Comment: Kumanikidza kushandisa zvinonyadzisira kunosanganisirwa neashoma erectile basa uye yakaderera ejaculatory kutonga mumajaya majaya.
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Mberi. Psychionze, 06 Kubvumbi 2021 | https://doi.org/10.3389/fpsyt.2021.517411
Buchholz Verena N., Mühle Christiane, Cohort Study pamusoro peZvinhu Zvinoshandisa Njodzi Zvinhu, Kornhuber Johannes, Lenz Bernd
ngovepo
Zvinonyadzisira kupindwa muropa uye kusagadzikana pabonde kuri kuramba kuchikwira mumajaya. Ongororo dzakapfuura dzinoratidza kuti prenatal uyerogen kuratidzwa kunoita basa mukupindwa muropa uye kuita pabonde. Pano, isu takaedza kana yakadzika yechipiri-kusvika-yechina minwe kureba chiyero (2D: 4D) uye gare gare zera pa spermarche, ese mairi zviratidzo zvekuisa zvepamusoro uyerogenji mazinga muUtero, inoenderana nepamhepo kuita zvekumanikidza (OSC chikero cheISST), erectile basa ( IIEF-5), uye ejaculatory control (PEPA) mu4,370 majaya (zera IQR: 25-26 makore) eCohort Study pamusoro peZvinhu Shandisa Njodzi Zviitiko. Ongororo ye Statistical yakaratidza kuti yakaderera 2D: 4D yakabatana nezvikwiriso zvepamusoro pachikamu cheOSC. Zvakare, zera repamusoro pa spermarche rakabatana neakakwira maOSC zvikoro uye yakadzikira erectile basa. Sezvineiwo, OSC kuomarara, asi kwete kuwanda kwekuona zvinonyadzisira kunoshandiswa, kwakabatana zvakashata ne erectile basa uye ejaculatory control. Ichi chidzidzo chekutanga kubatanidza ma proxies maviri akazvimiririra epa prenatal testosterone nhanho neOSC. Izvi zvakawanikwa zvinopa ruzivo rwekufungidzira mukati meiyo intrauterine mamiriro ehunhu hwepabonde uye hukama hwepabonde muhukuru.
ISSN = 1664-0640
ziviso
Boka rinokura rekutsvaga rinotsigira kuti kupindwa muropa nezvinonyadzisira kunokonzera mutoro mukuru kunyanya kune vechidiki varume (1, 2). Nekudaro, nekuda kwekusiyana kwakasiyana kwekufungidzira uye kuzvipa-chirevo kusarudzika, huwandu hwehuwandu hwehuwandu hwakanyanya. Nhasi, zvishoma zvinozivikanwa nezve maitiro ehupenyu anokonzeresa kupindwa muropa nezvinonyadzisira.
Kunyanyisa kushandisa zvinonyadzisira kunoonekwa sekusimudzira zvekusangana pabonde [zvekutarisa, ona (3)]. Erectile dysfunction inokanganisa zvakanyanya varume pamusoro pemakore makumi mana ekuberekwa neakambotaurwa huwandu hwehuwandu hwe40-1% muvarume vadiki uye 10-50% muvarume vakura kupfuura makore makumi manomwe (4). Nekudaro, psychogenic erectile kudzvinyirira mune varume vari pasi pemakore makumi mana yakakwira zvakanyanya mumakore gumi apfuura kusvika pamitengo yakakwira se40-14% muEuropean vane makore 28-18 makore (5-7). Iko kuwedzera kukuru kwepasirese kwekuona zvinonyadzisira kunoshandisa sekusimudzira pabonde kwakakurukurwa kuti kuve nekukanganisa kwe erectile Via shanduko muhuropi hwekukurudzira system (mesolimbic dopamine nzira) (3). Erections zvinoenderana nedopaminergic neurons mu ventral tegmental nzvimbo (VTA) uye dopamine receptors mu nucleus accumbens (NAc) (3, 8, 9). Uyu mubairo wegadziriro unogoneswa zvakanyanya panguva yekuona zvinonyadzisira nekuchinjika muhuropi yekubatanidza kune yekutanga prefrontal cortex inoonekwa mune zvidzidzo zvine porno kupindwa muropa zvichienzaniswa nekutonga (10). Zvakare, zvimwe zviitiko zvine chekuita nezvekupindwa muropa, sekuwedzera kwekunzwa kwekuziva, zvinoonekwa muhuropi mhinduro dzevanhu vakapindwa muropa nekuona zvinonyadzisira (11). Zvinonyadzisira zvine mukana wakakura wekupindwa muropa, uchifunga nezvekuwanika, kukwanisika, uye kusazivikanwa (2). Kupindwa muropa nazvo kunogona kutungamira mukuparara kwematambudziko, kubva pakushaya simba kwe erectile kusvika kune yakaderera chishuwo chepabonde muhukama hwepabonde uye hukama hukama (3). Kunyangwe makiriniki emarekodhi achiwanzoratidza kuvandudzwa kwebasa mushure mekurega kurega zvinonyadzisira, humbowo hwakananga hwechikonzero chinoshaikwa (3), sekuziva kwesainzi kwekumanikidza kwekushandisa zvinonyadzisira uye zvinokanganisa zvinoenderana. Zve organic organic kudzvinyirira, mukupesana, zvemwoyo zvine njodzi zvinhu zvinomiririra yakasimba fungidziro (4).
Ejaculatory control zvakare inoratidzika kunge inokanganiswa nekunyanyisa kushandiswa kwezvinonyadzisira muhutachiona hwevarwere, zvichikonzera mishumo ye ejaculation matambudziko mu33% yevarwere (12). Nguva isati yakwana ejaculation inoitika kazhinji muvechiri kuyaruka varume, kunyanya panguva yavo yekutanga kusangana pabonde (13) uye inoderera nekufamba kwenguva sechiitiko chinopa kuwedzera kutonga. Maitiro ekukurumidza kudzora ejaculatory control, maererano neInternational Society of Sexual Medicine, anozadzikiswa ne4-5% chete yehuwandu hwepasi rose. Uyezve, iyo pfungwa yekukurumidza ejaculatory control inokonzerwa nehukama hwevanhu kuburikidza nekuona zvinonyadzisira kushandiswa (14).
Vanhurume vanowanzo tarisira kupindwa muropa nezvinonyadzisira kupfuura vakadzi (15). Chidzidzo cheAustralia chakawana huwandu hwehuwandu hwehuwandu hwehuwandu hwezvikamu zvina kubva muzana mu4 varume uye 9,963% chete muvakadzi gumi ne1. Uyu musiyano wepabonde-uripo zvakare mune zvimwe zvisina-zvine chekuita nezvinhu zvine chekuita nezvinhu, zvakadai sekubhejera (16), internet mitambo (17, 18), uye kunwa doro (19). Kazhinji, misiyano yebonde inotangira mukusaenzana pabonde muX uye Y ma chromosomes ayo anoona kukura kwegonadal uyezve secretion yema androgens uye estrogens. Munguva yemawindo akaomarara (semuenzaniso, prenatal, perinatal, uye pubertal), aya mahormone ebonde anotungamira mukusingaperi kwesangano mhedzisiro pahunhu nehunhu zvinosarudzika kubva kunanga uye kuchinjika zviito zvekuita (20). Nekudaro, zvidzidzo zvakatsvaga basa re prenatal uyerogen kuratidzwa kuri kuita kwekupindwa muropa nehunhu. Chokwadi, humbowo hwekutanga hwesangano hwakaratidza kuti vhidhiyo yemitambo kupindwa muropa (21) uye kudhakwa kudhakwa (22, 23) ese ari maviri ane hukama nekuzvara prenatal uyerogen. Pamwe pamwe nehumwe humbowo hunobatanidza bonde rehormoni kuratidza kune kuvimba24-28), Izvi zvinoratidza kuti uyerogen chiitiko chakabatanidzwa muchirwere chekupindwa muropa. Uyezve, chidzidzo chemakonzo chinopa humbowo hwakananga hwekuti prenatal androgen receptor modulation inokanganisa kunwa doro panguva yehukuru (29). Zvidzidzo zvevanhu zvichibva pamamaki asina kunangana epamuviri yekuberekwa uyerogen yekutsigira inotsigira basa rayo repnnatal mukuvandudza uye kugadzirisa kweanopindwa muropa maitiro panguva yekukura. Kuferefeta kwenyaya iyi muvanhu hakugone kuitika nekuda kwekushushikana kwetsika uye nguva yakareba pakati penguva yekusununguka nekukura.
Tsvagurudzo yakavakirwa pakuedza kwemakonzo uye zvidzidzo zvehukama hwevanhu zvakaratidza mamaki epa prenatal uyeroji, senge yechipiri-kusvika-yechina kureba kwemunwe (2D: 4D) [(30, 31); asi onawo:32, 33) uye zera pakutanga ejaculation (urume) (34, 35). Maternal yemadzimai eplasma testosterone mazinga haana hukama neanavacheche 'huwandu hwehuwandu mune zvese bonde (36), Uye amniotic fluid fluid mazinga haabatanidzwe neane 2-gore-makore '2D: 4D (37). Imwe meta-ongororo yazvino yakawana yakaderera 2D: 4D (inoratidza yekuwedzera prenatal uyerogen kuratidzwa) muvanhurume vanezvinhu zvine chekuita nezvezvinhu uye zvisina-zvine chekuita nezvehunhu maitiro (Hedge's g = -0.427) asi kwete yevakadzi (Hedge's g = -0.260). Mhedzisiro iyi yaive yakasimba muiyo yekuongorora-kuenzanisa kunoenderana nevanhu vasina-vanovimba (Hedge's g = -0.427) (38), iyo inoratidza kuti 2D: 4D inonyanya kusimba zvine chekuita nekupindwa muropa pane kuwanda kana huwandu hwekushandisa. Zvakare, yakaderera 2D: 4D inosangana neakakura chiropa, mhasuru, uye myelotoxic mhedzisiro yedoro uye vanotarisira kuchipatara kumisikidzwa mune vanovimba varwere (22). Vanodhakwa-vanovimba nevarume vane yakaderera 2D: 4D zvakare vanodawo kutenga yakakwira-mutengo mutengo zvinwiwa zvinodhaka (23). Mukufananidza, varwere-vanodhakwa varwere (22) uye vanhu vanotaura nezvekunwa doro maitiro (39) zvakare taura gare gare zera pa spermarche. Ongororo yemhuka data inoratidza kuti prenatal androgen kurapwa kunowedzera pubertal kutanga zera mumurume makonzo (35). Kutorwa pamwechete, idzi dhata dzinoratidza kuti kukwirisa kwepamuviri yekuberekwa uyerogen kunokonzeresa munhu kuti akure nekuchengetedza kusagadzikana kwekupindwa muropa panguva yekukura. Sezvineiwo, basa razvino rinoratidza kuti kushushikana, kusvuta, uye kushandisa doro panguva yekuzvitakura kunowedzera prenatal testosterone kuratidzwa, sezvakaratidzwa nepazasi 2D: 4D muvanhu vana (22, 40). Nekudaro, hunhu hwaamai hungave hunoshanda, inova tarisiro yekudzivirira kupindwa muropa pakati pevana vake (41).
Doro rinoshandisa kusagadzikana uye kunetsekana kushandiswa kwekuona zvinonyadzisira kunoitika zvakanyanya muzvinhu zvakati wandei, izvo zvinoratidza zvakajairika etiopathogenetic nzira (42). Zvepabonde-zvine chekuita nemubairo haingoshanduke munzira imwechete yeiyo neural nzira semubairo wezvinodhaka, asi ivo zvakare vanogovana iwo akafanana mamorekuru vamiririri uye, sezvingabvira, iwo mauroni akafanana muNac, mukusiana nemimwe mibairo yepanyama senge chikafu (43). Iyo yekukurudzira-salience modhi yekupindwa muropa inokwana zvakanaka nekuparadzaniswa kunoonekwa mu porno kupindwa muropa kwekuwedzera kushuva ("kuda") uye kudzikisira mufaro kubva mukushandisa ("kufarira") (44). Sezvineiwo, kunyanya tarisiro yekunzwa yakakwira zvichitevera kunwa doro zvinowirirana neyezasi 2D: 4D23). Kuwedzera kune mamorekuru ekufungidzira kupindwa muropa, zvinonyadzisira zvinoshandiswa zvinogona kuve zvinokwezva kune varume vane yakaderera 2D: 4D, sezvo ivo vane yakanyanya kuzviparadzanisa kusagadzikana (45), Ratidza hutsinye kana hunhu hwekutonga mune mamwe mamiriro (46), uye vane chinzvimbo chakatarisana (47). Nekudaro, iro basa re intrauterine uyerogen muyero wepamhepo zvekumanikidza (OSC) uye zvine hukama pabonde zvinetswa hazvisati zvadzidzwa. Naizvozvo, isu takaedza edu ekutanga fungidziro dzinodzikira 2D: 4D uye gare gare zera pa spermarche zvine hukama neOSC.
Pamusoro peiyo mibairo-inoenderana masisitimu ezve prenatal uyerogen mazinga, prenatal uyuro yekuratidzira inoumba nhengo dzekubereka; kureva, yakaderera 2D: 4D (yakakwira prenatal testosterone) inoenderana neakakura penile kureba (48) uye yakakura testes (49). Yakaderera prenatal testosterone inoita mukadzi nhengo dzekubereka (50, 51). Zvakare, vanhu vane hupenyu hwese vasati vasvika ejaculation vane yakaderera 2D: 4D (52). Naizvozvo, isu takaongororawo kana 2D: 4D uye zera pa spermarche zvakabatana ne erectile basa uye / kana ejaculatory control.
nzira
Dhiyabhorosi Dhata
Iyo data yakaongororwa pano yakabva kune yekutanga kusvika kune yechitatu mafungu ekuongorora ehurefu hweCohort Kudzidza pamusoro peZvinhu Zvinoshandisa Njodzi Zviitiko (C-SURF; www.csourf.ch). Kubva 2010 kusvika 2012, 7,556 vechidiki vechirume vaipinda kunosungirwa kutorwa kweuto reSwitzerland vakapa mvumo yakanyorwa yakaziviswa, avo varume 5,987 1 vakapinda muWave 2. MuWave 5,036, 2012 varume vakapedza mubvunzo wemibvunzo kubva ku2013 kusvika 3, uye Wave 2016 yakatambanudzwa kubva ku2018 kusvika 5,160 uye yaisanganisira zviuru mazana mashanu nemakumi matanhatu (ona www.csourf.ch). Yese data yakaongororwa yakabva kuWave 3, kunze kwekuchinjisa kudzora uye erectile mashandisiro emabasa, ayo akaongororwa muWave 1 uye 2 chete. Isu takasanganisira vechidiki varume vaiti vanongokwezva vakadzi, nekuda kwezvikonzero zvakati: kutanga, isu taida kuwedzera homogeneity yemuenzaniso wedu maererano nehunhu hwepabonde; chechipiri, chinhu chimwe chakagadzirwa zvakanangana nekupinda kwechikadzi mune yechiGerman vhezheni.
2D: 4D
Zvakafanana nenzira dzinotsanangurwa ne (53) uye (39), vatori vechikamu vakarairwa kuti vazviongorore zvavo 2D: 4D (Mubvunzo wemibvunzo Nha. 3 ID: J18). Ivo vakanyora kureba kweiyo indekisi neminwe mhete mumamirimita kwemaoko avo ekurudyi neruboshwe kuruboshwe. Kuti ubvise zvisina kukodzera kukosha, kureba kwemunwe pazasi pe10 mm uye pamusoro pe100 mm (53) uye, zvichidaro, 2D: 4D kunze kweiyo 2.5 uye 97.5 percentiles (39, 54) vakasarudzika, sezvakatsanangurwa kare. Isu takasarudza zvinorehwa neruoko rwerudyi uye kuruboshwe 2D: 4D (Mean2D: 4D) seyekutanga kufungidzira uye kurudyi-ruoko 2D: 4D (R2D: 4D), kuruboshwe 2D: 4D (L2D: 4D), uye mutsauko uripakati peR2D: 4D uye L2D: 4D (2D: 4Dr-l) sevanoongorora vanofungidzira.
Zera rePubertal Onset
Yako-yakashumwa pubertal kutanga zera yaidzorwa kwenguva yakapfuura (makore apfuura kubva kubvira kuyaruka) uchishandisa chikamu chekuyera kuongororodza, sekurangarira kusarura kwakazara (55), kureva, mutsauko wezera rinoshanduka pazera rekuyaruka rinoenderana nemakore kubva pakuyaruka (zera razvino-zera rekuyaruka) rakabviswa. Zvakare, fungidziro pazasi pe9 dzakabviswa, zvichibva pane yapfuura mushumo (56) uye ongororo yapfuura ye2D: 4D uye pubertal kutanga zera (22).
CSO
Iyo Internet Bonde Kuongorora Bvunzo (ISST; http://www.recoveryzone.com/tests/sex-addiction/ISST/index.php, Yakagadzirwa naDelmonico, 1997) chishandiso chega-chega chekutarisa icho chinoratidzira kiriniki inonetsa pabonde internet-based behaviour. Factor kuongororwa kweiyo ISST data yakaratidza zvinhu zvishanu: OSC, maitiro epabonde epamhepo- magariro, maitiro epabonde epamhepo-akasarudzika, kushandisa mari pabonde pamhepo, uye kufarira kuita zvepamhepo online (57). Iyo OSC subscale yakaverengerwa muC-SURF yemibvunzo, ine matanhatu mabhinari (ehe / kwete) chinhu. Vateereri vasina kushanyira zvinonyadzisira webhusaiti mukati memwedzi gumi nemiviri yapfuura (12%, n = 1,064) vakabviswa pakuongorora. Sezvo makiriniki akakosha akatemwa-zvibodzwa zvisati zvavapo uye kutsvagurudza kudiki kunowanikwa pane iyi nyaya, takafunga kushandisa huwandu hwehuwandu senge chinoramba chichienderana mukuongorora kwedu.
Zvinonyadzisira Kushandiswa
Dhata kubva kuzvinhu zviviri zvaive zviripo: imwe pane frequency yekushandisa (kureva, mazuva ekushandisa pamwedzi) uye imwe pane iyo nguva yekushandisa kwega kwega. Muchikwata chedu, iyo interquartile renji (IQR) yemazuva ekushandisa yaive 3 kusvika mazuva gumi nemashanu pamwedzi. Nguva yekushandisa: ingangoita hapana, 15 kusvika <1 h, 2 kusvika <2 h, 3 kusvika <3 h, 4 h, kana zvimwe. Isu takafunga kuwanda kwekuti kuve neruzivo pano, sekusiyana kwekushandisa nguva yaive yakaderera, iine 4% yekuzvitaurira <90 h.
Erectile Function
Iyo International Index yeErectile Function (IIEF-5) Mubvunzo wemibvunzo une zvinhu zvishanu, zvakawanikwa uchishandisa mashanu-poindi Likert chikero. Iwe unoyera sei kuvimba kwako kuti iwe unogona kuwana nekuchengetedza erection? Pawaive nezvisungo zvekusimudzira bonde, kangani zvawakatemerwa zvakaomarara zvakakwana kuti upinde (kupinda panhengo yemurume mukati memukadzi)? Panguva yepabonde, kangani iwe waikwanisa kuchengetedza yako erection mushure mekunge wapinda mumwe wako? Panguva yepabonde, zvainge zvakaoma sei kuti urambe wakamira kusvika pakupedzisa kusangana? Pawakaedza kuita zvepabonde, zvaigutsa kangani kwauri? Huwandu hwehuwandu hwakaverengerwa seyakaenderera shanduko yekuongorora kwekubatana.
Ejaculatory Kudzora
Chinhu chimwe (mashanu-poindi Likert chikero) kubva kuPamberi Ejaculation Prevalence uye Attitude (PEPA) ongororo yakashandiswa (58): Mukati memwedzi mitanhatu yekupedzisira, unoyera sei kutonga kwako pamusoro pekusangana panguva yebonde repabonde?
Kutenderwa Kwetsika
Zvese zvidzidzo zvakapa kubvumwa kwakanyorwa kwakaziviswa vasati vaiswa mune yekutanga kudzidza. Chidzidzo ichi chakatenderwa neEthics Committee yeKiriniki Yekutsvagisa yeLausanne University Medical Chikoro (Protocol Nha. 15/07).
Statistical Analyzes
Yese data yakaongororwa uchishandisa IBM SPSS Statistics vhezheni 24 yeWindows (SPSS Inc., Chicago, IL, USA). Kana poindi dze data dzikashaikwa, chidzidzo chekudzidza chakabviswa pane yakatarwa kuongororwa (huwandu hwevanhu vakasanganisirwa mune yega ongororo hunonzi N). Tsananguro dzinotsanangurwa dzakaratidzwa muma frequency, mamedians, uye IQRs. Isu takashandisa iyo Wilcoxon yakasainwa-chinzvimbo bvunzo kuenzanisa mapoka anoenderana. Correlations akaonekwa achishandisa nzira yaSparonman, sezvo iyo data yaisawanzo kugoverwa. p <0.05 yaifungidzirwa kuve inoverengeka yakakosha kune maviri-mativi bvunzo. Semipartial kuwirirana pakati pezvasara kwakaitwa kuratidza humwe hunhu hunobatanidza iwo akasiyana. Sezvinotsanangurwa pazasi, isu zvakare takaparadzanisa mashandisirwo-frequency-ane hukama mhedzisiro kubva kune yakataurwa kumanikidzwa neyakaenzana-chikamu kuwirirana se post-hoc analysis.
Results
Cohort Demographics
Mushure mekuregererwa-nhanho kubviswa kwezvidzidzo zvakakundikana kusangana nemhando yepamusoro ye2D: 4D (n = 518) uye / kana pubertal kutanga zera (N = 94) uye vasina kukwezva vakadzi chete (N = 534), iyo yakazara cohort yakaratidzirwa seinotevera: zera 25 makore (IQR 25-26, N = 4,370 23.6); body mass index XNUMX kg / m2 (IQR 21.9-25.5, N = 4,362); 79.8% vanoshandira zvine pundutso (N = 4,369 3.0); dzidzo: 1.2% sekondari, 34.9% dzidzo yepamusorosoro, 4.4% yechipiri yekosi / yehunyanzvi dzidzo, 11.1% munharaunda koreji, 11.3% yekosi yepamusoro, 23.2% chikoro chepamusoro, 5.9% bachelor degree (yunivhesiti), 4.7% masters degree ( yunivhesiti), XNUMX% imwe (N = 4,358 82.9); chimiro chemuchato: 5.3% vasina, 0.1% vakaroora, 11.5% vakarambana, 0.2% vasina kuroora, kupatsanurwa, kana kurambana asi vachigara pamwe chete nemumwe (semuenzaniso, mumubatanidzwa wakanyoreswa), 0.0% vakaroora asi vakaparadzaniswa, XNUMX% chirikadzi (N = 4,363 37.5); 12% vaive vachiri kugara nevabereki vavo. Mumwedzi gumi nembiri yekupedzisira, 59.9% yaive nemumwe wepabonde naye, 5.9% yakanga isina, 34.2% yaive nevaviri kana kupfuura. Mean2D: 4D yaive 0.981 (IQR 0.955-1.000, 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 2), 4D: 0.000Dr-l 0.013 (IQR -0.012-XNUMX, N = 4,177).
Pakati pezvinhu zvinopedza zvinonyadzisira, 41% yakapa mhinduro imwechete kumibvunzo yeOSC; 18.4% yakashuma hunhu hunonetsa mbiri kubva kuOSC. Mune yedu cohort, 41.3% yakashuma zvirinani zvinyoro nyoro erection, uye 5% yakashuma yakasarudzika kudzora pamusoro peiyo ejaculation panguva yepabonde.
Prenatal Testosterone Makisi uye OSC
Kutanga, isu takaedza yedu huru yekufungidzira, tichiti iyo yakawedzera prenatal testosterone, sekuratidzwa neyepazasi Mean2D: 4D uye / kana yakakwira pubertal kutanga zera, inosanganisirwa neiyo yepamusoro OSC mamaki mune yedu cohort. Ipo Mean2D: 4D yakabatana zvakanyanya munzira inotarisirwa, iyo yega-yakashumwa pubertal yekutanga zera haina (Tafura 1).
Tafura 1. Correlation pakati pekusununguka testosterone mamakisi uye OSC.
Tevere, isu takadzora kweiyo chaiyo yekushandisa frequency mune yedu inotenderera inoshanduka OSC, sekunyanyisa kwakanyanya kumanikidza kwaibatanidzwa nekuwedzera kushandiswa (Rho = 0.184, p <0.001, N = 3,678), pubertal kutanga zera yakanga isina hukama pamwe nekushandisa frequency (Rho = -0.124, p <0.001, N = 3,680), asi Mean2D: 4D yakanga isiri (Rho = 0.008, p = 0.647, N = 3,274) uye isu takanga tichinyanya kufarira kuita kwekumanikidzwa, kupihwa imwe nhanho yekushandisa. Mushure mekugadzirisa kuwanda kwekushandisa, chikamu cheOSC chakabatana zvisirizvo neInoreva2D: 4D uye zvine hungwaru nezera rekutanga (zvese zvinoratidza yepamusoro testosterone yepamuviri), nekudaro ichitsigira pfungwa yedu yekutanga (Tafura 1).
mune post-hoc kuongorora, takaongorora hukama hweESC zvikwata neR2D: 4D, L2D: 4D, uye 2D: 4Dr-l (Tafura 2). L2D: 4D yakabatana zvakanyanya neOSC, nepo kungori maitiro akaonekwa paR2D: 4D.
Tafura 2. Post hoc kuongororwa kwe2D: 4D mamaki.
Sekusagadzikana kwekushushikana kwepfungwa uye hunhu sekutsvaga kwekunzwa kunogona kukanganiswa nepamuviri uye pubertal uyerogen kuratidzwa iyo inogona kupindirana nezvimwe zvakaonekwa mhedzisiro, isu takaita ongororo yekuongorora pane anowanikwa mamaki ekunyanya kusuwa, MDI (59), bipolar kusagadzikana, MDQ (60), uye kutsvaga kwekunzwa, BSSS (61). Ipo Mean2D: 4D haina kuenderana zvakanyanya nematanho aya zvakateerana (Rho = -0.002, p = 0.922, N = 4,155 0.015; Rho = -XNUMX, p = 0.335, N = 4,161 0.006; Rho = XNUMX, p = 0.698, N = 4,170), zera rekutanga rekuyaruka rakabatanidzwa nenhamba yakaderera yezviratidzo zvichiteerana (Rho = -0.032, p = 0.029, N = 4,717 0.050; Rho = -XNUMX, p = 0.001, N = 4,720) uye kushomeka kwekutsvaga (Rho = -0.118, p <0.001, N = 4,736).
Prenatal Testosterone Makisi uye Zvepabonde Kusashanda
Kuti tiongorore kukanganisa kwe testosterone yepabonde pakubata pabonde uye kuyedza mafungiro edu echipiri, isu takatanga kuongorora kuvandudzwa kwekudzora ejaculatory uye erectile basa nekufamba kwenguva (kureva, kubva paWave 1 kusvika Wave 2, nekuti kusagadzikana pabonde hakuna kuongororwa muWave 3). Paive nekuwedzera kwakakosha kwe erectile mashandiro ekufamba kwenguva asi hapana shanduko mune ejaculatory control (Z = -5.76, p <0.001; Z = -2.15, p = 0.830). Naizvozvo, isu takadzora edu anoenderana anoshanduka erectile basa (kubva kuWave 2) yezera. Pubertal kutanga zera rakabatana zvisizvo ne erectile basa (inodzorwa) asi kwete neijaculatory control; Mean2D: 4D haina kuenderana zvakanyanya neayo; maona Tafura 3.
Tafura 3. Prenatal testosterone mamaki uye pabonde mabasa.
Tichipiwa mazano mumabhuku ekuti zvinonyadzisira zvinoshandiswa zvinokanganisa kusagadzikana pabonde, takaongorora hukama pakati pekushandisa zvinonyadzisira, OSC, nemabasa epabonde. Sezvineiwo, zvinonyadzisira zvinoshandisa frequency hazvina kuenderana zvakanyanya ne erectile basa, nepo OSC yakaita, iine zvimwe zvinomanikidza zviratidzo zvine chekuita neashoma ejaculatory control uye mashoma erectile basa (Tafura 4); uyezve, maawa akapedzwa pane zvinonyadzisira mune yega yega chiitiko haana kuenderana zvakanyanya neayo.
Tafura 4. Zvinonyadzisira zvinoshandiswa uye zvekuita zvepabonde.
hurukuro
Pano tinorondedzera humbowo hwekutanga hwekufambiswa kwepamuviri uyerogenin kuratidzwa pane hunhu hweOSC muvanhurume panguva yehukuru hwevanhu vakuru Dhata redu rakasimbisa edu ekutanga ekufungidzira ayo akaderera 2D: 4D uye gare gare zera pa spermarche - ese ari maviri akazvimiririra achiratidza epamusoro prenatal testosterone mazinga - aive zvakanyanya (kunyangwe aine mashoma mhedzisiro saizi) yakabatana neiyo yakasimba OSC, kunyangwe yakavimbika zviyero zvehurefu hwemunwe kubva kune akawanda nyanzvi raters uye kiriniki dhata pane nguva yekuyaruka inotanga isipo.
Izvi zvakawanikwa zvinowirirana zvakanaka neruzivo ruripo. Mhinduro yemurume pabonde uye mubatanidzwa wepanyama mubairo unopindirana Via mesolimbic dopamine siginecha muVTA uye NAc (8). Iyi dunhu inoumba musimboti weiyo mubairo system uye, seakadaro, haingogadzirise mubairo wepabonde (62) asi zvakare zvinokonzeresa kupindwa muropa nezvinodhaka, senge kudhakwa (63). Prenatal testosterone inoratidzirwa kukanganisa kutanga uye kosi yekudhakwa kudhakwa (22), uye ongororo mumakonzo yakawana kuti prenatal modulation ye androgen receptors inokanganisa cerebral dopamine, serotonin, uye noradrenaline neurotransmitter mazinga mukukura (29). Mumakwai echikadzi, testosterone yepamuviri inowirirana zvakanaka nenhamba yema tyrosine hydroxylase-immunoreactive masero muVTA (64). Uyezve, methamphetamine kupindwa muropa kunopindiranawo neiyo imwechete substrates sekukurudzira pabonde (65). Kudzokorora maitiro ekuita zvepabonde uye kudzokororwa psychostimulant manejimendi zvese zvinokonzeresa kumusoro-mutemo weDeltaFosB, nekudaro ichikurudzira iyo mesolimbic nzira (43). Gene kutaura kweiyo mu-opioid receptor, mutambi anokosha muhutachiona hwehutachiona, inoita kunge bonde-rakanyatso shandurwa ne prenatal testosterone kupindira (29). Uyezve, iyo A118G musiyano wemu-opioid receptor geni inopindirana ne2D: 4D kufanotaura kudhakwa kudhakwa (66).
Ipo, OSC yaibatanidzwa neakakwirira epamuviri epaseti testosterone anoratidzwa neese mamaki, shandisa frequency yakaratidza hukama hwakapesana nezera rekuberekwa, iro rinogona kunge riri revanhu vezera revanhu vezera. Meta-ongororo ichangobva kuitika yakagumisawo kuti 2D: 4D inoenderana zvakanyanya nekupindwa muropa ne phenotypes pane kuwanda kana huwandu hwekushandisa (38). Muchidimbu, zviwanikwa zvedu zvese zvinosimbisa uye zvinowedzera kunzwisisa kwedu kwekupindwa muropa nezvinodhaka uye kupindwa muropa nemubairo wepabonde, kureva kuti, kuti vagovane iwo maseketi eiyo neural ari panjodzi yekuzvara uyerogenji mazinga.
Yedu yechipiri hypothesis, iyo yakawedzera prenatal testosterone inogona kukanganisa maitiro epabonde, yaingotsigirwa zvishoma neiyo data. Isu takawana kuwirirana kwakakosha pakati pekushanda kwe erectile nenguva yekuyaruka, nekuzotanga kugadziriswa kuchisanganisirwa nebasa shoma. zvisinei, isu hatina kuwana chinongedzo kune Mean2D: 4D. Uku kusawirirana kunogona kukonzerwa nemawindows akasiyana epamuviri panguva iyo 2D: 4D uye nguva yekushomeka yakatemwa. Zvidzidzo zviviri zvakazvimirira zvakapa humbowo hwe2D: kukura kwe4D kunoitika panguva yekutanga kubata (67, 68). Mukupesana, kana nguva yekushomeka yakatemwa chaizvo inoramba isingazivikanwe, uye zvinogona kufungidzirwa kuti nguva yekushambadzira haisi mucherechedzo chete wepamberi pekuberekwa uyerogen kuratidzwa asi zvakare inokonzeresa kurongeka kwehuropi panguva yekuyaruka.
Kuwedzera kutsvagurudza kunodikanwa kujekesa kana iko kurongeka kwesimba re prenatal uyerogen pane iyo mubairo sisitimu inopindirana iyi link, kunyangwe yakawedzera peripheral uyerogen receptors, ayo anobatanidzwa mune erectile basa (69) inoita basa, kana kuti kusagadzikana kweye erectile chiitiko chechipiri cheOSC uye, nekudaro, kunobva mukuwedzera kushandiswa kwezvinonyadzisira uye zvinokanganisa kumutsa zvepabonde panguva yepabonde. Via inobatanidza inokurudzira zvinhu.
Mune ramangwana, zvakagadziriswa maturusi ekuongorora anodikanwa kuti abvise kwakatangira kusagadzikana pabonde kwakabatana nekupindwa muropa nekunyadzisira nekunyatsoongorora mamiriro ezvinetso zvebonde, kufambira mberi kweOSC, nekushandisa zvinonyadzisira nekufamba kwenguva. Zvakare, zvinhu zvekuvandudza zvinofanirwa kutariswa, sezvo wedunhu remubairo uye yayo yekumberi kutonga iri panjodzi huru panguva yekuyaruka (70). Pamusoro pezvo, kumedzwa kwekuyedzwa kwekushandisa nguva zhinji, kupindira kwekiriniki kunoenderana nekuona zvinonyadzisira, uye kuferefetwa kwemhedzisiro yekusagadzikana kunofanira kuongororwa zvakadzama mune ramangwana, kuenderera mberi nekunzwisisa kweiyo etiology.
Ejaculatory control haina kuenderana nechero prenatal testosterone mucherechedzo. Kupihwa chidzidzo chekare chakamhan'arira chinongedzo pakati pe testosterone yekusununguka uye ejaculation isati yakwana (52), uku kutsvaga pakutanga kwaisatarisirwa. Nekudaro, iro boka rinotungamira mukudzidza iro rakasiyana neredu munzira dzinoverengeka. Kutanga, iyo Bolat et al. (52) kudzidza chete kwaisanganisira varwere vane nhoroondo yeupenyu hwese vasati vasvika ejaculation nyaya. Chechipiri, cohort yavo yaive yakura (zvinoreva makore makumi mana emakore). Chechitatu, hatizive kuti ruzivo rwekudzidza kwedu rwaive neruzivo sei mukudzora ejaculation panguva yekusangana, sezvo 40% isina kuroora, iyo inoganhurira ruzivo rwekuziva neakavanzika. Chechina, hunhu hwakanangana nehupombwe hauna kuongororwa muchidzidzo chedu.
Zvinonyadzisira zvine chekuita nezvebonde zvisati zvanyatsonzwisiswa. Ongororo ichangoburwa inotsanangura zvinonyadzisira, kuwanikwa kwayo, uye mafomu mazhinji akasiyana sechinhu chinoshamisa, icho, mukufamba kwenguva, chinotungamira kumatambudziko kuzadzikiswa kwakaringana muzvimiro zvepanyama (zvakabatana). Izvi, zvakare, zvinogona kukonzeresa nyaya dzinoverengeka, kubva kune erectile kudzvinyirira panguva yepabonde pamwe chete uye kunonoka kubuda, kusvika pakutadza kuburitsa zvachose panguva yepabonde repabonde (3). Isu takanga tisina dhata rakakwana muchidzidzo chezvino kusiyanisa pakati pekukurumidza uye kunonoka kukwirisa, sezvo ese ari maviri akafukidzwa nechinhu nezve ejaculatory control, icho chaive chisina kunaka chakabatana neOSC. Iyo ichangoburwa modhi inotsanangura vashandisi 'kudiwa kweakanyanya kunyanyisa zvinhu pamusoro penguva yekugona ejaculate haisati yasimbiswa (71), uye kuwedzera kushivirira parizvino hakusati kwanyatsotsanangurwa nezvekupindwa muropa nezvinonyadzisira. Nekudaro, zvinonyadzisira zvinoshandiswa zvinokanganisa kuzviisa pasi uye kuzvipupurira pachako fungidziro yeyakajairika nguva yekupedzisira.
Isu tinozviona zvichinakidza kuti OSC, kwete zvinonyadzisira inozvishandisa, yaibatanidzwa neashoma ejaculatory control uye mashoma erectile basa; izvi zvinoratidza kubatana kwakasimba pakati peOSC nekusagadzikana pabonde Via shanduko kune yemubairo sisitimu inopesana nehukama hwehukama nzira. Zvakare pano, kumwe kutsvagurudza kunodiwa kusabvisa chikonzero uye mhedzisiro.
Chidzidzo chezvino chiri pasi pezvikanganiso zvinoverengeka. 2D: 4D yaive yakazvimiririra, uye maficha ekuona zvinonyadzisira anoshandisa, erectile basa, uye ejaculatory control zvaive zvoga-zvataurwa. Zvinonyadzisira kupindwa muropa haisati yazivikanwa zviri pamutemo sehunhu, uye, nekudaro, tsananguro yadzo inosiyana (72). Pano, isu takatarisa pane iyo OSC subscale yeISST, inomiririra iyo yekumanikidza yeiyi hunhu hunodhakwa. Zvakare, isu takaongorora homogeneous cohort yevechidiki, vanoita bonde varume, vazhinji vacho vaive maCaucasian uye vasina; saka, zviwanikwa zvedu hazvigone kuve zvakaenzanisirwa kune mamwe mazera mapoka, zvebonde, madzinza, kana vakadzi. Chekupedzisira, 2D: 4D uye kutanga kwekuyaruka zvine hushoma huchokwadi sezviratidzo zvekuberekwa kwepenital uyerogen (33, 38, 73), uye zvingangoita kuti nguva yekupfachukira inokanganisawo kurongeka kwehuropi, sezvo kuyaruka iri zvakare nguva yakaoma yewindo (74). Naizvozvo, kuwana kwedu kwekudyidzana pakati penguva yekushomeka uye OSC inogona kwete kungova mhedzisiro yekuberekwa asi zvakare pubertal uyerogen inosangana nehukama.
Mukupedzisa, epamusoro prenatal uyerogen mazinga (anoratidzwa nemaviri akazvimiririra mamaki) anosanganiswa nekumanikidza kwakawanda kushandisa zvinonyadzisira. Kumwe kumanikidza kwekushandisa zvakare kunoenderana neashoma erectile basa uye yakaderera ejaculatory kutonga mumajaya majaya. Uye zvakare, shoma erectile basa yaibatanidzwa neepamusoro pubertal kutanga zera, iyo inogona kuratidza yakakwira prenatal uyerogen mazinga. Nekudaro, iyo etiology ye erectile kudzvinyirira uye kukwira kwayo kwakasimba mukupararira mukati memakore gumi apfuura kunogona kusanganisira kudyidzana kwechimiro chepamuviri kukudziridza kumanikidza kwepabonde pamhepo uye / kana kusagadzikana kwe erectile uye kuwedzera kuwanikwa kwezvinonyadzisira zvirimo. Zvidzidzo zvenguva yemberi zvinokurudzirwa kusabvisa mupiro wehukama hwezvinhu izvi uye nekuwedzera kunzwisiswa kweizvi hunhu kupindwa muropa nezvinetso zvine chekuita nezvebonde. Aya maonerwo anogona kubatsira kuvandudza zvirongwa zvekudzivirira, zvichitarisa zvimwe zvidzidzo zvine njodzi kukudziridza kupindwa muropa kana vanamai vane mazamu e testosterone asati aberekwa akakwirira.
Data Kuwanikwa Chirevo
Madhataseti akagadzirwa eichi chidzidzo anowanikwa pakukumbira kune anoenderana munyori.
Ethics Statement
Zvidzidzo zvinosanganisira vanhu vatori vechikamu zvakaongororwa uye zvakagamuchirwa neEthics Committee yeKiriniki Yekutsvagisa yeLausanne University Medical School (Protocol Nha. 15/07). Varwere / vatori vechikamu vakapa mvumo yavo yakanyorwa kuti vatore chikamu muchidzidzo ichi.
Nhengo dzeChikwata Chekudzidza nezveZvinhu Zvinoshandisa Njodzi Zviitiko
Gerhard Gmel: Kupindwa muropa neMishonga, Lausanne University Hospital CHUV, Yunivhesiti yeLausanne, Lausanne, Switzerland; Kupindwa muropa Switzerland, Lausanne, Switzerland; Center for Addiction uye Mental Health, Toronto, ON, Canada; Yunivhesiti yeWest yeEngland, Frenchay Campus, Bristol, United Kingdom ([email inodzivirirwa]). Meichun Mohler-Kuo: La Source, Chikoro cheNursing Sayenzi, HES-SO Yunivhesiti yeApplied Sayenzi uye Arts yeWestern Switzerland, Lausanne, Switzerland ([email inodzivirirwa]) Simon Foster: Institut für Epidemiologie, Biostatistik und Prävention, Hirschengraben, Zürich, Switzerland ([email inodzivirirwa]). Simon Marmet: Kupindwa muropa neMishonga, Lausanne University Hospital CHUV, Yunivhesiti yeLausanne, Lausanne, Switzerland ([email inodzivirirwa]). Joseph Studer: Kupindwa muropa neMishonga, Lausanne University Hospital CHUV, Yunivhesiti yeLausanne, Lausanne, Switzerland ([email inodzivirirwa]).
Munyori Mipiro
VB uye BL vakatora mimba uye vakagadzira iyo tsvagurudzo, vakaongorora iyo data, uye vakanyora iro chinyorwa. GG, MM, SM, SF, uye JS vakaita kuedza. CM naJK vakatsinhira pane zvakanyorwa uye ndokupa iwo wehungwaru. Vanyori vese vakapira kuchinyorwa uye vakatendera iyo yakatumirwa vhezheni.
Mari
Yechitatu C-SURF ongororo yakapihwa mari neSwiss National Science Foundation (Grant no. FN 33CS30_148493). Uku kutsvagisa kwesainzi kwakasimudzirwawo ne STAEDTLER Foundation, iyo German Federal Ministry of Education uye Research (IMAC-Pfungwa chirongwa: Kuvandudza Utano hwepfungwa uye Kuderedza Kupindwa muropa muUdiki neUyaruka kuburikidza neKufunga: Maitiro, Kudzivirira, uye Kurapa; 2018-2022; 01GL1745C ), uye Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) —Projekti ID 402170461-TRR265 (75). CM ishamwari yakabatana yeboka rekutsvagisa boka 2162 inobhadharwa neiyo DFG-270949263 / GRK2162.
Kurwisana kwezvaunofarira
Vanyori vanotaura kuti kutsvakurudza kwakaitwa mukusabatwa kweukama hwekutengeserana kana hwezvemari hunogona kunzi sekugona kukakavara kwechido.
Edhita wekubata akazivisa kubatana kwakabatana nemumwe wevanyori GG panguva yekuongorora.
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