A Clinical Research Of The Diagnostic Value Of Sex Hormones In Patients With Erectile Dysfunction

Objective: To investigate the changes of follicle-stimulating hormone(FSH),luteinizing hormone(LH),prolactin(PRL),total testosterone(TT)and estradiol(E2)in patients with erectile dysfunction(ED),the research focuses on the relationship between sex hormones and ED;To observe the changes of serum calculated free testosterone(cFT),testosterone secreting index(TSI)and free testosterone index(FTI)in patients with ED,this research probes into the diagnosis value of cFT,TSI,FTI in ED patients with androgen deficiency.Methods: All study subjects were required to be asked about the medical history,fill in the International Index of Erectile Function questionnaire and complete the Nocturnal Penile Tumescence examination.According to the history and the examination result of NPT,all the subjects were divided into the experimental group and the control group.We calculated cFT、bio-available testosterone(Bio-T)、TSI and FTI level by testing serum level of total serum FSH,LH,PRL,TT,E2,sex hormone-binding globulin(SHBG)and serum albumin(ALB)of 150 ED patients with abnormal NPT result and 25 controls with normal NPT result.cFT≤0.3nmol/L 、TSI≤2.8nmol/IU 、 FTI≤0.4nmol/nmol are regarded as the critical value,TT≤11.5nmol/L as the gold standard to access androgen deficiency,we calculated the rate of missed diagnosis 、misdiagnosis rate and coincidence rate of cFT,TSI,FTI.Results:1.In different age group of ED patients,FSH,LH,E2 level increased and TT level decreased along with age with no statistical difference whereas age-related declined of cFT、Bio-T、TSI、FTI and age-related increased of PRL have a statistically significant difference.There were statistically significant differences in PRL between the control group and the 20-40 years old ED group.With an evaluation criteria of TT≤11.5nmol/L,coincidence rate of cFT,TSI,FTI for diagnosing androgen deficiency in ED patients aged from 20 to 40 years old was 90.8%,85.8%,80.8%,respectively,;rate of missed diagnosis was 4.0%,33.3%,44.0%,respectively;and the misdiagnosis rate was 10.5%,19.4%,12.6%,respectively.Kappa value for cFT,TSI,FTI was 0.755,0.564,0.427,respectively.(P<0.05=2.In different scoring group of IIEF,serum level of TT、cFT、Bio-T、TSI、FTI showed no statistical difference for 20 to 40 year-old ED patients.Conclusion: PRL plays a role in the control of erectile function;cFT appears to be more valuable in the diagnosis of 20 to 40 years old ED patients with androgen deficiency than TT,TSI,TSI.