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砷暴露、性荷爾蒙與勃起功能障礙之相關研究

砷暴露、性荷爾蒙與勃起功能障礙之相關研究.

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砷暴露、性荷爾蒙與勃起功能障礙之相關研究

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  1. 砷暴露、性荷爾蒙與勃起功能障礙之相關研究 • 根據世界衛生組織對勃起功能障礙的定義為：陰莖持續、一直沒有辦法達到或維持足夠的勃起去進行性行為。據統計，約40-50%患有周邊動脈疾病的病人，會有勃起功能障礙的現象，且容易出現在40歲之後的男性。並有研究發現，患有勃起功能障礙的老年男性病患，海綿體動脈血管的粥狀硬化是導致勃起功能障礙的主因。除此之外，性荷爾蒙異常亦會影響到勃起的能力。已有研究指出砷會導致高血壓、糖尿病、缺血性心臟病、周邊血管疾病等，因此本篇研究將以國際勃起功能指標為評估工具，探討宜蘭砷暴露地區的男性居民是否有較高的勃起功能障礙盛行率及危險性，並針對性荷爾蒙與勃起功能障礙之間的相關性做更進一步的分析討論。本研究樣本包含台北地區萬芳社區男性居民及台北醫學大學家醫科的男性病患為對照組，共111人。及參與民國93年宜蘭羅東博愛醫院之砷暴露地區居民健康檢查的男性66人。分析其性荷爾蒙：睪固酮【Testosterone】、游離睪固酮【Free Testosterone,FT】、黃體激素【Luteinizing Hormone,LH】、性荷爾蒙結合球蛋白【Sex Hormone Binding Globulin,SHBG】、脫氫異雄固酮【Dehydroepiandrosterone,DHEA】及脫氫異雄固酮硫化物【Dehydroepiandrosteronesulfate, DHEA_S】。並利用國際勃起功能指標(IIEF-5)來判定勃起功能障礙的嚴重程度，分數≤7, 8~11, 12~21, 和≧22分別代表重度、中度、輕度勃起功能障礙及勃起功能正常。結果顯示砷暴露地區男性勃起功能障礙盛行率為83.3%，而對照組則為66.7%。在調整年齡及其相關危險因子後，發現砷暴露濃度大於50ppb者得到勃起功能障礙的危險性依照嚴重程度的不同，OR值分別為3.0(1.0-9.0)、4.2(1.6-10.6)、4.6(1.8-11.7)倍。而性荷爾蒙濃度與年齡及勃起功能障礙間亦有相關性存在。

  2. A study on association between arsenic, sex hormone and erectile dysfunction • According to the recommendations of the First International Consultation on Erectile Dysfunction (ED) co-sponsored by World Health Organisation, ED is defined as “the consistent or recurrent inability to attain and/or to maintain a penile erection sufficient for sexual performance”. Forty to fifty percent persons affected with peripheral arterial disease have ED, especially in male aged more than forty years old. Atherosclerotic disease of the cavernosal arteries has been shown to be a major cause of ED in the elderly patient. In addition, abnormalities of the sex hormone milieu may significantly affect the quality of penile erections. It also has shown that arsenic will lead to hypertension, diabetes mellitus, ischemic heart disease, peripheral vascular disease. The aim of this study is to explore the association between inorganic arsenic exposure, sex hormone and ED among male residents in Lanyan Basin. A total of 66 subjects were recruited through health examination in Lo-Tong PoHai Hospital as arsenic exposed group. 111 study subjects of non-arsenic exposed group were recruited through health examination in Taipei Wan-Fang Hospital and Taipei Medical University Hospital. Serum total testosterone, free testosterone, luteinizing hormone (LH), sex hormone binding globulin (SHBG), dehydroepiandrosterone (DHEA), dehydroepiandrosteronesulfate (DHEA_S) were examined using radio immunoassay (RIA). Questionnaire of International Idex of Erectile Function (IIEF-5) were used to screened the severity of erectile dysfunction of study subjects. Study subjects whose IIEF score ≤7, 8~11, 12~21, and ≧22 were grouped as severe, moderate, mild and normal group, respectively. The results show the prevelence of ED was 83.3% and 66.7% for arsenic-exposed group and non-exposed group, respectively. After adjustment for age, diabetes mellitus, hypertension, cardiovascular disease and cigarette smoking, risk of mild, moderate, and severe ED were 3.0, 4.2, and 4.6, respectively, compared with normal group for study subjects who drank well water with arsenic level greater than 50μg/l.

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