老年肥胖與睪固酮低下症

Obesity and Hypotestosterone in the Older People

10.29461/TGGa.202311_18(4).0001

王奕鈞(Yi-jun Wang)；陳杰(Chieh Chen)

代謝症候群 ； 心血管疾病風險 ； 睪固酮替代療法 ； 血中睪固酮濃度 ； 老年肥胖症 ； Metabolic syndrome ； cardiovascular disease risk ； testosterone replacement therapy ； blood testosterone concentration ； obesity in the elderly

台灣老年醫學暨老年學會雜誌

18卷4期（2023 / 11 / 01）

259 - 267

繁體中文;英文

睪固酮的作用包含性別分化、肌肉形成、增加骨質密度、促進紅血球生成、勃起功能、情慾等，隨著年齡的增長血清中睪固酮濃度約以每年0.4－2.6%的速率遞減，睪固酮缺乏被定義為與年齡增長和合併症相關的臨床綜合症狀之一，特點是血中睪固酮濃度高低和相關身體的狀況與疾病息息相關，睪固酮低下症與代謝症候群之間密切相關。睪固酮低下症可能會導致代謝症候群，而代謝症候群也可能會導致睪固酮低下症。由於這兩項都會使糖尿病及心血管疾病的風險提高，進而可能危害到男性的整體健康，因此醫療人員當臨床上發現患者有罹患睪固酮低下症時，亦需警覺並詳細評估是否同時具有代謝症候群，睪固酮低下定義為低於300 ng/dL或是12 nmol/L，會對身體多個器官產生不良的影響，導致生活品質下降包括：性功能變化；當睪固酮失調無論對男性（睪固酮低下）或女性（睪固酮過多）最明顯的是外觀肥胖，及腰圍過粗（腹部肥胖）與潛在的代謝功能障礙和心血管疾病等，老年、肥胖及慢性病患者血中睪固酮濃度相對較低，在這些族群身上出現的症狀確實與睪固酮濃度低下有所關聯，像是老年族群骨質疏鬆症與勃起功能障礙，代謝症候群等，身體脂肪的分佈與胰島素阻抗性。

The role of testosterone includes sex differentiation, muscle formation, bone cell growth and bone strength, production of red blood cells, and regulation of erectile function, etc. Aging had been shown to be caused by decreasing concentration of testosterone in serum at the rate of 0.4-2.6% per year. Low testosterone (defined as less than 350 ng/dL or 12 nmol/L) can adversely affect multiple organ systems and lead to a significant reduction in quality of life, including changes in sexual function. Hypotestosterone in males and excessive testosterone in females, often results in obesity in appearance and increased waist circumference (abdominal obesity). Both of which are related to potential metabolic dysfunction and cardiovascular diseases. The low concentration of testosterone in the elderly, obese and chronically ill patients, which can increase the risk of developing to osteoporosis, erectile dysfunction, abnormal body fat distribution, insulin resistance, and metabolic syndrome. Hypotestosteronism is a well-recognized and important disease, which is defined as a clinical biochemical syndrome associated with aging and comorbidities.