Андрология и генитальная хирургия. 2013; 14: 48-57
Место андрогенного дефицита в клиническом портрете современного урологического пациента
https://doi.org/10.17650/2070-9781-2013-3-48-57Аннотация
В статье на основе литературных данных и собственных клинических наблюдений и исследований рассматриваются прикладные аспекты андрогенного дефицита в урологической практике. Истинная частота андрогенного дефицита в мужской популяции остается точно не установленной, так как снижение синтеза тестостерона связано не только с возрастом, но и целым рядом других факторов, включая особенности географии района проживания, наличие или отсутствие других гормонально-метаболических нарушений, сопутствующей соматической коморбидности и т. д. В статье представлены результаты новейших зарубежных эпидемиологических исследований частоты распространенности андрогенного дефицита в различных странах мира, а также результаты первого в России пилотного эпидемиологического исследования распространенности андрогенного дефицита у мужчин в практике урологов и врачей смежных специальностей (Ярославское исследование, 2013). Показана тесная патогенетическая связь андрогенного дефицита и наиболее распространенных уроандрологических и соматических заболеваний у мужчин. На основе собственного клинического опыта предложены оптимальные алгоритмы комплексной диагностики андрогенного дефицита у урологических пациентов и показана необходимость включения препаратов тестостерона в фармакотерапию большинства мочеполовых заболеваний у мужчин. Проведен обзор показаний, противопоказаний, оценки факторов риска и препаратов для андрогензаместительной терапии (АЗТ). Описаны особенности накожных форм препаратов тестостерона (Андрогель) и проведен клинический анализ их настоящего и перспективного применения в рамках современной АЗТ.
Список литературы
1. Тюзиков И.А., Мартов А.Г., Калинченк о С.Ю. Новые системные механизмы патогенеза симптомов нижних мочевых путей у мужчин (литературный обзор). Бюлл Сиб медицины 2012;2:93–100.
2. Калинченко С.Ю., Тюзиков И.А., Греко в Е.А. и др. Комбинированная терапия андрогенами и ингибиторами 5α-редуктазы в лечении пациентов с ДГПЖ с возрастным гипогонадизмом:
3. целесообразность, эффективность и безопасность. Consilium Medicum 2012;7:10–8.
4. Тюзиков И.А., Мартов А.Г., Греко в Е.А. Взаимосвязь компонентов метаболического синдрома и гормональных нарушений в патогенезе заболеваний предстательной железы (обзор литературы). Экс и клин урология 2012;3:39–46.
5. Тюзиков И.А. Половые гормоны и хронические заболевания почек у мужчин (литературный обзор). Клин нефрол 2012;4:27–34.
6. Тюзиков И.А., Калинченко С.Ю. Трагедии и парадоксы хронического простатита. Урол сегодня 2012;6(22):12–3.
7. Шустер П.И. Возрастной андрогенный дефицит – один из ведущих этиологических факторов уролитиаза у мужчин. Мате р. IV Всероссийского Конгресса «Мужское здоровье». М., 2008. С. 37–8.
8. Grzegorczyk K., Krajewska M., Weyde W. et al. Gender and kidney diseases: the clinical importance and mechanisms of modifying effects. Postepy Hig Med Dosw (Online) 2011;65:849–57.
9. Iglesias P., Carrero J.J., Díez J.J. Gonadal dysfunction in men with chronic kidney disease: clinical features, prognostic implications and therapeutic options. J Nephrol 2012;25(1):31–42.
10. Gorbachinsky I., Akpinar H., Assimos D.G. Metabolic syndrome and urological diseases. Rev Urol 2010;12(4):157–80.
11. Hughes I.A., Werner R., Bunch T., Hiort O. Androgen insensitivity syndrome. Semin Reprod Med 2012;30(5):432–42.
12. Izumi K., Mizokami A., Lin W.J. et al. Androgen receptor roles in the development of benign prostate hyperplasia. Am J Pathol 2013;182(6):1942–9.
13. Matsumoto T., Sakari M., Okada M. et al. The androgen receptor in health and disease. Annu Rev Physiol 2013;75:201–24.
14. McVary K. Lower urinary tract symptoms and sexual dysfunction: epidemiology and pathophysiology. BJU Int 2006;97(Supp l. 2):23–8.
15. Ozden C., Ozdal O.L., Urgancioglu G. The correlation between metabolic syndrome and prostatic growth in patients with benign prostatic hyperplasia. Eur Urol 2007;51:199–203.
16. Schatzl G., Brössner C., Schmid S. Endocrine status in elderly men with lower urinary tract symptoms: correlation of age, hormonal status, and lower urinary tract function. The Prostate Study Group of the
17. Austrian Society of Urology. Urology 2000;55:397–402.
18. Yassin A.A., El-Sakka A.I., Saad F., Gooren L.J. Metabolic syndrome, testosterone deficiency and erectile dysfunction never come alone. Andrologia 2008;40:259–64.
19. Svartberg J., von Möhlen D., Schirmer H. Association of endogenous testosterone with blood pressure and left ventricular mass in men. The Tromsø Study. Eur J Endocrinol 2004;150:65–71.
20. Traish A.M., Saad F., Guay A. The dark side of testosterone deficiency: II. Type 2 diabetes and insulin resistance. J Androl 2009;30:23–32.
21. Ngo D.T., Chan W.P., Rajendran S. et al. Determinants of insulin responsiveness in young women: impact of polycystic ovarian syndrome, nitric oxide, and vitamin D. Nitric Oxide 2011;25:326–30.
22. Pilz S., März W., Wellnitz B. et al. Association of vitamin D deficiency with heart failure and sudden cardiac death in a large cross-sectional study of patients referred for coronary angiography. J Clin Endocrin Metab 2008;93:3927–35.
23. Шварц Г.Я. Витамин D и D-гормон. М.: Анахарсис, 2005. 152 с.
24. Wehr E., Pilz S., Boehm B.O. et al. Low free testosterone is associated with heart failure mortality in older men referred for coronary angiography. Eur J Heart Fail 2011;13:482–8.
25. Paez Borda A., Charnay-Sonnek F., Fonteyne V., Papaioannou E.G. Guidelines on Pain Management & Palliative Care EAU, 2013. 96 р.
26. Morgentaler A. Testosterone therapy in men with prostate cancer: scientific and ethical considerations. J Urol 201;189 (1 Supp l):26–33.
27. Morgentaler A. Goodbye androgen hypothesis, hello saturation model. Eur Urol 2012;62(5):765–7.
28. Morgentaler A., Lipshultz L.I., Bennet t R. et al. Testosterone therapy in men with untreated prostate cancer. J Urol 2011;185(4):1256–60.
29. Нишлаг Н., Бере Г.М. (ред.). Андрологи я: Мужское здоровье и дисфункция репродуктивной системы. Пер. с англ. М.: Международное Информационное Агентство, 2005. 554 с.
30. Калинченко С.Ю., Тюзиков И.А. Практическая андрология. М.: Практическая медицина, 2009. 400 с.
31. Шилл В.-Б., Комхаир Ф., Харгрив Т. (ред.). Клиническая андрология. Пер. с англ. М.: ГЭОТАР-Медиа, 2011. 800 с.
32. Wang C., Nieschlag E., Swerdloff R. et al. Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations. Eur J Endocrinol 2008;159(5):507–14.
33. Гончаров Н.П., Кация Г.В. Современны е методы определения тестостерона. Проблемы и их решение. Андро л и генит хир 2008;2:27–36.
34. Тюзиков И.А., Калинченко С.Ю. Андрогенны й дефицит в общей врачебной практике: эндокринология, рациональная диагностика и клинические «маски» (лекция). Часть 2. Рациональная клинико-лабораторная диагностика андрогенного дефицита у мужчин. Мед алфавит. Больница 2012;2(12):42–50.
35. Тюзиков И.А., Калинченко С.Ю. Андрогенны й дефицит в общей врачебной практике: эндокринология, рациональная диагностика и клинические «маски» (лекция). Часть 3. Клинические
36. «маски» андрогенного дефицита в общей врачебной практике. Мед алфавит. Больница 2012;3(15):59–68.
37. Тюзиков И.А. Калинченко С.Ю., Мартов А.Г. Андрогенный дефицит и соматические заболевания у мужчин: есть ли патогенетические связи? Земский врач 2012;3:12–4.
38. Дедов И.И., Калинченко С.Ю. Возрастной андрогенный дефицит у мужчин. М.: Практическая медицина, 2006. 240 с.
39. Jockenhovel F. Male Hyрogonadism. Auflage-Bremen: Uni-Med, 2004. 185 р.
40. Dohle G.R., Arver S., Bettocchi C. et al. Guidelines on male hypogonadism. EAU, 2013. 27 р.
41. Lunenfeld B., Saad F., Hoesl C.E. ISA, ISSAM and EAU recommendations for the investigation, treatment and monitoring of late-onset hypogonadism in males: scientific background and rationale. Aging Male 2005;8(2):59–74.
42. Kapoor D., Goodwin E., Channer K.S., Jones T.H. Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes. Eur J Endocrinol 2006;154(6):899–906.
43. Стандарт «Об утверждении стандарта первичной медико-санитарной помощи при инсулиннезависимом сахарном диабете». Приказ Минздрава РФ № 1581н от 28.12.12. Зарегистрирован в Минюсте РФ за № 27719 15.03.13.
44. Stellato R.K., Feldman H.A., Hamdy O. Testosterone, sex hormone-binding globulin, and the development of type 2 diabetes in middle-aged men: prospective results from the Massachusetts male aging study. Diabetes Care 2000;23:490–4.
45. Kupelian V., Shabsigh R., Araujo A.B. Erectile dysfunction as a predictor of the metabolic syndrome in aging men: results from the Massachusetts Male Aging Study. J Urol 2006;176:222–6.
46. Traish A.M., Miner M.M., Morgentale r A., Zitzmann M. Testosterone deficiency. Am J Med 2011;124(7):578–87.
47. Tajar A., Huhtaniemi I.T., O’Neill T.W. et al. Characteristics of androgen deficiency in late-onset hypogonadism: results from the European Male Aging Study (EMAS). J Clin Endocrinol Metab 2012;97(5):1508–16.
48. McHenry Martin C. Testosterone deficiency in older men: a problem worth treating. Сonsult Pharm 2012;27(3):152–63.
49. Rabijewski M., Papierska L., Kozakowsk i J., Zgliczyński W. The high prevalence of testosterone deficiency in population of Polish men over 65 years with erectile dysfunctions. Aging Male 2012;15(4):258–62.
50. Seisen T., Rouprêt M., Gallais J.L., Cost a P. Relevant clinical and biological criteria for the diagnosis of androgen deficiency in the aging male (ADAM). Prog Urol 2012;22(Suppl.1):21–6.
51. Handelsman D.J. Pharmacoepidemiology of testosterone prescribing in Australia, 1992–2010. Med J Aust 2012;196(10):642–5.
52. Spetz Holm A.C., Fredrikson M.G., Hammar M.L. Symptoms of testosterone deficiency in early middle aged men. Aging Male 2012;15(2):78–84.
53. Sun K., Liang G.Q., Chen X.F. et al. Survey for late-onset hypogonadism among old and middle-aged males in Shanghai communities. Asian J Androl 2012;14(2):338–40.
54. Claramonte M., García-Cruz E., Luque P., Alcaraz A. Prevalence and risk factors of erectile dysfunction and testosterone deficiency symptoms in a rural population in Uganda. Arch Esp Urol 2012;65(7):689–97.
55. Tan W.S., Ng C.J., Khoo E.M. et al. The triad of erectile dysfunction, testosterone deficiency syndrome and metabolic syndrome: findings from a multi-ethnic Asian men study (The Subang Men’s Health Study). Aging Male 2011;14(4):231–6.
56. Haring R., Völzke H., Felix S.B. et al. Prediction of metabolic syndrome by low serum testosterone levels in men: results from the study of health in Pomerania. Diabetes 2009;58(9):2027–31.
57. Доброхлеб В.Г. Ресурсный потенциал и занятость пожилых людей в современной России. Ярославль: Лад, 2004.
58. Тюзиков И.А. Результаты пилотного эпидемиологического исследования распространенности андрогенного дефицита у мужчин в амбулаторной практике урологов и врачей различных специальностей (Ярославское исследование). Урол сегодня 2013;2(24):16–7.
59. Тюзиков И.А. Результаты пилотного эпидемиологического исследования распространенности андрогенного дефицита у мужчин в амбулаторной практике врачей различных специальностей (Ярославское исследование, 2013). Матер. II Конгресса урологов Сибири. Томск, 2013. С. 179–81.
60. Тюзиков И.А. Новые патогенетические подходы к диагностике заболеваний предстательной железы у мужчин с ожирением, андрогенным дефицитом и диабетической нейропатией. Андрол и генит хир 2011;4:34–9.
61. Engeler D., Baranowsky A.P., Elneil S. et al. Guideline on chronic pelvic pain syndrome. European Association of Urology, 2013. 132 р.
62. Vesper H.W., Bhasin S., Wang C. et al. Interlaboratory comparison study of serum total testosterone [corrected] measurements performed by mass spectrometry methods. Steroids 2009;74(6):498–503.
63. Matsumoto A.M., Paulsen C.A., Hoppe r B.R. et al. Human chorionic gonadotropin and testicular function: stimulation of testosterone, testosterone precursors, and sperm production despite high
64. estradiol levels. J Clin Endocrinol Metab 1983;56(4):720–8.
65. Yurci A., Yucesoy M., Unluhizarci K. et al. Effects of testosterone gel treatment in hypogonadal men with liver cirrhosis. Clin Res Hepatol Gastroenterol 2011;35(12):845–54.
66. Heufelder A.E., Saad F., Bunck M.C., Gooren L. Fifty-two-week treatment with diet and exercise plus transdermal testosterone reverses the metabolic syndrome and improves glycemic control in men with newly diagnosed type 2 diabetes and subnormal plasma testosterone. J Androl 2009;30(6):726–33.
67. Dean J.D., Carnegie C., Rodzvilla J., Smith T. Long-term effects of testim(r) 1 % testosterone gel in hypogonadal men. Rev Urol 2004;6(Suppl. 6):22–9.
68. Dobs A.S., McGettigan J., Norwood P. et al. A novel testosterone 2 % gel for the treatment of hypogonadal males. J Androl 2012;33(4):601–7.
69. Davis S.R., Braunstein G.D. Efficacy and safety of testosterone in the management of hypoactive sexual desire disorder in postmenopausal women. J Sex Med 2012;9(4):1134–48.
70. Mazer N.A., Shifren J.L. Transdermal testosterone for women: a new physiological approach for androgen therapy. Obstet Gynecol Surv 2003;58(7):489–500.
71. Chudakov B., Ben Zion I.Z., Belmake r R.H. Transdermal testosterone gel prn application for hypoactive sexual desire disorder in premenopausal women: a controlled pilot study of the effects on the arizona sexual experiences scale for females and sexual function questionnaire. J Sex Med 2007;4(1):204–8.
72. Raghunandan C., Agrawal S., Dubey P. et al. A comparative study of the effects of local estrogen with or without local testosterone on vulvovaginal and sexual dysfunction in postmenopausal women. J Sex Med 2010;7(3):1284–90.
73. Lin E., McCabe E., Newton-Cheh C. et al. Effects of transdermal testosterone on natriuretic peptide levels in women: a randomized placebo-controlled pilot study. Fertil Steril 2012;97(2):489–93.
74. Тюзиков И.А., Калинченко С.Ю., Ворслов Л.О., Греков Е.А. Коррекция андрогенного дефицита при хроническом инфекционном простатите как патогенетический метод преодоления неэффек-
75. тивности стандартной антибактериальной терапии на фоне растущей антибиотикорезистентности. Андрол и генит хир 2013;1:55–63.
Andrology and Genital Surgery. 2013; 14: 48-57
A place of androgen deficiency in a clinical portrait of the modern urological patient
https://doi.org/10.17650/2070-9781-2013-3-48-57Abstract
In article on the basis of literary given both own clinical supervision and researches applied aspects of androgen deficiency in urological practice are considered. True androgen deficiency’ frequency in man’s population remains precisely not established as decrease in testosterone synthesis is connected not only with the age, but also varieties of other factors, including features of geography of area of residing, presence or absence of other hormonal and metabolic disorders, accompanying somatic comorbidity etc. Results of the newest foreign epidemiological researches of androgen deficiency prevalence worldwide, and also results of the first Russian pilot epidemiological research of androgen deficiency at men prevalence in practice of urologists and doctors of adjacent specialities (Yaroslavl Study, 2013) present in the article. Intime pathogenetic communication of androgen deficiency both the most widespread uroandrological and somatic diseases at men is shown. On the basis of own clinical experience optimum algorithms of complex diagnostics of androgen deficiency at urological patients are offered and also the necessity of inclusion of testosterone preparations for pharmacotherapy of the majority of male urinogenital diseases is shown. The review of indications, contra-indications, estimations of risk factors and preparations for androgen replacement therapy is spent. Features of transdermal forms of testosterone preparations (Аndrogel) are described and the clinical analysis of their present and perspective application within the limits of modern androgen replacement therapy is carried out.
References
1. Tyuzikov I.A., Martov A.G., Kalinchenk o S.Yu. Novye sistemnye mekhanizmy patogeneza simptomov nizhnikh mochevykh putei u muzhchin (literaturnyi obzor). Byull Sib meditsiny 2012;2:93–100.
2. Kalinchenko S.Yu., Tyuzikov I.A., Greko v E.A. i dr. Kombinirovannaya terapiya androgenami i ingibitorami 5α-reduktazy v lechenii patsientov s DGPZh s vozrastnym gipogonadizmom:
3. tselesoobraznost', effektivnost' i bezopasnost'. Consilium Medicum 2012;7:10–8.
4. Tyuzikov I.A., Martov A.G., Greko v E.A. Vzaimosvyaz' komponentov metabolicheskogo sindroma i gormonal'nykh narushenii v patogeneze zabolevanii predstatel'noi zhelezy (obzor literatury). Eks i klin urologiya 2012;3:39–46.
5. Tyuzikov I.A. Polovye gormony i khronicheskie zabolevaniya pochek u muzhchin (literaturnyi obzor). Klin nefrol 2012;4:27–34.
6. Tyuzikov I.A., Kalinchenko S.Yu. Tragedii i paradoksy khronicheskogo prostatita. Urol segodnya 2012;6(22):12–3.
7. Shuster P.I. Vozrastnoi androgennyi defitsit – odin iz vedushchikh etiologicheskikh faktorov urolitiaza u muzhchin. Mate r. IV Vserossiiskogo Kongressa «Muzhskoe zdorov'e». M., 2008. S. 37–8.
8. Grzegorczyk K., Krajewska M., Weyde W. et al. Gender and kidney diseases: the clinical importance and mechanisms of modifying effects. Postepy Hig Med Dosw (Online) 2011;65:849–57.
9. Iglesias P., Carrero J.J., Díez J.J. Gonadal dysfunction in men with chronic kidney disease: clinical features, prognostic implications and therapeutic options. J Nephrol 2012;25(1):31–42.
10. Gorbachinsky I., Akpinar H., Assimos D.G. Metabolic syndrome and urological diseases. Rev Urol 2010;12(4):157–80.
11. Hughes I.A., Werner R., Bunch T., Hiort O. Androgen insensitivity syndrome. Semin Reprod Med 2012;30(5):432–42.
12. Izumi K., Mizokami A., Lin W.J. et al. Androgen receptor roles in the development of benign prostate hyperplasia. Am J Pathol 2013;182(6):1942–9.
13. Matsumoto T., Sakari M., Okada M. et al. The androgen receptor in health and disease. Annu Rev Physiol 2013;75:201–24.
14. McVary K. Lower urinary tract symptoms and sexual dysfunction: epidemiology and pathophysiology. BJU Int 2006;97(Supp l. 2):23–8.
15. Ozden C., Ozdal O.L., Urgancioglu G. The correlation between metabolic syndrome and prostatic growth in patients with benign prostatic hyperplasia. Eur Urol 2007;51:199–203.
16. Schatzl G., Brössner C., Schmid S. Endocrine status in elderly men with lower urinary tract symptoms: correlation of age, hormonal status, and lower urinary tract function. The Prostate Study Group of the
17. Austrian Society of Urology. Urology 2000;55:397–402.
18. Yassin A.A., El-Sakka A.I., Saad F., Gooren L.J. Metabolic syndrome, testosterone deficiency and erectile dysfunction never come alone. Andrologia 2008;40:259–64.
19. Svartberg J., von Möhlen D., Schirmer H. Association of endogenous testosterone with blood pressure and left ventricular mass in men. The Tromsø Study. Eur J Endocrinol 2004;150:65–71.
20. Traish A.M., Saad F., Guay A. The dark side of testosterone deficiency: II. Type 2 diabetes and insulin resistance. J Androl 2009;30:23–32.
21. Ngo D.T., Chan W.P., Rajendran S. et al. Determinants of insulin responsiveness in young women: impact of polycystic ovarian syndrome, nitric oxide, and vitamin D. Nitric Oxide 2011;25:326–30.
22. Pilz S., März W., Wellnitz B. et al. Association of vitamin D deficiency with heart failure and sudden cardiac death in a large cross-sectional study of patients referred for coronary angiography. J Clin Endocrin Metab 2008;93:3927–35.
23. Shvarts G.Ya. Vitamin D i D-gormon. M.: Anakharsis, 2005. 152 s.
24. Wehr E., Pilz S., Boehm B.O. et al. Low free testosterone is associated with heart failure mortality in older men referred for coronary angiography. Eur J Heart Fail 2011;13:482–8.
25. Paez Borda A., Charnay-Sonnek F., Fonteyne V., Papaioannou E.G. Guidelines on Pain Management & Palliative Care EAU, 2013. 96 r.
26. Morgentaler A. Testosterone therapy in men with prostate cancer: scientific and ethical considerations. J Urol 201;189 (1 Supp l):26–33.
27. Morgentaler A. Goodbye androgen hypothesis, hello saturation model. Eur Urol 2012;62(5):765–7.
28. Morgentaler A., Lipshultz L.I., Bennet t R. et al. Testosterone therapy in men with untreated prostate cancer. J Urol 2011;185(4):1256–60.
29. Nishlag N., Bere G.M. (red.). Andrologi ya: Muzhskoe zdorov'e i disfunktsiya reproduktivnoi sistemy. Per. s angl. M.: Mezhdunarodnoe Informatsionnoe Agentstvo, 2005. 554 s.
30. Kalinchenko S.Yu., Tyuzikov I.A. Prakticheskaya andrologiya. M.: Prakticheskaya meditsina, 2009. 400 s.
31. Shill V.-B., Komkhair F., Khargriv T. (red.). Klinicheskaya andrologiya. Per. s angl. M.: GEOTAR-Media, 2011. 800 s.
32. Wang C., Nieschlag E., Swerdloff R. et al. Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations. Eur J Endocrinol 2008;159(5):507–14.
33. Goncharov N.P., Katsiya G.V. Sovremenny e metody opredeleniya testosterona. Problemy i ikh reshenie. Andro l i genit khir 2008;2:27–36.
34. Tyuzikov I.A., Kalinchenko S.Yu. Androgenny i defitsit v obshchei vrachebnoi praktike: endokrinologiya, ratsional'naya diagnostika i klinicheskie «maski» (lektsiya). Chast' 2. Ratsional'naya kliniko-laboratornaya diagnostika androgennogo defitsita u muzhchin. Med alfavit. Bol'nitsa 2012;2(12):42–50.
35. Tyuzikov I.A., Kalinchenko S.Yu. Androgenny i defitsit v obshchei vrachebnoi praktike: endokrinologiya, ratsional'naya diagnostika i klinicheskie «maski» (lektsiya). Chast' 3. Klinicheskie
36. «maski» androgennogo defitsita v obshchei vrachebnoi praktike. Med alfavit. Bol'nitsa 2012;3(15):59–68.
37. Tyuzikov I.A. Kalinchenko S.Yu., Martov A.G. Androgennyi defitsit i somaticheskie zabolevaniya u muzhchin: est' li patogeneticheskie svyazi? Zemskii vrach 2012;3:12–4.
38. Dedov I.I., Kalinchenko S.Yu. Vozrastnoi androgennyi defitsit u muzhchin. M.: Prakticheskaya meditsina, 2006. 240 s.
39. Jockenhovel F. Male Hyrogonadism. Auflage-Bremen: Uni-Med, 2004. 185 r.
40. Dohle G.R., Arver S., Bettocchi C. et al. Guidelines on male hypogonadism. EAU, 2013. 27 r.
41. Lunenfeld B., Saad F., Hoesl C.E. ISA, ISSAM and EAU recommendations for the investigation, treatment and monitoring of late-onset hypogonadism in males: scientific background and rationale. Aging Male 2005;8(2):59–74.
42. Kapoor D., Goodwin E., Channer K.S., Jones T.H. Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes. Eur J Endocrinol 2006;154(6):899–906.
43. Standart «Ob utverzhdenii standarta pervichnoi mediko-sanitarnoi pomoshchi pri insulinnezavisimom sakharnom diabete». Prikaz Minzdrava RF № 1581n ot 28.12.12. Zaregistrirovan v Minyuste RF za № 27719 15.03.13.
44. Stellato R.K., Feldman H.A., Hamdy O. Testosterone, sex hormone-binding globulin, and the development of type 2 diabetes in middle-aged men: prospective results from the Massachusetts male aging study. Diabetes Care 2000;23:490–4.
45. Kupelian V., Shabsigh R., Araujo A.B. Erectile dysfunction as a predictor of the metabolic syndrome in aging men: results from the Massachusetts Male Aging Study. J Urol 2006;176:222–6.
46. Traish A.M., Miner M.M., Morgentale r A., Zitzmann M. Testosterone deficiency. Am J Med 2011;124(7):578–87.
47. Tajar A., Huhtaniemi I.T., O’Neill T.W. et al. Characteristics of androgen deficiency in late-onset hypogonadism: results from the European Male Aging Study (EMAS). J Clin Endocrinol Metab 2012;97(5):1508–16.
48. McHenry Martin C. Testosterone deficiency in older men: a problem worth treating. Sonsult Pharm 2012;27(3):152–63.
49. Rabijewski M., Papierska L., Kozakowsk i J., Zgliczyński W. The high prevalence of testosterone deficiency in population of Polish men over 65 years with erectile dysfunctions. Aging Male 2012;15(4):258–62.
50. Seisen T., Rouprêt M., Gallais J.L., Cost a P. Relevant clinical and biological criteria for the diagnosis of androgen deficiency in the aging male (ADAM). Prog Urol 2012;22(Suppl.1):21–6.
51. Handelsman D.J. Pharmacoepidemiology of testosterone prescribing in Australia, 1992–2010. Med J Aust 2012;196(10):642–5.
52. Spetz Holm A.C., Fredrikson M.G., Hammar M.L. Symptoms of testosterone deficiency in early middle aged men. Aging Male 2012;15(2):78–84.
53. Sun K., Liang G.Q., Chen X.F. et al. Survey for late-onset hypogonadism among old and middle-aged males in Shanghai communities. Asian J Androl 2012;14(2):338–40.
54. Claramonte M., García-Cruz E., Luque P., Alcaraz A. Prevalence and risk factors of erectile dysfunction and testosterone deficiency symptoms in a rural population in Uganda. Arch Esp Urol 2012;65(7):689–97.
55. Tan W.S., Ng C.J., Khoo E.M. et al. The triad of erectile dysfunction, testosterone deficiency syndrome and metabolic syndrome: findings from a multi-ethnic Asian men study (The Subang Men’s Health Study). Aging Male 2011;14(4):231–6.
56. Haring R., Völzke H., Felix S.B. et al. Prediction of metabolic syndrome by low serum testosterone levels in men: results from the study of health in Pomerania. Diabetes 2009;58(9):2027–31.
57. Dobrokhleb V.G. Resursnyi potentsial i zanyatost' pozhilykh lyudei v sovremennoi Rossii. Yaroslavl': Lad, 2004.
58. Tyuzikov I.A. Rezul'taty pilotnogo epidemiologicheskogo issledovaniya rasprostranennosti androgennogo defitsita u muzhchin v ambulatornoi praktike urologov i vrachei razlichnykh spetsial'nostei (Yaroslavskoe issledovanie). Urol segodnya 2013;2(24):16–7.
59. Tyuzikov I.A. Rezul'taty pilotnogo epidemiologicheskogo issledovaniya rasprostranennosti androgennogo defitsita u muzhchin v ambulatornoi praktike vrachei razlichnykh spetsial'nostei (Yaroslavskoe issledovanie, 2013). Mater. II Kongressa urologov Sibiri. Tomsk, 2013. S. 179–81.
60. Tyuzikov I.A. Novye patogeneticheskie podkhody k diagnostike zabolevanii predstatel'noi zhelezy u muzhchin s ozhireniem, androgennym defitsitom i diabeticheskoi neiropatiei. Androl i genit khir 2011;4:34–9.
61. Engeler D., Baranowsky A.P., Elneil S. et al. Guideline on chronic pelvic pain syndrome. European Association of Urology, 2013. 132 r.
62. Vesper H.W., Bhasin S., Wang C. et al. Interlaboratory comparison study of serum total testosterone [corrected] measurements performed by mass spectrometry methods. Steroids 2009;74(6):498–503.
63. Matsumoto A.M., Paulsen C.A., Hoppe r B.R. et al. Human chorionic gonadotropin and testicular function: stimulation of testosterone, testosterone precursors, and sperm production despite high
64. estradiol levels. J Clin Endocrinol Metab 1983;56(4):720–8.
65. Yurci A., Yucesoy M., Unluhizarci K. et al. Effects of testosterone gel treatment in hypogonadal men with liver cirrhosis. Clin Res Hepatol Gastroenterol 2011;35(12):845–54.
66. Heufelder A.E., Saad F., Bunck M.C., Gooren L. Fifty-two-week treatment with diet and exercise plus transdermal testosterone reverses the metabolic syndrome and improves glycemic control in men with newly diagnosed type 2 diabetes and subnormal plasma testosterone. J Androl 2009;30(6):726–33.
67. Dean J.D., Carnegie C., Rodzvilla J., Smith T. Long-term effects of testim(r) 1 % testosterone gel in hypogonadal men. Rev Urol 2004;6(Suppl. 6):22–9.
68. Dobs A.S., McGettigan J., Norwood P. et al. A novel testosterone 2 % gel for the treatment of hypogonadal males. J Androl 2012;33(4):601–7.
69. Davis S.R., Braunstein G.D. Efficacy and safety of testosterone in the management of hypoactive sexual desire disorder in postmenopausal women. J Sex Med 2012;9(4):1134–48.
70. Mazer N.A., Shifren J.L. Transdermal testosterone for women: a new physiological approach for androgen therapy. Obstet Gynecol Surv 2003;58(7):489–500.
71. Chudakov B., Ben Zion I.Z., Belmake r R.H. Transdermal testosterone gel prn application for hypoactive sexual desire disorder in premenopausal women: a controlled pilot study of the effects on the arizona sexual experiences scale for females and sexual function questionnaire. J Sex Med 2007;4(1):204–8.
72. Raghunandan C., Agrawal S., Dubey P. et al. A comparative study of the effects of local estrogen with or without local testosterone on vulvovaginal and sexual dysfunction in postmenopausal women. J Sex Med 2010;7(3):1284–90.
73. Lin E., McCabe E., Newton-Cheh C. et al. Effects of transdermal testosterone on natriuretic peptide levels in women: a randomized placebo-controlled pilot study. Fertil Steril 2012;97(2):489–93.
74. Tyuzikov I.A., Kalinchenko S.Yu., Vorslov L.O., Grekov E.A. Korrektsiya androgennogo defitsita pri khronicheskom infektsionnom prostatite kak patogeneticheskii metod preodoleniya neeffek-
75. tivnosti standartnoi antibakterial'noi terapii na fone rastushchei antibiotikorezistentnosti. Androl i genit khir 2013;1:55–63.
