Effect Of Vasectomy On Late-Onset Hypogonadism In Middle-aged And Elderly Men

Objective: 1.To explore the effect of vasectomy on the serum level of androgen among middle-aged and elderly men;2.To evaluate the impact of vasectomy on the symptom score of late-onset hypogonadism;3.To analyze the relationship between vasectomy and morbidity of LOH in middle-aged and elderly men.Methods: 1.Investigation and sampling In th name of summer vacation social practice,researcher who were all trained uniformly took the forms of visit indoor or occasional sampling on the street to collect samples outside of Guizhou province;Investigation inside Guizhou was taken by stratified cluster sampling to survey Wuchuan County and Donggong Temple Town in Zunyi where vasectomy was conducted widely,and the physical examination and blood samples were also requested.2.Reproductive hormone test All fasting venous blood samples were collected from 6:00: 00 to 11: 00 am.Blood samples were placed in 4 ? refrigerator for 2 to 3 hours before obtaining the serum.Serum samples were put into freeze pipe separately,preserved in-80 ? refrigerator before detection.Beckman Access Immunoassay system(Uni Cel DXI800)was used to detect the total testosterone(TT),sex hormone binding globulin(SHBG),and luteinizing hormone(LH);In addition,Vermeulen formula was used to calculate free testosterone(c FT,and calculate free testosterone index(FTI)= TT/SHBG and testosterone secretion index(TSI)= TT/ LH.3.Statistical analysis Epi Data3.02 was used to enter data and SPSS18.0 was used for analysis.The difference between two groups of quantitative data were compared by independent samples t test,multi-group comparison used one-way analysis of variance,LSD method was used to the forward pairwise comparison;The difference between groups of qualitative data was compared by ?2 test,and Chi-square segmentation was used to compared forward difference;For analyzing the independent impact of vasectomy on LOH,TT(nmol/L),SHBG(nmol/L),CFT(nmol/L),TTI,FTI and LH(IU/L)set as dependent variables and independent variables were age waist-to-height ratio systolic blood pressure educational level marriage status smoking drinking and vasectomy,to build the multiple linear regression model;somatic symptoms psychological symptoms exual function and total score of AMS set as the dependent variables and the independent variables were age(year-old)vasectomy educational level marriage status smoking drinking to build the multiple linear regression model,for analyzing the independent impact of vasectomy on LOH symptoms;Logistic regression was used to analyze the independence impact of vasectomy on LOH morbidity.The test level is ? = 0.05.Results: 1.Basic information of subjects 1838 subjects were obtained in total,the average age was 63.16 ± 10.04 year-old,512 subjects underwent vasectomy,and the average age of vasectomy was 29.79 ± 8.36 year-old,median vasectomy age was 30 year-old.Subjects aged 40-49 year-old,50-59 year-old,60-69 year-old and o ver 70year-old were 114(6.2%),555(30.2%),656(35.7%)and 513(27.9%)respectively;Subjects from the western,central,southern and northern regions were 294(16.0%),937(51.0%),270(14.7%),259(14.1%)and 78(4.2%)respectively;468 subjects came from the urban,accounting for 25.5%,the rest came from the rural,accounting for 74.5%;2.Effects of vasectomy on androgen The average level of androgen in vasectomy group: TT(17.39 ± 6.57),SHBG(70.28 ± 40.90)and LH(10.85 ± 11.73)were significantly higher verse non-vasectomy group TT(16.01 ± 5.41),SHBG(58.91 ± 36.89)and LH(8.86 ± 6.49)respectively;FTI in vasectomy group(0.30 ± 0.12)was lower verse non-vasectomy group(0.33 ± 0.15),the difference was statistically significant(P <0.05);After adjusted confounding factors — age waist-to-height ratio systolic blood pressure(mm Hg)educational level marriage status smoking drinking et al,the differences between vasectomy and TT,SHBG,c FT,FTI,TSI,LH were no longer statistically significant(P> 0.05);3.Effects of vasectomy on LOH Symptoms The AMS score in vasectomy group were significantly higher verse non-vasectomy group,the difference was statistically significant(P<0.05).After adjusting the confounding factors-age educational level marriage status smoking drinking et al,vasectomy was significantly related with somatic symptoms(?: 1.661,95% CI: 1.221,2.102),psychological symptoms(?: 0.355,95% CI: 0.048,0.661),sexual function symptoms(?: 1.890,95% CI: 1.468,2.295)and AMS total score(?:3.813,95%CI:2.848,4.788)(P <0.05);Somatic symptoms score,sexual function score,psychological symptom score and AMS total score in the 30-year-old vasectomy group were significantly higher verse non-vasectomy group(P <0.05);4.Relationship between vasectomy and LOH morbidity The positive rate of LOH symptoms and morbidity rate of LOH defined by domestic and o verseas and our research group standard in vasectomy group were higher than non-vasectomy group respectively,the difference was statistically significant.After corrected confounding factors,LOH symptoms diagnosed by domestic and overseas and our research group standardcompared with the negative symptoms,the OR(OR95% CI)for vasectomy history was 4.560(2.695,7.715),5.854(3.302,10.379),4.615(2.878,7.400)respectively;LOH clinical patients diagnosed by domestic and o verseas and our research group standard compared with non-patients,the OR(OR95% CI)for vasectomy history was 2.480(1.169,5.263),2.249(1.265,3.995)and 1.853(1.187,2.893)respectively.Conclusion: No evidence supported that vasectomy may change the serum level of androgen in middle-aged and elderly men,but may lead to an increase of the LOH symptom score and the clinical LOH morbidity.