cav sib ceg hauv kev ntsuam xyuas kev sib raug zoo ntawm kev suav lossis ntsuas bioavailable testosterone hauv cov neeg laus laus zoo li peb txoj kev tshawb fawb (60 xyoo thiab siab dua).
Cov ntaub ntawv tsis sib haum xeeb tshuaj xyuas kev tshawb pom kuj tuaj yeem raug ntaus nqi los ntawm txoj kev kuaj testosterone (xws li, immunoassay vs LC / MS) siv. Piv txwv li, qhov tseeb thiab qhov tseeb ntawm cov txheej txheem immunoassay tau raug nug tsis ntev los no, tshwj xeeb tshaj yog thaum ntsuas qib qis ntawm testosterone (31), tus yam ntxwv cuam tshuam nrog kev laus. Qhov tseeb, ntawm qhov qis dua ntawm testosterone, txog li 40% ntawm cov txiaj ntsig ntawm immunoassay sib txawv los ntawm ntau dua 20% los ntawm kev siv tshuaj ntsuam xyuas tau los ntawm kub-txheej txheem LC / MS-MS mus kom ze (31). Xws li, testosterone qhov tseem ceeb muab los ntawm LC / MS yog tus qauv nyiam ua ke nrog SHBG thiab albumin kom tau txais bioavailable lossis active testosterone. Ntxiv mus, hauv peb qhov kev tshuaj ntsuam, sijhawm pw tsaug zog yog ib qho tseem ceeb tshaj plaws covariates uas tuaj yeem cuam tshuam cov concentration ntawm bioavailable testosterone.
Nws tau raug pom tias tus nqi ntawm kev pw tsaug zog hmo ntuj ntsuas los ntawm polysomnography yog ib qho kev kwv yees ntawm cov neeg koom nrog thaum sawv ntxov tag nrho thiab qib testosterone dawb (32). Tsis tas li ntawd, 7 hnub ntawm kev txwv tsis pub pw tsaug zog (5 teev pw tsaug zog ib hmo) hauv cov txiv neej hluas ua rau txo qis testosterone theem ntawm ~ 10% -15% (33). Hauv feem ntau cov kev tshawb fawb uas tau tshawb xyuas cov koom haum ntawm kev suav / ntsuas bioavailable testosterone (21–26,28,29), pw tsaug zog ntev tsis suav nrog cov sib txawv, thiab yog li ntawd, qhov no yuav yog qhov kev piav qhia txog qhov tsis sib xws hauv cov ntaub ntawv uas twb muaj lawm. Hauv peb cov ntaub ntawv, suav nrog sijhawm pw tsaug zog raws li covariate tuaj yeem ua rau txo qis hauv peb cov qauv loj; Txawm li cas los xij, kev ntseeg siab hauv peb cov ntaub ntawv thiab kev txheeb xyuas tau suav nrog suav nrog lub sijhawm pw tsaug zog.
Thaum kawg, lwm lub zog ntawm peb txoj kev tshawb fawb yog cov kev txheeb xyuas cov ntaub ntawv ua haujlwm, uas peb tau tshawb xyuas cov kab sib raug zoo ntawm testosterone thiab kev paub txog kev ua tau zoo dua li kev tshawb xyuas qhov kev pheej hmoo ntawm kev twv ua ntej (qhov tsis sib xws) ntawm kev txawj ntse raws li qib testosterone raws li lwm tus tau ua (12). Kev kwv yees los ntawm cov qauv linear tshawb xyuas tag nrho cov kev faib tawm ntawm qhov sib txawv es tsis yog dichotomizing cov ntaub ntawv rau saum toj / hauv qab qhov pib. Qhov no yog qhov kev pom ntau dua, xws li los ntawm tus qauv linear regression, ib tus tuaj yeem kwv yees qhov loj ntawm kev hloov pauv, tsis zoo li nws qhov tshwm sim.
Yog li ntawd, ntau txoj hauv kev los ntsuas bioavailable testosterone, ntau lub hnub nyoog sib txawv, covariates, kev txheeb xyuas cov txheeb cais, thiab cov cuab yeej ntsuas kev paub txog kev txawj ntse ntawm cov kev tshawb fawb tau suav nrog cov koom haum sib txawv ntawm bioavailable testosterone nrog kev paub txog kev ua haujlwm hauv cov txiv neej laus.
Undoubtedly, kev tshawb fawb ntxiv yog xav tau los txhim kho peb txoj kev nkag siab ntawm qhov muaj peev xwm ua rau qhov txuas tau muab hais tias peb cov kev txhais lus tsawg yog raws li qhov tsis txaus ntawm cov ntawv nyeem txog yuav ua li cas testosterone yuav hloov lub hlwb lub cev thiab yuav ua li cas uas txhais tau tias hloov pauv hauv kev txawj ntse.
Piv txwv li, Testosterone tuaj yeem cuam tshuam qhov kev nco qab los ntawm kev ua kom cov neuron ntim ntawm rostral hippocampus (34), kev hloov pauv uas yuav raug ntaus nqi rau cov nyhuv ncaj qha ntawm androgen receptors hauv hippocampus (35) thiab lawv cov cawv ntawm synaptic plasticity (36) txij li nws tau pom tias muaj peev xwm mus sij hawm ntev-zoo li cortical plasticity impairment yog qhov tshwm sim tseem ceeb hauv Alzheimer's cov neeg mob (37), thaum qhov kev puas tsuaj no cuam tshuam nrog kev nco tsis zoo (37). Tsis tas li ntawd, lwm qhov kev piav qhia qhia txog qhov nce qib ntawm neurotrophins, suav nrog cov paj hlwb loj hlob hauv hippocampus thiab kev tswj hwm ntawm nws cov receptor los ntawm forebrain neurons (38), nrog rau depolarization ntawm N-methyl-d-aspartate receptor hauv hippocampal pyramidal hlwb thiab regeneration ntawm nws cov neurotransmitter evoked ua (39).
Cov kev tshawb fawb yav tom ntej tshwj xeeb tsim los kom paub meej txog kev cuam tshuam ntawm bioavailable testosterone ntawm qib ntshav sib txawv ntawm kev paub txog kev ua haujlwm thiab nws cov thawj tswj hwm, tshwj xeeb yog cov kev tshawb fawb ntev los saib xyuas cov kev hloov pauv hauv testosterone thoob plaws lub neej. Cov txheej txheem zoo li no, txawm tias muaj kev sib tw logistically, yuav ua rau muaj kev nkag siab tshiab rau hauv lub luag haujlwm ntawm lub hnub nyoog cuam tshuam txog kev poob qis hauv qib testosterone ntawm kev paub txog kev ua haujlwm. Txhim kho peb txoj kev nkag siab txog qhov cuam tshuam ntawm testosterone ntawm kev paub txog kev ua haujlwm hauv cov hnub nyoog laus dua tuaj yeem muaj txiaj ntsig zoo rau kev txhim kho cov kev pabcuam kho mob los txhim kho cov neeg mob kev kho mob thiab cov txiaj ntsig thiab txuas ntxiv kev noj qab haus huv.
Lub zog thiab kev txwv
Peb txoj kev tshawb xyuas rov qab los ntawm kev siv cov ntaub ntawv loj hauv teb chaws sawv cev (piv txwv li, NHANES) uas tau raug tswj xyuas kom zoo. Tsis tas li ntawd, ntau covariates tau hloov kho thaum lub sij hawm kev tshuaj ntsuam xyuas kom raug (thiab cais tawm) kev koom tes ntawm bioavailable testosterone thiab kev paub txog kev ua haujlwm hauv cov neeg laus. Hauv kev ua li ntawd, ib hmos ceev ceev cov ntsiab lus ntawm bioavailable testosterone, uas tsis yog tag nrho cov testosterone, tau siv los tshawb txog kev sib raug zoo ntawm testosterone thiab kev paub txog kev ua haujlwm, kov yeej cov kev cuam tshuam hnub nyoog cuam tshuam ntawm testosterone los ntawm SHBG thiab albumin qib (40).
Txawm li cas los xij, nws tseem ceeb heev uas peb txoj kev tshawb fawb kuj muaj ntau yam kev txwv. Cov kev tshawb fawb soj ntsuam uas siv tus qauv hla ntu tsis tuaj yeem nthuav tawm qhov ua rau-thiab-tshuaj cuam tshuam kev sib raug zoo ntawm kev vam khom thiab kev ywj pheej. Tsis tas li ntawd, lub siab lub ntsws tuaj yeem cuam tshuam rau kev puas siab puas ntsws los ntawm kev hloov pauv hauv kev paub txog kev ua tau zoo uas yuav tsis cuam tshuam ncaj qha nrog rau tag nrho thiab / lossis bioavailable testosterone qib. Testosterone tuaj yeem hloov pauv amygdala kev ua haujlwm thiab kev sib txuas, txo kev ua haujlwm sib txuas nrog lub orbitofrontal cortex thaum lub ntsej muag txiav txim siab, thiab nce hauv kev teb rau kev xav lub ntsej muag (41-43). Thaum kawg, kev paub txog kev ua haujlwm uas tau sau los ntawm NHANES tau tsom mus rau yam ntawm kev paub txog kev ua tau zoo thiab yuav tsis tuaj yeem sawv cev tag nrho kev paub txog kev ua haujlwm tau muab rau ntau yam kev puas siab puas ntsws thiab cov cuab yeej ntsuas tau lees paub. Piv txwv li, rov qab cov lej rov qab tuaj yeem ua rau cov parietal, occipital, frontal, thiab lub cev nqaij daim tawv mus rau qhov ntau dua uas tsis yog qhov kev sim rov qab rov qab (44).
Xaus
Hauv cov pej xeem ntawm cov neeg laus dua 60 xyoo, suav bioavailable testosterone tau cuam tshuam nrog cov cim tshwj xeeb ntawm kev paub txog kev ua haujlwm xws li kev ua haujlwm nrawm, tab sis tsis muaj kev cuam tshuam rau kev kawm, kev hais lus zoo ntawm lub cim xeeb, thiab kev nkag siab ntawm kev nco. Qhov sib npaug ntawm peb txoj kev nkag siab txog qhov cuam tshuam ntawm testosterone ntawm kev paub txog kev ua haujlwm qiv rau qhov kev xav ntawm qhov xav tau kev tshawb fawb ntxiv tshwj xeeb uas tsim los kom paub meej txog kev cuam tshuam ntawm bioavailable testosterone ntawm qib ntshav sib txawv ntawm kev txawj ntse thiab nws cov thawj.
