Ihe nrịbama nke Mmekorita nke etrogen na-aga n'ihu na mmekorita nke mmekorita nwoke na nwanyi na mmekorita nwoke na nwanyi (2021)

ikwu: Ejikọtara iji ihe ndị gba ọtọ na-akpali agụụ mmekọahụ na obere ọrụ erectile na njikwa ejaculatory dị ala na ụmụ okorobịa.

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N'ihu. Isi mgbaka, 06 Eprel 2021 | https://doi.org/10.3389/fpsyt.2021.517411

Buchholz Verena N., Mühle Christiane, Ọmụmụ otu ndị otu gbasara ihe egwu eji eme ihe, Kornhuber Johannes, Lenz Bernd

nkịtị

Ikiri ihe na-akpali agụụ mmekọahụ na arụrụ ọrụ mmekọahụ na-arị elu na ụmụ okorobịa. Nnyocha ndị gara aga na-atụ aro na ikpughe androgen prenatal na-ekere òkè na ahụ ahụ na arụ ọrụ mmekọahụ. N'ebe a, anyị nwalere ma obere mkpịsị aka nke abụọ ruo nke anọ (2D: 4D) na mgbe e mesịrị na spermarche, ma ihe ngosi ntinye nke ọkwa androgen dị elu na utero, na-ejikọta ya na mmekorita mmekọahụ na ntanetị (OSC scale of ISST), ọrụ erectile ( IIEF-5), na njikwa ejaculatory (PEPA) n'ime ụmụ okorobịa 4,370 (afọ IQR: 25-26 afọ) nke ọmụmụ ihe gbasara otu ihe na-eji ihe ize ndụ eme ihe. Nyocha ndekọ ọnụ ọgụgụ gosiri na 2D dị ala: 4D jikọtara ya na akara dị elu na ọnụ ọgụgụ OSC. Ọzọkwa, afọ dị elu na spermarche jikọtara ya na akara OSC dị elu yana mbelata ọrụ erectile. N'ụzọ na-akpali mmasị, ịdị njọ OSC, mana ọ bụghị ugboro ole a na-eji ihe ndị gba ọtọ eme ihe, jikọtara ya na ọrụ erectile na njikwa ejaculatory. Nke a bụ ọmụmụ izizi ijikọ proxies abụọ nọọrọ onwe ha nke ọkwa testosterone prenatal na OSC. Nchọpụta ndị a na-enye nghọta ọhụrụ banyere nhụsianya intrauterine nke omume mmekọahụ na ọrụ mmekọahụ metụtara ya n'oge okenye.

ISSN=1664-0640

Okwu Mmalite

Otu nnyocha na-eto eto na-akwado na ịṅụ ihe na-akpali agụụ mmekọahụ riri ahụ na-ebute oke ibu karịsịa nye ụmụ nwoke na-eto eto (1, 2). Otú ọ dị, n'ihi ụdị echiche dị iche iche na nleba anya na-akọwa onwe ya, atụmatụ mgbasa ozi ezughị oke. Taa, a machaghị usoro ihe ndị na-akpata ihe ndị na-akpali agụụ mmekọahụ riri ahụ́.

A na-atụle iji ihe ndị gba ọtọ na-akpali agụụ mmekọahụ na-eme ihe iji kwalite mmekọahụ rụrụ arụ [maka nyocha, lee (3)). Nrụ ọrụ erectile na-emetụta ndị nwoke karịrị afọ 40 na ọnụ ọgụgụ ndị a na-akọ na mbụ nke 1-10% na ụmụ nwoke na 50-100% n'ime ụmụ nwoke karịrị afọ 70 (XNUMX).4). Agbanyeghị, dysfunction psychogenic erectile na ụmụ nwoke na-erubeghị afọ 40 ebiliwo nke ukwuu n'ime afọ iri gara aga ruo ọnụego ruru 14-28% na ndị Europe gbara afọ 18-40 (XNUMX-XNUMX).5-7). A tụlewo mmụba dị egwu zuru ụwa ọnụ nke ikiri ndị gba ọtọ dị ka mkpali mmekọahụ iji kpalite arụrụ arụ erectile. via mgbanwe na usoro mkpali nke ụbụrụ (ụzọ mesolimbic dopamine)3). Mmeghachi omume na-adabere na neurons dopaminergic na mpaghara ventral tegmental (VTA) na ndị na-anabata dopamine na nucleus accumbens (NAc) (3, 8, 9). Usoro ụgwọ ọrụ a na-arụ ọrụ nke ọma n'oge a na-ekiri ihe ndị gba ọtọ na mgbanwe na njikọ ụbụrụ na cortex prefrontal hụrụ na isiokwu ndị nwere ihe na-akpali agụụ mmekọahụ riri ahụ ma e jiri ya tụnyere njikwa.10). Ọzọkwa, a na-ahụ ihe omume ndị ọzọ metụtara ihe riri ahụ, dị ka mmetụta uche na-abawanye, na nzaghachi ụbụrụ nke ndị mmadụ na-ekiri ihe gba ọtọ riri ahụ (11). Ihe na-akpali agụụ mmekọahụ nwere ikike dị elu nke ịṅụ ọgwụ ọjọọ, na-atụle ohere ya, ohere ọ ga-eri, na amaghị aha (2). Nri ahụ na ya nwere ike ibute nnukwu nsogbu, sitere na nrụrụ erectile ruo na agụụ mmekọahụ dị ala na mmekọ nwoke na nwanyị na nsogbu mmekọrịta (3). Ọ bụ ezie na akụkọ gbasara ụlọ ọgwụ na-atụkarị aro ka ọ rụọ ọrụ mgbe ọ kwụsịrị ikiri ihe ndị gba ọtọ, ihe àmà kpọmkwem nke mmetụta na-akpata adịghị adị (3), dị ka nghọta sayensị nke iji ihe na-akpali agụụ mmekọahụ na-amanye na arụrụ ọrụ ya jikọtara ya. Maka dysfunction organic erectile, n'ụzọ dị iche, ihe ize ndụ nke obi na-anọchi anya ndị amụma siri ike (4).

O yiri ka ọ na-emetụta oke agụụ mmekọahụ site na ịṅụbiga mmanya ókè na ndị ọrịa hypersexual, na-ebute akụkọ banyere nsogbu ejaculation na 33% nke ndị ọrịa.12). Ejaculation akaghi aka na-emekarị na ụmụ nwoke na-eto eto, karịsịa n'oge mbụ ha na-enwe mmekọahụ (13) ma na-ebelata ka oge na-aga ka ahụmahụ na-enye njikwa ụbara. Usoro maka njikwa ejaculatory akaghi aka, dị ka International Society of Sexual Medicine si kwuo, mezuru naanị 4-5% nke ndị bi n'ụwa niile. Ọzọkwa, echiche nke njikwa ejaculatory akabeghị aka na-emetụta mmekọrịta mmadụ na ibe ya site na iri ihe ndị na-akpali agụụ mmekọahụ (14).

Ụmụ nwoke na-enwekarị mmasị na ikiri ihe gba ọtọ karịa ụmụ nwanyị (15). Nnyocha e mere n'Australia chọtara ọnụ ọgụgụ nke onwe nke 4% n'ime ụmụ nwoke 9,963 yana naanị 1% n'ime ụmụ nwanyị 10,131. Ọdịiche a dabere na mmekọahụ dịkwa na ihe riri ahụ ndị ọzọ anaghị emetụta ihe gbasara ihe, dịka ịgba chaa chaa (16), egwuregwu ịntanetị (17, 18), na ịṅụ mmanya na-aba n'anya (19). N'ozuzu, esemokwu mmekọahụ na-esite na enweghị ahaghị nhata mmekọahụ na chromosomes X na Y nke na-ekpebi mmepe gonadal na mgbe e mesịrị secretion nke androgens na estrogens. N'oge windo nwere mmetụta (dịka ọmụmaatụ, prenatal, perinatal, and pubertal), homonụ mmekọahụ ndị a na-eduga na nhazi nhazi na-adịgide adịgide na ụbụrụ na omume nke a na-akpa ókè site na mmetụta mmegharị ozugbo na mgbanwe.20). Ya mere, ọmụmụ enyochala ọrụ nke ikpughe androgen prenatal na-akpata omume riri ahụ. N'ezie, ihe akaebe mbụ gbasara mkpakọrịta egosila na egwuregwu egwuregwu vidiyo riri ahụ (21) na mmanya na-aba n'anya bụ (22, 23) ha abụọ metụtara mkpughe androgen tupu ịmụ nwa. Yana ihe akaebe sitere na mkpụrụ ndụ ihe nketa na-ejikọta homonụ mmekọahụ na-egosi ịdabere na ya (24-28), nke a na-egosi na ọrụ androgen na-etinye aka na pathology nke riri ahụ. Ọzọkwa, ọmụmụ òké na-enye ihe akaebe na-egosi na mgbanwe mgbanwe androgen receptor modulation na-emetụta ịṅụ mmanya na-aba n'anya n'oge okenye (29). Ọmụmụ mmadụ dabere na akara na-apụtaghị ìhè nke ikpughe androgen prenatal na-akwado ọrụ ọmụmụ ya na mmepe na mmezi nke omume riri ahụ n'oge okenye. Nnyocha nke okwu a kpọmkwem n'ime ụmụ mmadụ agaghị ekwe omume n'ihi nchegbu ụkpụrụ omume na ogologo oge dị n'etiti oge ịmụ nwa na ntozu okè.

Nnyocha dabere na nnwale òké na ọmụmụ mkpakọrịta mmadụ achọpụtala akara nke ọkwa androgen prenatal, dị ka nha ogologo mkpịsị aka nke abụọ ruo nke anọ (2D: 4D) [(30, 31); ma hụkwa:(32, 33)] na afọ na mbụ ejaculation (spermarche) (34, 35). A na-ejikọta ọkwa testosterone nke nne nne mmadụ na oke ọnụọgụ ụmụ amụrụ ọhụrụ na nwoke na nwanyị abụọ (36), na ọkwa testosterone nke mmiri amniotic na-adịghị mma na ụmụaka dị afọ 2' 2D: 4D (37). Meta-analysis na nso nso a hụrụ 2D dị ala: 4D (na-egosi mmụba nke ikpughe androgen prenatal) n'ime ụmụ nwoke nwere omume na-eri ahụ na-emetụtaghị ihe (Hedge's). g = -0.427) mana ọ bụghị maka ụmụ nwanyị (Hedge's g = -0.260). Mmetụta a siri ike karị na nyocha sub-ntụnyere dabere na ndị na-adabereghị na ya (Hedge's g = -0.427) (38), nke na-egosi na 2D: 4D nwere njikọ siri ike na ihe riri ahụ karịa ugboro ole ma ọ bụ ọnụọgụ ojiji. Ọzọkwa, 2D dị ala: 4D na-ejikọta ya na imeju, akwara, na mmetụta myelotoxic nke mmanya na ụlọ ọgwụ na-atụ anya na ndị ọrịa dabere (22). Ụmụ nwoke ndị na-aṅụ mmanya na-aba n'anya nwere 2D dị ala: 4D dịkwa njikere ịzụta ihe ọṅụṅụ mmanya dị ọnụ ala (23). N'otu aka ahụ, ndị ọrịa na-aṅụ mmanya na-aba n'anya (22) na ndị mmadụ n'otu n'otu na-ekwupụta omume ịṅụbiga mmanya ókè (39) na-akọkwa afọ ndụ mgbe e mesịrị na spermarche. Ihe omuma nnwale nke anụmanụ na-egosi na ọgwụgwọ androgen tupu ịmụ nwa na-abawanye afọ mmalite mmalite n'ime oke ụmụ nwoke (35). N'ịchịkọta ọnụ, data ndị a na-egosi na ikpughe androgen nke dị elu na-ebute mmadụ ịmalite ma nọgide na-enwe nsogbu ndị na-eri ahụ n'oge ọ bụ okenye. N'ụzọ na-akpali mmasị, ọrụ na-adịbeghị anya na-egosi na nchekasị, ịṅụ sịga, na ịṅụ mmanya na-aba n'anya n'oge ime ime na-abawanye ikpughe testosterone prenatal, dị ka 2D dị ala: 4D gosipụtara na ụmụ mmadụ (22, 40). Ya mere, omume nne nwere ike ịbụ ihe dị irè, ebumnuche ọhụrụ maka mgbochi riri ahụ n'etiti ụmụ ya (41).

Nsogbu ịṅụ mmanya na-aba n'anya na iji nsogbu nke ihe ndị na-akpali agụụ mmekọahụ na-agbakọta nke ọma n'ọtụtụ akụkụ, nke na-egosi usoro etiopathogenetic nkịtị.42). Ụgwọ ọrụ metụtara mmekọahụ ọ bụghị naanị na-agbakọta n'otu ụzọ ahụ akwara dị ka ụgwọ ọrụ ọgwụ, mana ha na-ekerịtakwa otu ndị ogbugbo molecular na, ikekwe, otu neurons na NAc, n'adịghị ka ụgwọ ọrụ eke ndị ọzọ dị ka nri.43). Ụdị ihe na-akpali akpali nke riri ahụ dabara nke ọma na nkewa ahụ a na-ahụ na ihe nkiri ndị gba ọtọ riri ahụ nke ịba ụba agụụ ("chọrọ") na mbelata ụtọ site na iji ("masịrị") (44). N'ụzọ na-akpali mmasị, karịsịa atụmanya inwe mmetụta dị elu na-eso ịṅụ mmanya na-aba n'anya kwekọrọ na 2D dị ala: 4D (23). Na mgbakwunye na amụma mkpụrụ ndụ ihe na-eri ahụ, iji ihe na-akpali agụụ mmekọahụ eme ihe nwere ike ịmasị ndị ikom nwere 2D dị ala: 4D, n'ihi na ha nwere oke ikewapụ (dị elu).45), gosi mkpasu iwe ma ọ bụ omume ọchịchị n'ọnọdụ ụfọdụ (46), na ndị ọzọ na-adabere n'ọkwa (47). Agbanyeghị, amụbeghị ọrụ nke intrauterine androgen level in online mmekọahụ compulsivity (OSC) na arụrụ ọrụ mmekọahụ metụtara ya. Ya mere, anyị nwalere echiche anyị bụ isi nke na-ebelata 2D: 4D na afọ imecha na spermarche metụtara OSC.

Na mgbakwunye na mmetụta nke sistemu metụtara ụgwọ ọrụ nke ọkwa androgen prenatal, mkpughe androgen prenatal na-akpụzi akụkụ ọmụmụ; ntụgharị, 2D dị ala: 4D ( testosterone prenatal dị elu) jikọtara ya na ogologo penile ka ukwuu (48) na ule ndị buru ibu (49). Testosterone dị n'afọ ime nwa na-eme ka akụkụ ahụ nke ọmụmụ (ụmụ nwanyị)50, 51). Ọzọkwa, ndị mmadụ nwere ejaculation akaghi aka ndụ nwere 2D dị ala: 4D (52). Ya mere, anyị nyochakwara ma 2D: 4D na afọ na spermarche jikọtara ya na ọrụ erectile na / ma ọ bụ njikwa ejaculatory.

ụzọ

Data igwe mmadụ

Ihe data a tụlere ebe a sitere na ebili mmiri nyocha nke mbụ ruo nke atọ nke ọmụmụ otu ogologo ogologo na ihe ize ndụ eji eme ihe (C-SURF; www.c-surf.ch). Site na 2010 ruo 2012, ụmụ nwoke 7,556 na-aga ọrụ mmanye maka ndị agha Switzerland nyere nkwenye ederede ederede, nke ndị ikom 5,987 so na Wave 1. Na Wave 2, ụmụ nwoke 5,036 dechara ajụjụ ọnụ site na 2012 ruo 2013, na Wave si 3. 2016 ma gụnye ụmụ nwoke 2018 (lee www.c-surf.ch). Ihe niile nyochara sitere na Wave 3, ma e wezụga maka njikwa ejaculatory na mgbanwe ọrụ erectile, nke a na-enyocha na Waves 1 na 2 naanị. Anyị gụnyere ụmụ nwoke na-eto eto bụ ndị na-akọ na ọ bụ naanị mmasị ụmụ nwanyị, n'ihi ọtụtụ ihe kpatara ya: nke mbụ, anyị chọrọ ịbawanye n'otu n'otu nke ihe atụ anyị n'ihe gbasara omume mmekọahụ; nke abụọ, otu ihe ka emepụtara kpọmkwem maka ịbanye n'ime ikpu na ụdị German.

2D:4D

Yiri usoro ndị akọwapụtara (53) na (39), A gwara ndị sonyere ka ha jiri onwe ha tụọ 2D: 4D (Ajụjụ Nke 3 ID: J18). Ha dekọtara ogologo mkpịsị aka ndeksi na milimita maka aka nri na aka ekpe ha iche. Iji kpochapụ ụkpụrụ ezighi ezi, ogologo mkpịsị aka n'okpuru 10 mm na karịa 100 mm (53) na, emesịa, 2D:4D n'èzí nke 2.5 na 97.5 percentiles (39, 54) ewepụrụ, dị ka akọwara na mbụ. Anyị họrọ 2D: 4D (Mean2D: 4D) n'aka aka nri na aka ekpe dị ka onye amụma mbụ na aka nri 2D: 4D (R2D: 4D), aka ekpe 2D: 4D (L2D: 4D), na ọdịiche dị n'etiti R2D: 4D na L2D: 4D (2D: 4Dr-l) dị ka ndị na-ebu amụma.

Afọ mmalite mmalite

A na-achịkwa afọ mmalite mmalite nke onwe onye maka oge gafere (afọ gafere kemgbe ọ bụ nwata) na-eji nyocha ngbanwe nke akụkụ, ebe ọ bụ na icheta echiche na-ewu ewu (55), ntụgharị, ọdịiche dị na afọ agbanwe agbanwe na mmalite mmalite nke jikọtara ya na afọ kemgbe oge ntolite (afọ ugbu a-eto eto) wepụrụ. Ọzọkwa, e wepụrụ atụmatụ ndị dị n'okpuru 9, dabere na akụkọ gara aga (56) na nyocha gara aga nke 2D: 4D na afọ mmalite mmalite (22).

CSO

Nleba anya mmekọ nwoke na nwanyị ịntanetị (ISST; http://www.recoveryzone.com/tests/sex-addiction/ISST/index.php, nke Delmonico mepụtara, 1997) bụ ngwa nyocha nke na-achọpụta omume dabere na ịntanetị nwere nsogbu ahụike. Ihe nyocha nke data ISST chọpụtara ihe ise: OSC, omume mmekọahụ n'ịntanetị - mmekọrịta ọha na eze, omume mmekọahụ n'ịntanetị dịpụrụ adịpụ, mmefu mmekọahụ n'ịntanetị, na mmasị na omume mmekọahụ n'ịntanetị (57). Agụnyere subscale OSC na ajụjụ C-SURF, nke nwere ihe ọnụọgụ abụọ (ee/ee e). Ndị na-agabeghị ebe nrụọrụ weebụ na-akpali agụụ mmekọahụ n'ime ọnwa 12 gara aga (22.4%, n = 1,064) ewepụrụ na nyocha. Ebe ọ bụ na ọnụ ọgụgụ mbelata dị mkpa na ụlọ ọgwụ adịbeghị na nyocha dị ntakịrị na okwu a, anyị kpebiri iji akara nchikota dị ka mgbanwe na-aga n'ihu na nyocha anyị.

Iri ihe na-akpali agụụ mmekọahụ

Data sitere na ihe abụọ dị: otu na ugboro ojiji (ya bụ, ụbọchị oriri kwa ọnwa) na otu na ogologo oge ojiji ọ bụla. N'ime otu anyị, ọnụọgụ interquartile (IQR) nke ụbọchị oriri bụ ụbọchị 3 ruo 15 kwa ọnwa. Ogologo oge ojiji: ọ fọrọ nke nta ka ọ bụrụ nke ọ bụla, 1 ruo <2 h, 2 ruo <3 h, 3 ruo <4 h, 4 h, ma ọ bụ karịa. Anyị tụlere ugboro ole ka ọ bụrụ ihe ọmụma karịa ebe a, ebe mgbanwe dị na oge oriri dị ala, yana 90% na-akọ onwe ya <1 h.

Ọrụ Erectile

Ajuju nke International Index of erectile Function (IIEF-5) nwere ihe ise, nke ejiri akara Likert nwere akara ise. Kedu ka ị ga-esi tụọ obi ike gị na ị nwere ike nweta ma nọgide na-ere ọkụ? Mgbe ị nwere mmewere site na mkpali mmekọahụ, ugboro ole ka erection gị siri sie ike maka ịbanye (itinye amụ n'ime ikpu)? Mgbe ị na-enwe mmekọahụ, ugboro ole ka ị na-enwe ike ịnọgide na-eguzobe gị mgbe ị banyere n'ime onye òtù ọlụlụ gị? Mgbe a na-enwe mmekọahụ, olee otú o si sie ike ịnọgide na-enwe nguzozi gị ruo n'oge mmekọ nwoke na nwanyị? Mgbe ị nwara inwe mmekọahụ, ugboro ole ka ọ na-eju gị afọ? Edebere akara nchikota dịka mgbanwe na-aga n'ihu maka nyocha njikọ.

Nchikota nke nsi

Otu ihe (ihe dị ka Likert dị isi ise) sitere na nyocha Premature Ejaculation Prevalence and Attitude (PEPA) jiri mee ihe (58): N'ime ọnwa isii gara aga, kedu ka ị ga-esi tụọ njikwa gị na ejaculation n'oge mmekọ nwoke na nwanyị?

Nkwado Ụkpụrụ

Isiokwu niile nyere nkwenye ederede tupu etinye ha n'ọmụmụ ihe mbụ. Kọmiti ụkpụrụ omume maka nyocha ahụike nke ụlọ akwụkwọ ahụike Mahadum Lausanne kwadoro ọmụmụ ihe a (Protocol No. 15/07).

Nyocha nchịkọta akụkọ

A tụlere data niile site na iji IBM SPSS Statistics ụdị 24 maka Windows (SPSS Inc., Chicago, IL, USA). Mgbe isi ihe data na-efu, a na-ewepụ isiokwu ọmụmụ na nyocha a kapịrị ọnụ (ọnụọgụ ndị mmadụ gụnyere na nyocha ọ bụla a na-akọ dị ka N). Ekọwapụtara ọnụ ọgụgụ nkọwa n'ọtụtụ ugboro, etiti na IQR. Anyị jiri ule mbinye aka Wilcoxon tụnyere otu dabere. Achọpụtara mmekọrịta site na iji usoro ọkwa Spearman, ebe ọ bụ na anaghị ekesa data ahụ. p A na-ewere <0.05 dị ka ọnụ ọgụgụ dị mkpa maka ule ihu abụọ. A na-eme mmekọ nke ọkara n'etiti ihe ndị fọdụrụ iji kpughee njikọ dị iche iche na-ejikọta mgbanwe ndị ahụ. Dịka akọwara n'okpuru ebe a, anyị kewakwara mmetụta metụtara ugboro ugboro oriri site na mmụkọ akọpụtara site na mmekọ nke ọkara akụkụ dị ka a post-hoc nyocha.

Results

Ọnụọgụ ọnụ ọgụgụ ndị otu

Mgbe mwepu nke amamihe dị n'usoro nke isiokwu ndị na-emezughị njiri mara mma nke 2D: 4D (n = 518) na/ma ọ bụ afọ mmalite mmaliteN = 94) na ndị na-enweghị mmasị na ụmụ nwanyị (N = 534), ngụkọta otu ahụ ka e ji mara dịka ndị a: afọ 25 (IQR 25–26, N = 4,370); Ọnụ ọgụgụ anụ ahụ 23.6 kg / m² (IQR 21.9–25.5, N = 4,362); 79.8% na-arụ ọrụ nke ọma (N = 4,369 ; agụmakwụkwọ: 3.0% agụmakwụkwọ sekọndrị, 1.2% agụmakwụkwọ ọrụ aka, 34.9% agụmakwụkwọ sekọndrị / nka nka, 4.4% kọleji obodo, 11.1% ụlọ akwụkwọ sekọndrị, 11.3% ụlọ akwụkwọ sekọndrị, 23.2% nzere bachelọ ( mahadum), 5.9% masters degree mahadum), 4.7% ndị ọzọ (N = 4,358 ; Ọkwa alụmdi na nwunye: 82.9% alụghị di, 5.3% lụrụ di na nwunye, 0.1% a gbara alụkwaghịm, 11.5% alụbeghị di, ndị kewapụrụ, ma ọ bụ ịgba alụkwaghịm mana ha na onye ibe ha na-ebikọ (dịka ọmụmaatụ, na mmekorita edebanyere aha), 0.2% lụrụ di ma kewapụrụ, 0.0% di ha nwụrụ (N = 4,363 ; 37.5% ka ha na nne na nna ha bi. N'ime ọnwa iri na abụọ gara aga, 12% nwere otu onye mmekọ nwoke na nwanyị, 59.9% enweghị nke ọ bụla, 5.9% nwere abụọ ma ọ bụ karịa. Mean34.2D:2D bụ 4 (IQR 0.981–0.955, N = 4,177), R2D:4D 0.986 (IQR 0.951–1.000, N = 4,269), L2D:4D 0.986 (IQR 0.951–1.000 N = 4,278), 2D:4Dr-l 0.000 (IQR -0.013–0.012, N = 4,177).

N'ime isiokwu ndị na-akpali agụụ mmekọahụ, 41% nyere ma ọ dịkarịa ala otu nzaghachi dị mma na ajụjụ OSC; 18.4% kọrọ opekata mpe omume abụọ nwere nsogbu sitere na OSC. N'ime otu anyị, 41.3% kọrọ opekata mpe nsogbu nrụzi dị nro, na 5% kwuru na njikwa adịghị mma maka ejaculation n'oge mmekọahụ.

Prenatal Testosterone Markers na OSC

Nke mbụ, anyị nwalere echiche anyị bụ isi, na-ekwupụta na ụbara testosterone prenatal, dị ka egosiri Mean2D: 4D na/ma ọ bụ karịa mmalite mmalite afọ, jikọtara ya na akara OSC dị elu na otu anyị. Ọ bụ ezie na Mean2D: 4D jikọtara nke ọma na ntụzịaka a na-atụ anya ya, afọ mmalite mmalite nke nwata akọpụtaghị onwe ya.Isiokwu 1).

Na-esote, anyị na-achịkwa maka oge oriri n'ezie na OSC na-adabere na anyị, ebe ọ bụ na e jikọtara ya na mgbagwoju anya na-abawanye (Rho = 0.184, p <0.001, N = 3,678), ejikọtara afọ mmalite mmalite na oge oriri na-adịghị mma (Rho = -0.124, p <0.001, N = 3,680), mana Mean2D: 4D abụghị (Rho = 0.008, p = 0.647, N = 3,274) na anyị nwere mmasị kpọmkwem na akụkụ compulsivity, nyere ụfọdụ ọkwa oriri. Mgbe emezigharị maka ugboro ojiji, akara OSC jikọtara nke ọma na Mean2D: 4D yana nke ọma na mmalite mmalite nwata (ha abụọ na-egosi ọkwa testosterone dị elu nke prenatal), yabụ na-akwado echiche anyị bụ isi.Isiokwu 1).

na a post-hoc nyocha, anyị nyochara mmekọrịta nke akara OSC na R2D: 4D, L2D: 4D, na 2D: 4Dr-l (Isiokwu 2). L2D:4D jikọtara nke ọma na OSC, ebe ọ bụ naanị usoro a hụrụ maka R2D: 4D.

Dị ka adịghị ike maka nsogbu ọnọdụ uche na àgwà dị ka ịchọta mmetụta nwere ike imetụta ime nwa yana ikpughe androgen na-eto eto nke nwere ike ịkwado ụfọdụ mmetụta ndị ahụ, anyị mere nyocha nyocha na ọnụọgụ dịnụ maka nnukwu ịda mbà n'obi, MDI.59), ọrịa bipolar, MDQ (60), na ịchọ mmetụta, BSSS (61). Ebe Mean2D: 4D ejikọtaghị nke ọma na usoro ndị a n'otu n'otu (Rho = -0.002, p = 0.922, N = 4,155; Rho = -0.015, p = 0.335, N = 4,161; Rho = 0.006, p = 0.698, N = 4,170), afọ ntolite dị elu jikọtara ya na ọnụ ọgụgụ dị ala nke mgbaàmà n'otu n'otu (Rho = -0.032, p = 0.029, N = 4,717; Rho = -0.050, p = 0.001, N = 4,720) na obere mmetụta na-achọ (Rho = -0.118, p <0.001, N = 4,736).

Ihe nrịbama Testosterone Prenatal na Mmekọahụ Mmekọahụ

Iji nyochaa mmetụta nke testosterone prenatal na arụrụ ọrụ mmekọahụ ma nwalee echiche nke abụọ anyị, anyị buru ụzọ nyochaa mmepe nke njikwa ejaculatory na arụ ọrụ erectile n'ime oge (ya bụ, site na Wave 1 ruo Wave 2, ebe ọ bụ na enyochaghị nsogbu mmekọahụ na Wave 3). Enwere mmụba dị ukwuu na ọrụ erectile ka oge na-aga mana ọ nweghị mgbanwe na njikwa ejaculatory (Z = -5.76, p <0.001; Z = -2.15, p = 0.830. Ya mere, anyị na-achịkwa ọrụ erectile na-adabere na anyị (site na Wave 2) maka afọ. Oge mmalite nke nwa agbọghọ nwere njikọ na-adịghị mma na ọrụ erectile (a na-achịkwa) ma ọ bụghị na njikwa ejaculatory; Mean2D:4D ejikọtaghị nke ọma na nke ọ bụla; hụ Isiokwu 3.

Nyere aro na akwụkwọ ndị na-akpali agụụ mmekọahụ na-emetụta arụrụ ọrụ mmekọahụ, anyị nyochara mmekọrịta dị n'etiti iji ihe gba ọtọ, OSC, na ọrụ mmekọahụ. N'ụzọ na-akpali mmasị, iji ihe na-akpali agụụ mmekọahụ eme ihe ugboro ugboro ejikọtaghị ọnụ na ọrụ erectile, ebe OSC mere, na-enwe mgbaàmà mgbagwoju anya karịa njikwa ejaculatory na-erughị ọrụ na-arụ ọrụ erectile.Isiokwu 4); Ọzọkwa, awa a na-etinye na ikiri ndị gba ọtọ n'oge ọ bụla ejikọtaghị nke ọma na nke ọ bụla.

Nkwurịta

N'ebe a, anyị na-akọwa ihe akaebe mbụ nke mmetụta nke ikpughe androgen prenatal na omume OSC na ụmụ nwoke n'oge ntorobịa. Ihe data anyị kwadoro echiche anyị bụ isi nke na-ebelata 2D: 4D na mgbe e mesịrị na spermarche-ma na-egosipụta onwe ha na ọkwa testosterone dị elu-bụ nke ọma (n'agbanyeghị na ọ nwere obere mmetụta) jikọtara ya na OSC siri ike, n'agbanyeghị nha ogologo mkpịsị aka site n'aka ọtụtụ ndị ọkachamara ọkachamara. na data ụlọ ọgwụ na oge mmalite mmalite adịghị adị.

Nchọpụta ndị a dabara nke ọma na ihe ọmụma dị adị. A na-agbaziri nzaghachi omume nwoke na nwanyị na ụgwọ ọrụ okike via mesolimbic dopamine na-egosi na VTA na NAc (8). Sekit a na-etolite isi nke usoro ụgwọ ọrụ na, dị ka ndị dị otú ahụ, ọ bụghị nanị na-edozi ụgwọ ọrụ mmekọahụ (62) mana ọ na-ebutekwa ihe riri ahụ, dị ka aṅụrụma (63). A na-atụ aro testosterone Prenatal ka ọ metụta mmalite na usoro ịdabere na mmanya na-aba n'anya (22), na nnyocha e mere na ụmụ oke chọpụtara na mgbanwe mgbanwe nke ndị na-anabata androgen na-emetụta ụbụrụ ụbụrụ dopamine, serotonin, na noradrenaline neurotransmitter n'oge okenye (29). N'ime atụrụ nwanyị, testosterone na-amụ nwa na-ejikọta ọnụ na ọnụ ọgụgụ nke tyrosine hydroxylase-immunoreactive cell na VTA.64). Ọzọkwa, riri ahụ methamphetamine bụkwa nke otu mkpụrụ ndụ akwara dị ka mkpali mmekọahụ (na-emekọrịta ihe).65). Omume mmekọahụ ugboro ugboro na nchịkwa psychostimulant ugboro ugboro na-ebute usoro nke DeltaFosB, si otú ahụ na-achọpụta ụzọ mesolimbic.43). Okwu mkpụrụ ndụ nke onye na-anabata mu-opioid, onye bụ isi ihe na-akpata ọrịa riri ahụ, yiri ka ọ bụ mgbanwe mmekọahụ kpọmkwem site na ntinye aka nke testosterone prenatal.29). Ọzọkwa, ụdị A118G nke mu-opioid receptor gene na-emekọ ihe na 2D: 4D iji buo amụma ịdabere na mmanya.66).

Ebe, OSC jikọtara ya na ọkwa testosterone dị elu dị elu gosipụtara site na nrịbama abụọ ahụ, ugboro ugboro na-egosi mmekọrịta dị iche na afọ mmalite mmalite, nke nwere ike ịbụ mmetụta otu ndị ọgbọ. Meta-analysis na nso nso a kwubiri na 2D: 4D metụtara phenotypes riri ahụ karịa ugboro ma ọ bụ ọnụọgụ ojiji (38). Na nchịkọta, nchoputa anyị na-ewusi ma na-emekwuwanye nghọta anyị banyere ịṅụ ọgwụ ọjọọ na ịṅụ ọgwụ ọjọọ na ụgwọ ọrụ mmekọahụ, ya bụ, na ha nwere ike ịkekọrịta otu sekit akwara na-adịghị ike na ọkwa androgen prenatal.

Echiche nke abụọ anyị, na ụbara testosterone prenatal nwekwara ike imetụta ọrụ mmekọahụ, bụ naanị akụkụ nke data kwadoro. Anyị chọtara njikọ dị ịrịba ama n'etiti ọrụ erectile na oge ntolite, na mmalite nke emechara na-ejikọta ya na obere ọrụ; Otú ọ dị, anyị ahụghị njikọ na Mean2D:4D. Enweghị nkwekọ a nwere ike ịbụ n'ihi windo dị iche iche nke ịmụ nwa n'oge a na-ekpebi oge 2D: 4D na oge uto. Ọmụmụ ihe abụọ nwere onwe ha enyela ihe akaebe nke 2D: mmepe 4D na-eme n'oge mmalite ime (67, 68). N'ụzọ dị iche, mgbe a na-ekpebi oge n'oge uto, ọ ka na-edoghị anya, na enwere ike iche na oge ntolite abụghị naanị akara maka ikpughe androgen tupu nwa mana ọ na-emetụtakwa nhazi ụbụrụ n'oge uto.

Ọ dị mkpa nyocha ọzọ iji dokwuo anya ma mmetụta nhazi nke androgen prenatal na usoro ụgwọ ọrụ na-edozi njikọ a, ma ọ bụ ụbara ndị na-anabata androgen, nke na-etinye aka na arụ ọrụ erectile.69) na-ekere òkè, ma ọ bụ na arụrụ arụ erectile bụ mmetụta nke abụọ nke OSC na, ya mere, na-ebilite site na ịba ụba nke ọdịnaya ndị gba ọtọ ma na-emetụta agụụ mmekọahụ n'oge mmekọ nwoke na nwanyị. via akụkụ mkpali metụtara.

N'ọdịnihu, a chọrọ ngwaọrụ nyocha akwadoro iji mebie mmalite nke arụrụ ọrụ mmekọahụ metụtara ihe ndị na-akpali agụụ mmekọahụ riri ahụ site n'ịtụle ọnọdụ nke ihe isi ike mmekọahụ, ọganihu nke OSC, na ihe ndị na-akpali agụụ mmekọahụ ka oge na-aga. Ọzọkwa, ekwesịrị ịtụle ihe mmepe, n'ihi na sekit ụgwọ ọrụ na njikwa prefrontal ya dị oke mfe n'oge uto (70). Tụkwasị na nke a, a ga-enyocha nlezianya nyocha nke ugboro ole oriri, ihe omume ụlọ ọgwụ na-adabere na ihe ndị na-akpali agụụ mmekọahụ, na nyocha nke mmetụta ọgwụ na-adịghị mma n'ọdịnihu, iji nwetakwuo nghọta nke etiology dị n'okpuru.

Njikwa ejaculatory adịghị ejikọta ma akara testosterone tupu ịmụ nwa. Nyere ọmụmụ ihe gara aga na-akọ njikọ dị n'etiti testosterone prenatal na ejaculation akaghi aka (52), Nchọpụta a bụ ihe a na-atụghị anya ya na mbụ. Otú ọ dị, òtù ndị a na-amụ n’ọmụmụ ihe ahụ dị iche na nke anyị n’ụzọ dị iche iche. Nke mbụ, Bolat et al. (52) ọmụmụ gụnyere naanị ndị ọrịa nwere akụkọ ndụ ogologo oge nke nsogbu ejaculation akaghi aka. Nke abụọ, ndị otu ha tọrọ (pụtara afọ 40). Nke atọ, anyị amaghị otú ihe ọmụmụ anyị si nwee ahụmahụ na ịchịkwa ejaculation n'oge mmekọahụ, ebe 82% bụ ndị na-alụbeghị di, nke na-egbochi mmụta ahụmahụ na onye nwere ntụkwasị obi. Nke anọ, enyochaghị omume metụtara ihe ndị gba ọtọ n'ọmụmụ ihe anyị.

Aghọtabeghịkwa arụrụ ọrụ mmekọahụ metụtara ihe ndị gba ọtọ. Nyochaa n'oge na-adịbeghị anya na-akọwa ihe na-akpali agụụ mmekọahụ, nnweta ya, na ọtụtụ ụdị dị iche iche dị ka ihe mkpali dị elu, nke, n'ime ogologo oge, na-eduga ná nsogbu na-enweta mkpali zuru oke na ntọala okike (mmekọrịta). Nke a, n'aka nke ya, nwere ike ịkpata nsogbu dị iche iche, site na nrụrụ erectile n'oge mmekọ nwoke na nwanyị na-egbu oge na ejaculation na-egbu oge, na enweghị ike ịmịpụta kpamkpam n'oge mmekọ nwoke na nwanyị.3). Anyị enweghị data zuru oke na ọmụmụ ihe ugbu a iji mata ọdịiche dị n'etiti oge akaghi aka na nke na-egbu oge, n'ihi na ha abụọ na-ekpuchi ihe gbasara njikwa ejaculatory, bụ nke jikọtara ya na OSC na-adịghị mma. Ihe nlereanya e bipụtara na nso nso a na-akọwa mkpa ndị ọrụ maka ihe ndị dị oke egwu karịa oge iji nwee ike ịpụpụ ekwenyebeghị (71), na abawanye ndidi ugbu a ka akọwapụtabeghị nke ọma maka ikiri ndị gba ọtọ. Agbanyeghị, iji ihe na-akpali agụụ mmekọahụ na-emetụta atụmatụ nke onwe na nke akọpụtara onwe ya nke oge a na-adịghị ahụ anya.

Anyị hụrụ na ọ bụ ihe na-atọ ụtọ na OSC, ọ bụghị ihe ndị na-akpali agụụ mmekọahụ na-eji onwe ya, ejikọtara ya na njikwa ejaculatory na arụ ọrụ na-erughị ala; nke a na-egosi njikọ chiri anya n'etiti OSC na nsogbu mmekọahụ via mgbanwe na usoro nkwụghachi ụgwọ dị iche na usoro mmekọrịta mmekọrịta. Ọzọkwa ebe a, ọ dị mkpa ịchọkwu nnyocha iji wepụ ihe kpatara ya na mmetụta ya.

Ọmụmụ ihe a dị ugbu a nwere oke oke. 2D: 4D bụ ọnụ ọgụgụ nke onwe ya, na ugboro ole nke iji ihe gba ọtọ, ọrụ erectile, na njikwa ejaculatory na-akọ onwe ya. Achọpụtabeghị ihe riri ahụ na-akpali agụụ mmekọahụ dị ka ihe riri ahụ, ya mere, nkọwa ya dịgasị iche (72). N'ebe a, anyị lekwasịrị anya na OSC subscale nke ISST, na-anọchite anya akụkụ mkpali nke omume riri ahụ. Ọzọkwa, anyị nyochara otu ìgwè ndị na-eto eto, ndị nwoke na-edina ụdị onwe, ndị ọtụtụ n'ime ha bụ ndị Caucasian na ndị na-alụbeghị di; ya mere, nchoputa anyị enweghị ike ịchịkọta ya na ọgbọ ndị ọzọ, usoro mmekọahụ, agbụrụ, ma ọ bụ nwanyị. N'ikpeazụ, 2D: 4D na mmalite mmalite nwere oke nkwado dị ka ihe nrịbama maka ikpughe androgen prenatal (33, 38, 73), na o yikarịrị ka oge ntozu nwa na-emetụtakwa nhazi ụbụrụ kpọmkwem, n'ihi na oge ntozu na-abụkwa windo oge dị nro (74). Ya mere, nchọta anyị nwere njikọ n'etiti oge ndị na-eto eto na OSC nwere ike ọ bụghị naanị n'ihi ịmụ nwa kamakwa ọ bụ ihe nhụsianya nke androgen na-ejikọta ya.

Na mmechi, ọkwa androgen dị elu dị elu nke afọ ime (nke ndị nrịbama abụọ nọọrọ onwe ha gosipụtara) jikọtara ya na iji ihe na-akpali agụụ mmekọahụ na-akpali akpali karị. A na-ejikọta ya na ihe ndị ọzọ na-amanye n'aka ya na obere ọrụ erectile na njikwa ejaculatory dị ala na ụmụ okorobịa. Na mgbakwunye, ọrụ erectile pere mpe jikọtara ya na afọ mmalite mmalite nke ntozu nwa, nke nwere ike igosi ọkwa androgen dị n'ihu nwa. Ya mere, etiology nke nrụrụ erectile na ịrị elu ya nke ukwuu n'ime afọ iri gara aga nwere ike ịgụnye mmekọrịta nke prenatal predisposition iji zụlite mmekọahụ n'ịntanetị na / ma ọ bụ arụrụ arụ erectile na ịba ụba nke ọdịnaya ndị gba ọtọ. A na-akwado ọmụmụ ihe n'ọdịnihu ka ọ kwụsịtụ ntinye aka nke ihe ndị a ma mee ka nghọta nke omume riri ahụ na nsogbu mmekọahụ metụtara ya. Nghọta ndị a nwere ike inye aka n'ịmepụta mmemme mgbochi, na-elekwasị anya ma ọ bụ isiokwu dị n'ihe ize ndụ ịzụlite ihe riri ahụ ma ọ bụ ndị nne nke ọkwa testosterone dị n'afọ dị elu.

Nkwupụta nnweta data

Ihe ndekọ data ewepụtara maka ọmụmụ ihe a dị na arịrịọ onye dere ya kwekọrọ.

Nkwupụta Ụkpụrụ

A tụlere ọmụmụ ihe ndị metụtara ndị sonyere mmadụ ma kwado ya site na Kọmitii Ethics for Clinical Research of Lausanne University Medical School (Protocol No. 15/07). Ndị ọrịa/ndị so na ya nyere nkwenye ha ederede ka ha sonye na ọmụmụ ihe a.

Ndị otu ọmụmụ ihe gbasara ihe egwu eji eme ihe

Gerhard Gmel: Ọgwụ riri ahụ, Ụlọ Ọgwụ Mahadum Lausanne CHUV, Mahadum Lausanne, Lausanne, Switzerland; Switzerland riri ahụ, Lausanne, Switzerland; Center for Addiction and Mental Health, Toronto, ON, Canada; Mahadum nke West nke England, Frenchay Campus, Bristol, United Kingdom ([email protected]). Meichun Mohler-Kuo: La Source, Ụlọ Akwụkwọ nke Nọọsụ Sayensị, HES-SO University of Applied Sciences and Arts nke Western Switzerland, Lausanne, Switzerland ([email protected]). Simon Foster: Institut für Epidemiologie, Biostatistik und Prävention, Hirschengraben, Zürich, Switzerland[email protected]). Simon Marmet: Ọgwụ riri ahụ, Ụlọ Ọgwụ Mahadum Lausanne, CHUV, Mahadum Lausanne, Lausanne, Switzerland ([email protected]). Joseph Studer: Ọgwụ riri ahụ, Ụlọ Ọgwụ Mahadum Lausanne, CHUV, Mahadum Lausanne, Lausanne, Switzerland ([email protected]).

Onye nyere onyinye

VB na BL chepụtara ma chepụta nyocha ahụ, nyochaa data ahụ, wee dee ihe odide ahụ. GG, MM, SM, SF, na JS mere nnwale ndị ahụ. CM na JK kwuru okwu na ihe odide a wee nye ntinye ọgụgụ isi. Ndị ode akwụkwọ niile nyere aka na akụkọ ahụ wee kwado ụdị ewepụtara.

ego

Ndị Switzerland National Science Foundation kwadoro nyocha C-SURF nke atọ (Grant no. FN 33CS30_148493). STAEDTLER Foundation kwalitekwara nyocha sayensị a, Federal Federal Ministry of Education and Research (IMAC-Mind project: Imelite Health Mental Health and Reducing Addiction in Childhood and Adolescence by Mindfulness: Mechanisms, Prevention, and Treatment; 2018-2022; 01GL1745C). ), na Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) - NJ oru ngo 402170461-TRR265 (75). CM bụ onye mmekọ nke otu ọzụzụ nyocha 2162 nke DFG-270949263/GRK2162 kwadoro.

Nsogbu nke Mmasị

Ndị na-ede akwụkwọ na-ekwupụta na e mere nchọpụta ahụ na enweghi mmekọrịta ọ bụla ma ọ bụ ego ma ọ bụ ego nke a pụrụ iwere dị ka ihe nwere ike ịmasị.

Onye nchịkọta akụkọ njikwa ahụ kwupụtara mmekọ nke ya na otu n'ime ndị odee GG n'oge nyocha.