Abstract: Background　The hypothalamic-pituitary-gonadal axis function gradually declined with increasing age in men.Partial Androgen Deficiency in the Aging Male（PADAM） mainly testosterone deficiency caused abdominal obesity,type 2 diabetes mellitus,metabolic syndrome,cardiovascular disease,decreased bone and muscle strength and quality,sexual dysfunction,depression,and cognitive disorders.Objective　To investigate the change of testosterone level in men and the prevalence of PADAM.Methods　A total of 5 743 heathy men who accepted routine examination from the First Affiliated Hospital of Wenzhou Medical University from 2011 to 2014 and met the inclusion criteria were collected.All subjects were divided into 6 groups,including 20- years old group （142 cases）,30- years old group （1 261 cases）,40- years old group （2 346 cases）,50- years old group （1 339 cases）,60- years old group （552 cases） and 70-85 years old group （103 cases）.Testosterone level in all subjects was measured and recorded.Testosterone level （11.1 nmol/L） in 20- years old group was suggested to be a threshold for the diagnosis of PADAM.Results　Testosterone level was 15.14 （16.87,25.05） nmol/L in all subjects,the average annual prevalence of PADAM was 16.8%.Testosterone level was negatively correlated with age （rs=-0.041,P=0.002）.Testosterone level in 30- years old group,40- years old group,50- years old group,60- years old group and 70-85 years old group was significantly lower than that in 20- years old group （P<0.05）.The average annual decline rate of testosterone level in 6 groups was 1.3%.Testosterone level in 30- years old group,40- years old group and 50- years old group in 2011,2012,2013 was higher than that in 2014 （P<0.05）.The average annual decline rate of testosterone level in 30- years old group was 1.7%；the average annual decline rate of testosterone level in 40- years old group and 50- years old group was 1.5% and 3.0%,respectively.There was no significant difference in the prevalence of PADAM among all age groups （P>0.05）.The prevalence of PADAM of 50- years old group in 2011,2012,2013 was lower than that in 2014 （P<0.05）.The prevalence of PADAM in 50- years old group showed a trend of increase with time （P<0.05）.Logistic regression analysis showed that year was the influence factor of PADAM prevalence （P<0.05）.Conclusion　Testosterone level gradually decreased with age increasing in healthy Wenzhou male.Testosterone level in 30-59 years old male gradually declined with age increasing.Testosterone level was relatively stable after 50 years old.The prevalence of PADAM in 50-59 years old men gradually increased year by year.

Key words: Testosterone, Partial androgen deficiency in the aging male, Man

摘要： 背景　随着男性年龄增长，下丘脑-垂体-性腺轴功能逐渐衰退，因睾酮缺乏造成的中老年男性雄激素部分缺乏综合征（PADAM）会导致腹部肥胖、2型糖尿病、代谢综合征、心血管疾病、骨骼肌肉质量下降、性功能减退、情绪抑郁和认知障碍等。目的　探讨男性睾酮水平及PADAM患病率变化。方法　收集2011—2014年于温州医科大学附属第一医院体检的符合纳入标准的健康男性5 743例为研究对象。按照年龄分为20~岁组（142例）、30~岁组（1 261例）、40~岁组（2 346例）、50~岁组（1 339例）、60~岁组（552例）、70~85岁组（103例）。检测并记录所有研究对象睾酮水平。以20~岁组P10睾酮水平（11.1 nmol/L）作为阈值来判断PADAM患病率。结果　研究对象睾酮水平为15.14（16.87，25.05）nmol/L，年平均PADAM患病率为16.8%。睾酮水平与年龄呈负相关（rs=-0.041，P=0.002）。30~岁组、40~岁组、50~岁组、60~岁组、70~85岁组睾酮水平均低于20~岁组（P<0.05）。6个年龄组睾酮水平年平均下降率为1.3%。30~岁组、40~岁组、50~岁组2011、2012、2013年睾酮水平均高于2014年（P<0.05）。30~岁组睾酮水平年平均下降率为1.7%；40~岁组、50~岁组睾酮水平年平均下降率分别为1.5%、3.0%。各年龄组PADAM患病率比较，差异无统计学意义（P>0.05）。50~岁组2011、2012、2013年PADAM患病率均低于2014年（P<0.05）。50~岁组PADAM患病率随时间呈上升趋势（P<0.05）。Logistic回归分析结果显示，年份是PADAM患病率的影响因素（P<0.05）。结论　温州地区健康男性睾酮水平随年龄增长缓慢下降，30~59岁男性睾酮水平随年龄升高逐步下降，50岁后睾酮水平相对平稳；50~59岁男性的PADAM患病率随年份逐渐升高。

关键词: 睾酮, 中老年男性雄激素部分缺乏综合征, 男人