Validity of midday total testosterone levels in older men with erectile dysfunction.

Autor:	Welliver RC Jr; Division of Urology, Southern Illinois University School of Medicine, Springfield, Illinois. Electronic address: rwelliver@siumed.edu., Wiser HJ; Springfield Clinic, Springfield, Illinois., Brannigan RE; Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Feia K; Department of Urology, University of Minnesota School of Medicine and Minneapolis Veterans Affairs Healthcare System, Minneapolis, Minnesota., Monga M; Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio., Köhler TS; Division of Urology, Southern Illinois University School of Medicine, Springfield, Illinois.
Jazyk:	angličtina
Zdroj:	The Journal of urology [J Urol] 2014 Jul; Vol. 192 (1), pp. 165-9. Date of Electronic Publication: 2014 Feb 08.
DOI:	10.1016/j.juro.2014.01.085
Abstrakt:	Purpose: Based on studies showing the circadian rhythmicity of testosterone the optimal time of day to draw total testosterone in men has classically been reported as between 8 and 11 a.m. However, further studies demonstrated that the testosterone circadian rhythmicity becomes blunted with age. Materials and Methods: We retrospectively reviewed the charts of 2,569 men who presented with erectile dysfunction for total testosterone and draw times. We compared the men by age group, including less than 40 years and 5-year groupings after age 40 years. Total testosterone was analyzed for variability during the most common draw time hours (7 a.m. to 2 p.m.). Results: Mean total testosterone at 7 to 9 a.m. and 9 a.m. to 2 p.m. clinically and statistically differed only in men younger than 40 vs 40 to 44 years old (mean difference 207 ng/dl, 95% CI 98-315, p = 0.0004 vs 149 ng/dl, 95% CI 36-262, p = 0.01). No other group showed a clinically and statistically significant difference between those periods. Conclusions: Total testosterone in men with erectile dysfunction who are younger than 45 years should be drawn as close to 7 a.m. as possible because a statistically and clinically relevant decrease in testosterone will occur during the course of the day. Men older than 45 years with erectile dysfunction can have total testosterone drawn at any time before 2 p.m. without misleading results. (Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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