Zolemba za Prenatal Androgen Exhibition Correlate Yogwirizana Ndi Kugonana Kwapaintaneti ndi Ntchito ya Erectile mwa Achinyamata (2021)

Ndemanga: Kuonera zolaula kumalumikizidwa ndi kuchepa kwa magwiridwe antchito komanso kuwongolera kotsika kwa anyamata.

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Kutsogolo. Psychiatry, 06 April 2021 | https://doi.org/10.3389/fpsyt.2021.517411

Buchholz Verena N., Mühle Christiane, Cohort Study on Drug Use Risk Factors, Kornhuber Johannes, Lenz Bernd

Kudalirika

Zolaula zolaula komanso kusowa pogonana zikuchulukirachulukira anyamata. Kafukufuku wam'mbuyomu akuwonetsa kuti kuwonetsedwa kwa prenatal androgen kumathandizira pakuchepetsa komanso magwiridwe antchito. Apa, tinayesa ngati kutalika kwachiwiri mpaka kwachinayi kutalika kwa chala (2D: 4D) komanso msinkhu wakubadwa pa spermarche, zonse zomwe zikuwonetsa mayendedwe apamwamba a androgen mu utero, yolumikizana ndi kukakamira pa intaneti (OSC sikelo ya ISST), ntchito ya erectile ( IIEF-5), ndi ejaculatory control (PEPA) mwa anyamata a 4,370 (zaka IQR: zaka 25-26) za Kafukufuku wa Cohort pa Zinthu Zogwiritsa Ntchito Zowopsa. Kafukufuku wowerengera adawulula kuti 2D yotsika: 4D yolumikizidwa ndi zambiri pamlingo wa OSC. Kuphatikiza apo, msinkhu wapamwamba pa spermarche yolumikizidwa ndi zambiri za OSC ndikuchepetsa ntchito ya erectile. Chosangalatsa ndichakuti, kuuma kwa OSC, koma osati kuchuluka kwa zolaula komwe kumagwiritsidwa ntchito, yolumikizidwa molakwika ndi ntchito ya erectile ndikuwongolera kupuma. Aka ndi kafukufuku woyamba kuphatikiza ma proxie awiri odziyimira pawokha a testosterone ya prenatal ndi OSC. Zotsatira izi zimapereka chidziwitso chazomwe zimachitika pakukonda kwamisala yokhudzana ndi kugonana komanso zochitika zokhudzana ndi kugonana munthu atakula.

YAM'MBUYO = 1664-0640

Introduction

Kafukufuku wochulukirapo amathandizira kuti kuzolowera zolaula kumabweretsa vuto lalikulu makamaka kwa anyamata achimuna (1, 2). Komabe, chifukwa cha magawo osiyanasiyana amalingaliro komanso kudzipangira malipoti, kuchuluka kwa kuchuluka sikulondola. Masiku ano, ndizochepa zomwe zimadziwika paziwonetsero zomwe zimayambitsa zolaula.

Kugwiritsa ntchito zolaula mopitirira muyeso kumawerengedwa kuti kumalimbikitsa zovuta zakugonana [powunikira, onani (3)]. Kulephera kwa Erectile kumakhudza makamaka amuna azaka zopitilira 40 azaka zakubadwa zomwe zili ndi 1-10% mwa anyamata achichepere ndi 50-100% mwa amuna azaka zopitilira 70 (4). Komabe, vuto la psychogenic erectile mwa amuna ochepera zaka 40 lakwera kwambiri mzaka khumi zapitazi kufika pamitengo yokwera mpaka 14-28% ku Azungu azaka zapakati pa 18-40 zaka (5-7). Kuwonjezeka kwakukulu kwa zolaula kumagwiritsidwa ntchito ngati kukakamiza kugonana kwakhala kukufotokozedwa kuti kupangitse kukanika kwa erectile kudzera zosintha muubongo wolimbikitsira ubongo (mesolimbic dopamine njira) (3). Zosintha zimadalira ma dopaminergic neurons mu ventral tegmental area (VTA) ndi ma dopamine receptors mu nucleus accumbens (NAc) (3, 8, 9). Njira yolandirayi imathandizidwa kwambiri pakuwonera zolaula ndikusintha kwamalumikizidwe aubongo ku preortalal cortex yomwe imawoneka m'mitu yolaula poyerekeza ndi zowongolera (10). Komanso, zochitika zina zokhudzana ndi zosokoneza bongo, monga kuchuluka kwa chidwi cha chidwi, zimawonedwa muubongo mayankho a anthu omwe amakonda kugwiritsa ntchito zolaula (11). Zithunzi zolaula zimakhala ndi chizoloŵezi choledzera, poganizira kupezeka, kuthekera, komanso kudziwika (2). Kuledzeretsa kumeneku kumatha kubweretsa mavuto ambiri, kuyambira pakukanika kwa erectile mpaka pakuchepetsa chilakolako chogonana pamavuto apabanja komanso maubwenzi (3). Ngakhale malipoti azachipatala nthawi zambiri amawonetsa kusintha kwa magwiridwe antchito atapewa zolaula, umboni wowonekera wazomwe zimayambitsa ukusowa (3), monga kumvetsetsa kwasayansi pankhani yogwiritsa ntchito zolaula komanso zovuta zina zomwe zimachitika chifukwa cha zolaula. Kulephera kwa organic kwa erectile, mosiyana, ziwopsezo zamtima zimayimira olosera zamtsogolo (4).

Kuwongolera kutsekemera kumawonekeranso kuti kumakhudzidwa ndikuwonera zolaula kwa odwala omwe ali ndi vuto logonana amuna kapena akazi okhaokha, zomwe zimapangitsa kuti pakhale malipoti azovuta za 33% ya odwala (12). Kutulutsa msanga msanga kumachitika pafupipafupi mwa anyamata achichepere, makamaka pakagonana koyamba (13) ndipo amachepetsa pakapita nthawi momwe chidziwitso chimaperekera kuwongolera. Njira zoyendetsera kukakamira msanga, malinga ndi International Society of Sexual Medicine, zimakwaniritsidwa ndi 4-5% yokha ya anthu padziko lonse lapansi. Kuphatikiza apo, malingaliro a kuwongolera asanakwane kutulutsa magazi amakhudzidwa ndimakhalidwe azikhalidwe pogwiritsa ntchito zolaula (14).

Amuna amakonda kwambiri zolaula kuposa akazi (15). Kafukufuku waku Australia adapeza kuchuluka kwa 4% mwa amuna 9,963 ndipo 1% yokha mwa akazi 10,131. Kusiyana kwakugonana kumeneku kumapezekanso pazinthu zina zosagwirizana ndi zinthu zina, monga kutchova juga (16), masewera a pa intaneti (17, 18), komanso kudalira mowa (19). Mwambiri, kusiyana kwakugonana kumayamba chifukwa cha kusakwanira kwa kugonana kwama X ndi Y ma chromosomes omwe amatsimikizira kukula kwa gonadal ndikusungunuka kwa ma androgens ndi estrogens. Nthawi yamawindo azovuta (mwachitsanzo, kubereka, kubereka, komanso kubereka), mahomoni ogonana awa amatsogolera pakukonzekera kwanthawi yayitali muubongo ndi machitidwe omwe amasankhidwa chifukwa cha zochita zawo molunjika komanso zosintha (20). Chifukwa chake, kafukufuku adasanthula gawo la kuwonekera kwa prenatal androgen pazomwe zimayambitsa chizolowezi. Zowonadi, umboni woyamba wamagulu wanena kuti kusuta makanema (21) ndi kudalira mowa ndi (22, 23) zonse zokhudzana ndi kuwonetsedwa kwa prenatal androgen. Pamodzi ndi umboni wamtundu womwe umalumikiza mahomoni ogonana kuwonetsa kudalira (24-28), Izi zikusonyeza kuti ntchito ya androgen imakhudzidwa ndi matenda osokoneza bongo. Kuphatikiza apo, kafukufuku wama rodent amapereka umboni wowonekeratu kuti kusinthasintha kwa mapangidwe a androgen receptor kumakhudza kumwa mowa mukamakula (29). Maphunziro aumunthu potengera zisonyezo zosadziwika za prenatal androgen expression zimathandizira kutenga nawo gawo pakubereka ndikukula kwamakhalidwe olowerera atakula. Kufufuzira kwachindunji kwa nkhaniyi mwa anthu sikungatheke chifukwa cha zovuta zamakhalidwe ndi nthawi yayitali pakati pa nthawi yobereka ndi munthu wamkulu.

Kafukufuku wokhudzana ndi kuyesa kwa mbewa komanso kafukufuku wamgwirizano wa anthu apeza chizindikiro cha prenatal androgen level, monga gawo lachiwiri mpaka lachinayi kutalika kwa chala (2D: 4D) [(30, 31); koma onaninso: (32, 33)] ndi zaka poyamba kutulutsa (umuna) (34, 35). Magulu a testosterone am'mayi a amayi amalumikizana molakwika ndi kuchuluka kwa manambala a makanda mwa amuna kapena akazi okhaokha (36), ndipo ma testosterone amniotic fluid amayanjana molakwika ndi 2D azaka za 2: 4D (37). Kusanthula kwaposachedwa kwa meta kunapeza kutsika kwa 2D: 4D (zomwe zikuwonetsa kuwonetsedwa kwa prenatal androgen) mwa amuna omwe ali ndi zizolowezi zokhudzana ndi mankhwala osokoneza bongo (Hedge's g = -0.427) koma osati akazi (Hedge's g = -0.260). Zotsatirazi zinali zamphamvu pakuwunika pang'ono poyerekeza kudalira anthu osadalira (Hedge's g = -0.427) (38), zomwe zikuwonetsa kuti 2D: 4D ndiyokhudzana kwambiri ndi kusuta kuposa kuchuluka kwa kuchuluka kapena kagwiritsidwe kake. Kuphatikiza apo, kutsika kwa 2D: 4D imagwirizana ndi chiwindi, minofu, ndi myelotoxic zotsatira zakumwa zoledzeretsa komanso kulandira kuchipatala kwa odwala omwe amadalira (22). Amuna omwe amadalira mowa omwe ali ndi 2D yotsika: 4D amakhalanso okonzeka kugula zakumwa zamtengo wapatali (23). Mofananamo, odwala omwe amadalira mowa (22) ndi anthu omwe anena zakumwa zoledzeretsa (39) amafotokozanso zaka zakubadwa pambuyo pa umuna. Kafukufuku woyesa nyama akuwonetsa kuti chithandizo cha prenatal androgen chimakulitsa msinkhu woberekera m'makoswe amphongo (35). Kuphatikizidwa, izi zikuwonetsa kuti kuwonekera kwambiri kwa mayi asanabadwe ndi androgen kumapangitsa kuti munthu azitha kukhala ndi mavuto osokoneza bongo atakula. Chosangalatsa ndichakuti, ntchito yaposachedwa ikuwonetsa kuti kupsinjika, kusuta, komanso kumwa mowa mukakhala ndi pakati kumawonjezera kuwonetsedwa kwa testosterone, monga akuwonetsera 2D yotsika: 4D mwa ana amunthu (22, 40). Chifukwa chake, machitidwe aumayi atha kukhala othandiza, chandamale chopewa kuletsa ana ake (41).

Vuto lakumwa mowa komanso kugwiritsa ntchito zolaula movutikira kumachitika m'njira zingapo, zomwe zimafotokoza njira zodziwika bwino za etiopathogenetic (42). Malipiro okhudzana ndi kugonana samangotembenukira munjira yofananira ndi mphotho ya mankhwala osokoneza bongo, komanso amagawana nawo nkhalapakati omwewo, ndipo mwina, ma neuron omwewo mu NAc, mosiyana ndi mphotho zina zachilengedwe monga chakudya (43). Chizoloŵezi cholimbikitsana ndi chizoloŵezi chogonana chimagwirizana bwino ndi kudzipatula komwe kumawoneka mu zolaula zolaula zakulakalaka ("kufuna") ndikuchepetsa chisangalalo pakugwiritsa ntchito ("kukonda") (44). Chosangalatsa ndichakuti, makamaka chiyembekezo chodzimva kuti chimamwa kwambiri mukamamwa mowa mofanana ndi 2D yotsika: 4D (23). Kuphatikiza pa zomwe zimapangitsa kuti munthu akhale osokoneza bongo, kugwiritsa ntchito zolaula kumatha kukhala kosangalatsa kwa amuna omwe ali ndi 2D yotsika: 4D, popeza ali ndi tsankho lapadera (45), onetsani zamtopola kapena zowongolera munthawi zina (46), ndipo amakonda kutchuka (47). Komabe, gawo la intrauterine androgen mulingo wokhudzana ndi kugonana pa intaneti (OSC) ndi zovuta zake zokhudzana ndi kugonana sizinaphunzirebe. Chifukwa chake, tinayesa malingaliro athu oyambira omwe amatsitsa 2D: 4D komanso msinkhu wotsatira pa spermarche ndizokhudzana ndi OSC.

Kuphatikiza pazomwe zimakhudzana ndi mphotho zomwe zimakhudzana ndi kubereka kwa androgen, kuwonetsedwa kwa prenatal androgen kumawumba ziwalo zoberekera; ie, kutsika 2D: 4D (testosterone yobereka kwambiri) imagwirizana ndi kutalika kwa penile (48) ndi mayeso akulu (49). Testosterone yocheperako yobereka imathandizira ziwalo zoberekera (50, 51). Kuphatikiza apo, anthu omwe ali ndi vuto lomangotulutsa msanga moyo wawo wonse amakhala ndi 2D yotsika: 4D (52). Chifukwa chake, tidafufuzanso ngati 2D: 4D ndi zaka pa spermarche zimalumikizidwa ndi erectile ntchito ndi / kapena kuwongolera kupuma.

Njira

Zambiri Zaanthu

Zambiri zomwe zafufuzidwa pano zimachokera pamafunde oyamba mpaka achitatu ofufuza a Longitudinal Cohort Study on Substance Use Risk Factors (C-SURF; www.cssff.ch). Kuchokera 2010 mpaka 2012, anyamata achichepere 7,556 omwe amapita kukakamizidwa kulowa usitikali ankhondo aku Switzerland adapereka chidziwitso chodziwitsidwa, omwe amuna 5,987 adatenga nawo gawo mu Wave 1. Mu Wave 2, amuna 5,036 adamaliza kufunsa mafunso kuchokera ku 2012 mpaka 2013, ndipo Wave 3 idayambira 2016 mpaka 2018 ndikuphatikiza amuna 5,160 (onani www.cssff.ch). Zambiri zosanthula zimachokera ku Wave 3, kupatula kuwongolera kwamphamvu ndi magwiridwe antchito a erectile, omwe adayesedwa mu Waves 1 ndi 2 okha. Tidaphatikizanso anyamata achichepere omwe amangonena kuti amakopeka ndi akazi, pazifukwa zingapo: choyamba, timafuna kukulitsa kufanana kwa zitsanzo zathu pankhani yokhudza kugonana; chachiwiri, chinthu chimodzi chidapangidwa kuti chilowe mu nyini mu mtundu waku Germany.

2D: 4D

Zofanana ndi njira zomwe zafotokozedwa ndi (53) ndi (39), ophunzira adalangizidwa kuti adziyese okha 2D: 4D (Mafunso Nambala 3 ID: J18). Adalemba kutalika kwa cholozera ndi zala zazing'ono m'mamilimita pamanja awo akumanja ndi kumanzere padera. Kuti muchotse zolakwika, kutalika kwa zala pansi pa 10 mm ndi kupitirira 100 mm (53), kenako, 2D: 4D kunja kwa 2.5 ndi 97.5 percentiles (39, 54) sanatulutsidwe, monga tafotokozera kale. Tidasankha tanthauzo lamanja lamanja ndi lamanzere 2D: 4D (Mean2D: 4D) ngati wolosera woyamba ndi dzanja lamanja 2D: 4D (R2D: 4D), 2D yakumanzere: 4D (L2D: 4D), ndi kusiyana pakati pa R2D: 4D ndi L2D: 4D (2D: 4Dr-l) ngati olosera zamtsogolo.

Zaka Zotsatsa

Zaka zodziyimira nokha zakubadwa zimayang'aniridwa kwakanthawi kanthawi (zaka zapita kuyambira kutha msinkhu) pogwiritsa ntchito kulumikizana pang'ono, popeza kusankhana kumbuyo kuli ponseponse (55), mwachitsanzo, kusiyana kwa msinkhu wosintha paubwana womwe umayenderana ndi zaka kuyambira kutha msinkhu (zaka zakubadwa msinkhu) zidachotsedwa. Kuphatikiza apo, kuyerekezera kotsika 9 sikunatengeredwe, kutengera lipoti lapitalo (56) ndi kusanthula kwam'mbuyomu kwa 2D: 4D komanso zaka zoyambira (XNUMX)22).

OSC

Kuyesa Kuyesa Kugonana Kwapaintaneti (ISST; http://www.recoveryzone.com/tests/sex-addiction/ISST/index.php, Yopangidwa ndi Delmonico, 1997) ndi chida chodziyesera chokha chomwe chimazindikiritsa zovuta zokhudzana ndi kugonana pa intaneti. Kusanthula kwama data a ISST kunazindikira zinthu zisanu: OSC, machitidwe ogonana pa intaneti-mayanjano, machitidwe ogonana pa intaneti, kugwiritsa ntchito intaneti, komanso chidwi pakugonana pa intaneti (57). Subscale ya OSC idaphatikizidwa mufunso la C-SURF, lokhala ndi zinthu zisanu ndi chimodzi (inde / ayi). Omwe sanapite kukaona zolaula m'miyezi yapitayi ya 12 (22.4%, n = 1,064) sanaphatikizidwe pakuwunika. Popeza zochepetsedwa zofunikira pakadali pano sizikupezeka ndipo kafukufuku wochepa alipo pankhaniyi, tidaganiza zogwiritsa ntchito chiwerengerocho ngati chosinthasintha pakupenda kwathu.

Kugwiritsa Ntchito Zolaula

Zambiri zochokera kuzinthu ziwiri zimapezeka: imodzi pafupipafupi kagwiritsidwe ntchito (mwachitsanzo, masiku ogwiritsira ntchito pamwezi) ndi imodzi nthawi yayitali pakugwiritsa ntchito kulikonse. Pagulu lathu, masiku angapo ogwiritsira ntchito ma interquartile (IQR) anali masiku 3 mpaka 15 pamwezi. Kutalika kwakugwiritsa ntchito: pafupifupi palibe, 1 mpaka <2 h, 2 mpaka <3 h, 3 mpaka <4 h, 4 h, kapena kupitilira apo. Timawona kuti pafupipafupi ndizopindulitsa pano, popeza kusiyanasiyana kwa nthawi yogwiritsira ntchito kunali kotsika, ndi 90% yodzidziwitsa nokha <1 h.

Ntchito Erectile

International Index of Erectile Function (IIEF-5) Mafunso ali ndi zinthu zisanu, zomwe zimagwiritsidwa ntchito pogwiritsa ntchito sikelo ya Likert ya mfundo zisanu. Kodi mumayesa bwanji chidaliro chanu choti mutha kukhala ndi erection? Mukakhala ndi zovuta zokhudzana ndi kugonana, kodi zovuta zanu zinali zovuta bwanji kuti zilowerere (kulowa mbolo mu nyini)? Pogonana, ndi kangati kamene munakwanitsa kukhalabe ndi erection mutalowa m'banja lanu? Nthawi yogonana, zinali zovuta bwanji kuti mukhale ndi erection mpaka kumaliza kugonana? Pamene mumayesa kugonana, zinali zokhutiritsa kangati kwa inu? Chiwerengerocho chidalembedwa ngati chosinthira mosalekeza pakusanthula kwakanema.

Kuwongolera Kutulutsa

Chinthu chimodzi (mfundo zisanu za Likert scale) kuchokera ku kafukufuku wa Premature Ejaculation Prevalence and Attitude (PEPA) adagwiritsidwa ntchito (58): M'miyezi isanu ndi umodzi yapitayi, kodi mumayesa bwanji kulamulira kwanu mukamakondana mukamagonana?

Kuvomerezeka kwa Ethical

Maphunziro onse adapereka chidziwitso cholemba asanalembedwe paphunziro loyambirira. Kafukufukuyu adavomerezedwa ndi Ethics Committee for Clinical Research of Lausanne University Medical School (Protocol No. 15/07).

Zosanthula Zosati

Zambiri zidasinthidwa pogwiritsa ntchito IBM SPSS Statistics mtundu 24 wa Windows (SPSS Inc., Chicago, IL, USA). Ma data akusowa, mutu wowerengerawo sanaphatikizidwe pakuwunika komweku (kuchuluka kwa anthu omwe aphatikizidwa pakuwunika kulikonse akuti N). Ziwerengero zofotokozera zidafotokozedwa pafupipafupi, azam'kati, ndi ma IQR. Tidagwiritsa ntchito mayeso osayina a Wilcoxon kuyerekeza magulu omwe amadalira. Ma Correlation adadziwika pogwiritsa ntchito njira ya Spearman, popeza zambiri sizimagawidwa nthawi zambiri. p <0.05 imawonedwa kuti ndiyofunikira pamayeso amitundu iwiri. Malumikizano apakati pazotsalira adachitidwa kuti awulule kulumikizana komwe kulumikizana ndi zosinthazo. Monga tafotokozera pansipa, tidasiyanitsanso zomwe zimachitika pafupipafupi chifukwa chakukakamizidwa ndi zolumikizana pang'ono ngati posachedwa kusanthula.

Results

Chiwerengero cha Gulu

Pambuyo pochotsedwa mwanzeru pamitu yomwe yalephera kukwaniritsa zofunikira za 2D: 4D (n = 518) ndi / kapena zaka zoyambira kubzala (N = 94) ndipo sanakopeke ndi akazi okha (N = 534), gulu lonse limadziwika motere: zaka 25 (IQR 25-26, N = 4,370); kuchuluka kwa thupi 23.6 kg / m² (IQR 21.9-25.5, XNUMX) N = 4,362); 79.8% amagwiritsidwa ntchito bwino (N = 4,369); maphunziro: 3.0% maphunziro aku sekondale, 1.2% maphunziro aukadaulo, 34.9% maphunziro a sekondale / ukadaulo, 4.4% koleji yakumidzi, 11.1% sukulu yasekondale, 11.3% sekondale, 23.2% bachelor degree (yunivesite), 5.9% masters degree ( yunivesite), 4.7% ena (N = 4,358); okwatirana: 82.9% osakwatira, 5.3% okwatirana, 0.1% osudzulana, 11.5% osakwatirana, olekanitsidwa, kapena osudzulidwa koma akukhala limodzi ndi mnzake (mwachitsanzo, mgulu lolembetsa), 0.2% adakwatirana koma adapatukana, 0.0% amasiye (N = 4,363); 37.5% anali akukhalabe ndi makolo awo. M'miyezi 12 yomaliza, 59.9% idagonana ndi m'modzi, 5.9% analibe, 34.2% anali ndi awiri kapena kupitilira apo. Kutanthauza2D: 4D inali 0.981 (IQR 0.955-1.000, N Nambala = 4,177), R2D: 4D 0.986 (IQR 0.951-1.000, N = 4,269), L2D: 4D 0.986 (IQR 0.951-1.000 N Nambala = 4,278), 2D: 4Dr-l 0.000 (IQR -0.013-0.012, N = 4,177).

Mwa nkhani zomwe zimawononga zolaula, 41% idapereka mayankho osachepera amodzi pamafunso a OSC; 18.4% adanenapo zosachepera zovuta ziwiri kuchokera ku OSC. Mgulu lathu, 41.3% idanenanso zovuta zochepa zopumira, ndipo 5% adanenanso kuti sangathe kuwongolera nthawi yogonana.

Zizindikiro za Prenatal Testosterone ndi OSC

Choyamba, tinayesa malingaliro athu akulu, ndikunena kuti testosterone yakubala, monga akuwonetsera ndi Mean2D yotsika: 4D ndi / kapena zaka zoyambira kubereka, zimalumikizidwa ndi kuchuluka kwa OSC pagulu lathu. Ngakhale Mean2D: 4D yolumikizidwa kwambiri pamayendedwe omwe akuyembekezeredwa, zaka zomwe adadzinena okha kuti sanabadwe sizinatero (Gulu 1).

Kenako, tidawongolera pafupipafupi momwe timagwiritsira ntchito OSC, popeza kukakamizidwa kwambiri kumalumikizidwa ndi kugwiritsidwa ntchito kowonjezera (Rho = 0.184, p <0.001, N = 3,678), zaka zoyambira kuberekera zimalumikizidwa molakwika ndi pafupipafupi (Rho = -0.124, p <0.001, N = 3,680), koma Mean2D: 4D sanali (Rho = 0.008, p = 0.647, N = 3,274) ndipo tinali ndi chidwi kwambiri ndi kukakamizidwa, chifukwa chogwiritsa ntchito. Pambuyo pokonza pafupipafupi momwe ntchito imagwirira ntchito, kuchuluka kwa OSC kumalumikizidwa molakwika ndi Mean2D: 4D ndipo motsimikizika ndi zaka zoyambira (zonse zomwe zikuwonetsa mulingo wapamwamba wa prenatal testosterone), potero timathandizira lingaliro lathu loyambirira (Gulu 1).

mu posachedwa kusanthula, tidasanthula maubale azambiri za OSC ndi R2D: 4D, L2D: 4D, ndi 2D: 4Dr-l (Gulu 2). L2D: 4D yolumikizidwa kwambiri ndi OSC, pomwe panali zochitika zokha pa R2D: 4D.

Popeza kusatetezeka kwamatenda amisala ndi zikhalidwe monga kufunafuna chidwi kumatha kukhudzidwa ndi kubadwa kwa amayi komanso kubereka kwa androgen komwe kumatha kuyambitsa zina mwazomwe zawonedwa, tidasanthula pazomwe zilipo pakukhumudwa kwakukulu, MDI (59), matenda ochititsa munthu kusinthasintha zochitika, MDQ (60), ndi kufunafuna chidwi, BSSS (61). Pomwe Mean2D: 4D sinagwirizane kwambiri ndi izi (Rho = -0.002, p = 0.922, N = 4,155; Kuyenda = -0.015, p = 0.335, N = 4,161; Rho = 0.006, p = 0.698, N = 4,170), zaka zoyambira kutha msinkhu zimalumikizidwa ndi ziwerengero zochepa (Rho = -0.032, p = 0.029, N = 4,717; Kuyenda = -0.050, p = 0.001, N = 4,720) ndikufunafuna zochepa (Rho = -0.118, p <0.001, N = 4,736).

Zizindikiro za Prenatal Testosterone komanso Kulephera Kugonana

Kuti tifufuze zamphamvu za testosterone yobereka pa zovuta zakugonana ndikuyesa malingaliro athu achiwiri, tidasanthula koyamba kwa kuwongolera kwamphamvu ndi magwiridwe antchito a erectile pakapita nthawi (mwachitsanzo, kuyambira Wave 1 mpaka Wave 2, popeza kulephera kwa kugonana sikunayesedwe mu Wave 3). Panali kuwonjezeka kwakukulu kwa magwiridwe antchito a erectile pakapita nthawi koma osasintha pakuwongolera ()Z = -5.76, p <0.001; Z = -2.15, p = 0.830). Chifukwa chake, tidawongolera ntchito yathu yodalira erectile (kuchokera ku Wave 2) pazaka. Zaka zakubadwa zakubadwa zimalumikizidwa molakwika ndi ntchito ya erectile (yoyendetsedwa) koma osati ndi kuwongolera koyendetsa; Kutanthauza2D: 4D sinagwirizane kwambiri ndi mwina; mwawona Gulu 3.

Popeza malingaliro m'mabuku omwe zolaula zimakhudza kusokonekera kwa kugonana, tidasanthula ubale womwe ulipo pakati pa zolaula, OSC, ndi zochitika zogonana. Chosangalatsa ndichakuti, kugwiritsa ntchito zolaula sikunkagwirizana kwenikweni ndi magwiridwe antchito a erectile, pomwe OSC idatero, ndi zizindikilo zowonjezereka zokhudzana ndi kuchepa kwamphamvu pakukoka ndi ntchito yochepera ya erectile (Gulu 4); Komanso, maola omwe amawonetsedwa pa zolaula nthawi iliyonse sanagwirizane kwambiri ndi onsewa.

Kukambirana

Apa tikulongosola umboni woyamba wakukhudzidwa kwa kuwonetsedwa kwa prenatal androgen pamachitidwe a OSC mwa amuna atakula. Zambiri zathu zimatsimikizira malingaliro athu oyamba omwe amachepetsa 2D: 4D komanso msinkhu wakubadwa ku spermarche-zonse zosonyeza kuchuluka kwa ma testosterone asanabadwe - zinali zazikulu (ngakhale zili ndi kukula kwakanthawi kochepa) zogwirizana ndi OSC yamphamvu, ngakhale miyeso yodalirika yazitali zazala kuchokera kwa akatswiri angapo komanso zambiri zamankhwala zanthawi yakutha msinkhu sizikupezeka.

Zotsatira izi zikugwirizana bwino ndi zomwe zilipo kale. Kuyankha kwakugonana kwamphongo ndi mphotho yofananira yofananira ndiyotetezedwa kudzera mesolimbic dopamine siginecha mu VTA ndi NAc (8). Dera ili ndilo maziko a mphotho ndipo, motero, sikuti amangoyanjanitsa mphotho yakugonana (62) komanso zimayambitsa zosokoneza bongo, monga uchidakwa (63). Testosterone ya uchembere imakhudzidwa kuti isayambitse kuyambika komanso kudalira mowa (22), ndipo kafukufuku wama mbewa adapeza kuti kusinthika kwa mapangidwe a androgen receptors kumakhudza ubongo dopamine, serotonin, ndi milingo ya noradrenaline neurotransmitter atakula (29). Mwa nkhosa zazimayi, testosterone yobereka imalumikizana bwino ndi kuchuluka kwa maselo a tyrosine hydroxylase-immunoreactive mu VTA (64). Kuphatikiza apo, mankhwala osokoneza bongo a methamphetamine amathandizidwanso ndi magawo omwewo a neural monga kukondoweza (65). Khalidwe logonana lobwerezabwereza komanso kuwongolera ma psychostimulant mobwerezabwereza kumathandizira kukhazikitsa malamulo a DeltaFosB, potero amalimbikitsa njira ya mesolimbic (43). Gene kufotokozera za mu-opioid receptor, wosewera wofunikira pamatenda osokoneza bongo, akuwoneka kuti ndi ogonana makamaka osinthidwa ndimankhwala osokoneza bongo a testosterone (29). Kuphatikiza apo, mtundu wa A118G wamtundu wa mu-opioid receptor umalumikizana ndi 2D: 4D kulosera zakudalira kwa mowa (66).

Pomwe, OSC idalumikizidwa ndi milingo yayikulu yakubadwa kwa testosterone yomwe imawonetsedwa ndi zolembera zonse ziwiri, kugwiritsa ntchito pafupipafupi kumawonetsa ubale wosiyana ndi zaka zoyambira, zomwe zitha kukhala gulu la anzawo. Kusanthula kwaposachedwa kwa meta kunatsimikiziranso kuti 2D: 4D imakhudzana kwambiri ndi zosokoneza bongo kuposa kuchuluka kapena kuchuluka kwa kagwiritsidwe ntchito (38). Mwachidule, zomwe tapeza zimalimbikitsa ndikumvetsetsa kwathu zakumwa mankhwala osokoneza bongo komanso chizolowezi cha mphotho yakugonana, kuti athe kugawana nawo ma circuits omwewo omwe ali pachiwopsezo cha milingo ya prenatal androgen.

Lingaliro lathu lachiwiri, lomwe limachulukitsa kubadwa kwa testosterone lingakhudzenso zochitika zogonana, limangothandizidwa pang'ono ndi zomwe zidasungidwazo. Tapeza kulumikizana kwakukulu pakati pa magwiridwe antchito a erectile ndi nthawi yakutha msinkhu, pomwe pambuyo pake kumalumikizidwa ndi kuchepa kwa ntchito; komabe, sitinapeze ulalo wa Mean2D: 4D. Kusasinthasintha kumeneku kumatha kukhala chifukwa cha mawindo osiyanasiyana apakati pomwe 2D: 4D ndi nthawi yaubereki zimatsimikizika. Kafukufuku wodziyimira payokha apereka umboni wa 2D: Kukula kwa 4D kumachitika nthawi yomwe mayi ali ndi pakati (67, 68). Mosiyana ndi izi, nthawi yakubadwa ikatsimikizika sichikudziwika bwinobwino, ndipo titha kuganiza kuti nthawi ya pubertal sichizindikiro chokha chakuwonekera kwa prenatal androgen komanso imakhudza kayendedwe kaubongo panthawi yachinyamata.

Kafukufuku wowonjezera amafunikira kuti adziwe ngati zomwe bungwe la prenatal androgen limachita pa mphothoyo limayimira ulalowu, ngakhale zowonjezera zotumphukira za androgen, zomwe zimakhudzidwa ndi ntchito ya erectile (69) amatenga gawo, kapena ngati kuwonongeka kwa erectile ndi gawo lachiwiri la OSC, chifukwa chake, kumabwera chifukwa chogwiritsa ntchito zolaula zambiri ndikukhala ndi chilakolako chogonana panthawi yogonana kudzera mbali zolimbikitsa.

M'tsogolomu, zida zovomerezeka zowunikira zimafunikira kuthana ndi magwero azovuta zakugonana zokhudzana ndi zolaula pofufuza molondola momwe zimakhalira zovuta zakugonana, kupita patsogolo kwa OSC, komanso kugwiritsa ntchito zolaula pakapita nthawi. Komanso, zinthu zachitukuko ziyenera kuganiziridwa, popeza gawo la mphotho ndi kuwongolera koyambirira kumakhala pachiwopsezo chachikulu pa unyamata (70). Kuphatikiza apo, kuyeserera koyeserera kwa kuchuluka kwa zakumwa, njira zakuchipatala zochokera ku kudziletsa pa zolaula, ndikufufuza zamankhwala zomwe zimayambitsa kukanika kuyenera kufufuzidwa mosamala mtsogolomo, kuti apititse patsogolo kumvetsetsa kwa zamatsenga.

Kuwongolera kwamadzimadzi sikunayanjane ndi chikhomo cha testosterone chobereka. Popeza kafukufuku wam'mbuyomu amafotokoza kulumikizana pakati pa testosterone yobereka ndi kutaya msanga msanga (52), izi sizimayembekezereka. Komabe, gulu lomwe limachita nawo kafukufukuyu linali losiyana ndi lathu m'njira zingapo. Choyamba, a Bolat et al. (52) Kafukufuku amangophatikiza odwala omwe ali ndi mbiri yamoyo wonse yazotulutsa msanga. Chachiwiri, gulu lawo linali lalikulu (zaka zakubadwa 40). Chachitatu, sitikudziwa momwe maphunziro athu adadziwira bwino pakuthana ndi kukondana panthawi yogonana, popeza 82% ndiosakwatiwa, zomwe zimalepheretsa kuphunzira kwamunthu wachinsinsi. Chachinayi, machitidwe okhudzana ndi zolaula sanayesedwe phunziroli.

Zovuta zokhudzana ndi zolaula sizimvetsetsedwa bwino. Kuwunikanso kwaposachedwa kumafotokoza zolaula, kupezeka kwake, ndi mitundu yambiri yosiyanasiyana monga cholimbikitsira chauzimu, chomwe, m'kupita kwanthawi, chimabweretsa mavuto okhala ndi chidwi chokwanira pamayendedwe achilengedwe. Izi, zimatha kuyambitsa zovuta zingapo, kuyambira pakukanika kwa erectile panthawi yogonana komanso kuchedwetsa kukodzedwa, mpaka kulephera kutulutsa umuna wonse panthawi yogonana (3). Tinalibe chidziwitso chokwanira phunziroli pano kusiyanitsa kusamvana msanga ndi kuchedwa, popeza zonsezi zimakutidwa ndi chinthu chokhudza kuwongolera, komwe kumalumikizidwa ndi OSC. Mtundu wofalitsidwa posachedwa wofotokozera kufunikira kwa ogwiritsa ntchito zinthu zowopsa kwakanthawi kuti athe kutulutsa umunthu sunatsimikizidwebe (71), ndi kulolerana kowonjezeka pakadali pano sichinafotokozeredwe bwino za zolaula. Komabe, kugwiritsa ntchito zolaula kumakhudza kuyerekezera komanso kudziyerekeza komwe kumachitika pakanthawi kochepa.

Timazipeza zosangalatsa kuti OSC, osati zolaula zomwe zimazigwiritsa ntchito, zimalumikizidwa ndi zochepetsera zochepa komanso ntchito zochepa za erectile; izi zikusonyeza kulumikizana kolimba pakati pa OSC ndi kukanika kugonana kudzera zosintha pamachitidwe a mphotho mosiyana ndi njira zophatikizira anthu. Komanso apa, kafukufuku wambiri amafunikira kuti athetse zomwe zimayambitsa ndi zotsatira zake.

Kafukufuku wapano ali ndi malire angapo. 2D: 4D inali yodziyesa yokha, ndipo kuchuluka kwa zolaula kumagwiritsa ntchito, ntchito ya erectile, ndikuwongolera komwe kumadzichitira okha. Kuledzera kwamankhwala olaula sikudziwikebe monga chizolowezi chamakhalidwe, chifukwa chake tanthauzo lake limasiyanasiyana (72). Apa, tidayang'ana pa subscale ya OSC ya ISST, yoyimira kukakamira kwamakhalidwe amenewa. Kuphatikiza apo, tidasanthula gulu laling'ono la amuna achimuna, amuna kapena akazi okhaokha, ambiri aiwo anali aku Caucasus komanso osakwatira; Chifukwa chake, zomwe tapeza sizingafanane ndi magulu ena azibadwa, malingaliro azakugonana, mafuko, kapena akazi. Pomaliza, 2D: 4D ndi kutha msinkhu zimakhala ndizovomerezeka zochepa ngati zizindikiritso za prenatal androgen (33, 38, 73), ndipo zikuwoneka kuti nthawi yotha kubereka imakhudzanso gulu laubongo, popeza kutha msinkhu ndiwonso nthawi yovuta (74). Chifukwa chake, kupeza kwathu kuyanjana pakati pa nthawi ya pubertal ndi OSC sikungakhale chifukwa cha kubadwa kwa amayi okhaokha komanso chiwonetsero cha pubertal androgen chokhudzana ndi zovuta.

Pomaliza, kuchuluka kwa ma prenatal androgen (omwe akuwonetsedwa ndi zilembo ziwiri zodziyimira pawokha) kumalumikizidwa ndikuwonetsa zolaula kwambiri. Kugwiritsa ntchito mokakamiza kumalumikizidwa ndi kuchepa kwa magwiridwe antchito komanso kuwongolera kotsika mwa anyamata. Kuphatikiza apo, kuchepa kwa ntchito ya erectile kumalumikizidwa ndi msinkhu woyambira kwambiri, womwe ungawonetse milingo yayikulu ya prenatal androgen. Chifukwa chake, etiology ya kuwonongeka kwa erectile ndi kuchuluka kwake kwakachulukirachulukira mzaka khumi zapitazi zitha kuphatikizira kulumikizana kwa zomwe zingapangitse kuti azikhala ndi chilakolako chogonana pa intaneti komanso / kapena kutayika kwa erectile komanso kupezeka kwa zolaula. Kafukufuku wamtsogolo amalimbikitsidwa kuti asasokoneze zopereka zomwe zimapangitsa izi kumvetsetsa za vutoli komanso zovuta zokhudzana ndi kugonana. Izi zitha kuthandiza kukhazikitsa mapulogalamu opewera, kuwunikira omwe ali pachiwopsezo chokhala ndi chizolowezi ichi kapena amayi omwe kuchuluka kwawo kwa testosterone kumakhala kochuluka.

Statement Yopezeka ndi Data

Masamba omwe apangidwa phunziroli amapezeka ngati mungapemphe wolemba womwewo.

Chikhalidwe

Kafukufuku wokhudza anthu omwe atenga nawo mbali adawunikiridwa ndikuvomerezedwa ndi Ethics Committee for Clinical Research of Lausanne University Medical School (Protocol No. 15/07). Odwala / omwe adatenga nawo gawo adapereka chidziwitso cholemba kuti atenge nawo mbali phunziroli.

Mamembala a Cohort Study on Substance Use Risk Factors

Gerhard Gmel: Mankhwala Osokoneza Bongo, Chipatala cha Lausanne University CHUV, University of Lausanne, Lausanne, Switzerland; Chizolowezi Switzerland, Lausanne, Switzerland; Center for Addiction and Mental Health, Toronto, ON, Canada; Yunivesite ya West of England, Campus ya Frenchay, Bristol, United Kingdom ([imelo ndiotetezedwa]). Meichun Mohler-Kuo: La Source, Sukulu ya Nursing Science, HES-SO University of Applied Science and Arts of Western Switzerland, Lausanne, Switzerland ([imelo ndiotetezedwa]). A Simon Foster: Chipangizo cha Epidemiologie, Biostatistik und Prävention, Hirschengraben, Zürich, Switzerland ([imelo ndiotetezedwa]). Simon Marmet: Mankhwala Osokoneza Bongo, Chipatala cha Lausanne University CHUV, University of Lausanne, Lausanne, Switzerland ([imelo ndiotetezedwa]). Joseph Studer: Mankhwala Osokoneza Bongo, Chipatala cha Lausanne University CHUV, University of Lausanne, Lausanne, Switzerland ([imelo ndiotetezedwa]).

Zopereka za Wolemba

VB ndi BL adatenga ndikuchita kafukufukuyu, adasanthula zomwe adalemba, ndikulemba zolembedwazo. GG, MM, SM, SF, ndi JS adachita zoyesazo. CM ndi JK adatinso zolembedwazo ndikupereka chidziwitso kwa ophunzira. Olemba onse adathandizira pankhaniyi ndikuvomereza zomwe zaperekedwa.

ndalama

Kafukufuku wachitatu wa C-SURF adathandizidwa ndi Swiss National Science Foundation (Grant no. FN 33CS30_148493). Kafukufuku wasayansiyu adalimbikitsidwanso ndi STAEDTLER Foundation, Unduna wa Zamaphunziro ndi Kafukufuku ku Germany (IMAC-Mind projekiti: Kukweza Mental Health ndikuchepetsa Kuledzera muubwana ndi unyamata kudzera mu Kulingalira: Njira, Kupewa, ndi Chithandizo; 2018-2022; 01GL1745C ), ndi Deutsche Forschungsgemeinschaft (DFG, Germany Research Foundation) -Project ID 402170461-TRR265 (75). CM ndi mnzake wothandizana nawo mgulu lophunzirira kafukufuku 2162 lolipiridwa ndi DFG-270949263 / GRK2162.

Kusamvana kwa Chidwi

Olembawo akunena kuti kufufuza kunkachitika popanda mgwirizano uliwonse wa zamalonda kapena zachuma zomwe zingatengedwe kuti zingatheke kukangana.

Mkonzi woyang'anira uja adati adalumikizana ndi m'modzi mwa olemba GG panthawi yakubwereza.