Tlhaloso: Ho sebelisa litšoantšo tse manyala tse hlephisang boitšoaro ho amahanngoa le ts'ebetso e tlase ea erectile le taolo e tlase ea ejaculatory ho bahlankana.
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Ka pele. Psychiatry, 06 April 2021 | https://doi.org/10.3389/fpsyt.2021.517411
Buchholz Verena N., Mühle Christiane, Boithuto ba Cohort mabapi le Lintho tse Kotsi tsa Ts'ebeliso ea Lithethefatsi, Kornhuber Johannes, Lenz Bernd
inahaneloang
Ho lemalla litšoantšo tse manyala tse hlephisang boitšoaro le ho se sebetse ka thobalano ho atile haholo ho bahlankana. Boithuto ba pejana bo fana ka maikutlo a hore ho pepeseha ha androgen le prenatal ho bapala karolo ea ho lemalla le ts'ebetso ea thobalano. Mona, re ile ra leka hore na karo-karolelano ea bolelele ba menoana ea bobeli ho isa ho bone (2D: 4D) le lilemo tsa morao-rao ho spermarche, ka bobeli li-putative litsupa tsa maemo a phahameng a androgen ho utero, e tsamaellanang le ho qobelloa ho etsa thobalano inthaneteng (OSC Scale ea ISST), mosebetsi oa erectile ( IIEF-5), le taolo ea ejaculatory (PEPA) ho bahlankana ba 4,370 (lilemo tsa IQR: 25-26 lilemo) tsa Thuto ea Cohort mabapi le Ts'ebeliso ea Ts'ebeliso ea Lithethefatsi. Liphuputso tsa lipalo-palo li senotse hore 2D e tlase: 4D e hokahane le lintlha tse holimo sekoleng sa OSC. Ho feta moo, lilemo tse phahameng ho spermarche li tsamaisana le lintlha tse phahameng tsa OSC le ho fokotsa ts'ebetso ea erectile. Ho khahlisang ke hore, ho tiea ha OSC, empa eseng makhetlo a ts'ebeliso ea litšoantšo tsa bootsoa, a amanang hampe le ts'ebetso ea erectile le taolo ea ejaculatory. Ena ke thuto ea pele ea ho kopanya li-proxie tse ikemetseng tsa boemo ba testosterone ba pelehi le OSC. Liphuputso tsena li fana ka temohisiso e ncha ea boits'oaro ba intrauterine ea boits'oaro ba thobalano le ts'ebetso e amanang le thobalano ho motho e moholo.
ISSN = 1664-0640
Selelekela
Phuputso e ntseng e hola e ts'ehetsa hore bokhoba ba litšoantšo tsa bootsoa bo baka moroalo o moholo haholo ho banna ba batona (1, 2). Leha ho le joalo, ka lebaka la mekhahlelo e fapaneng ea likhopolo le leeme la ho itlaleha, likhakanyo tsa bongata ha lia nepahala. Kajeno, ha ho tsejoe hanyane ka mekhoa ea likokoana-hloko e tlatsetsang bokhobeng ba litšoantšo tsa bootsoa.
Ts'ebeliso e litšila ea litšoantšo tse manyala tse hlephisang boitšoaro e nkoa e le ho khothaletsa likotsi tsa thobalano [bakeng sa tlhahlobo, bona (3)]. Ho se sebetse ha Erectile ho ama haholoholo banna ba kaholimo ho lilemo tse 40 ba nang le sekhahla sa ho ata ha 1-10% ho banna ba bacha le 50-100% ho banna ba baholo ho feta lilemo tse 70 (4). Leha ho le joalo, ho se sebetse ha erectile ea psychogenic ho banna ba ka tlase ho lilemo tse 40 ho nyolohile haholo lilemong tse leshome tse fetileng ho fihla ho litefiso tse phahameng ho 14-28% ho batho ba Europe ba lilemo li 18-40 lilemo (5-7). Keketseho e kholo ea litšoantšo tse manyala tse hlephisang boitšoaro e sebelisoa e le ts'usumetso ea thobalano ho builoe ka eona ho baka ho se sebetse ha erectile dessyecik liphetoho tsamaisong e susumetsang ea boko (mesolimbic dopamine pathway) (3). Likhetho li latela li-dopaminergic neurons sebakeng sa ventral tegmental (VTA) le li-receptor tsa dopamine ka har'a li-nucleus accumbens (NAc) (3, 8, 9). Sistimi ena ea moputso e sebelisoa haholo nakong ea ho shebella litšoantšo tse manyala tse hlephisang boitšoaro ka liphetoho tsa khokahano ea boko ho cortex ea pele e bonoang lihloohong tse lemalloang ke litšoantšo tsa bootsoa ha li bapisoa le taolo (10). Hape, liketsahalo tse ling tse amanang le bokhoba ba tahi, joalo ka kutloisiso e eketsehileng ea kutloisiso, li bonoa karabong ea boko ba batho ba lemaletseng litšoantšo tsa bootsoa (11). Litšoantšo tse manyala tse hlephisang boitšoaro li na le monyetla o moholo oa ho lemalla lithethefatsi, ha ho nahanoa hore li ka fumaneha habonolo, ka theko e tlase ebile ha li tsejoe (2). Ho e lemalla ho ka lebisa ho hlaheng ha mathata, ho tloha ho se sebetse ha erectile ho isa ho takatso e tlase ea thobalano ka thobalano e arohaneng le mathata a kamano (3). Le ha litlaleho tsa bongaka hangata li fana ka maikutlo a ntlafatso ea ts'ebetso kamora ho ila litšoantšo tsa bootsoa, bopaki bo tobileng ba phello ea sesosa bo haella (3), joalo ka kutloisiso ea mahlale ea tšebeliso e mpe ea litšoantšo tsa bootsoa le litlamorao tsa eona. Bakeng sa ho se sebetse ha organic erectile, ka lehlakoreng le leng, likotsi tsa pelo le methapo li emela likhakanyo tse matla (4).
Taolo ea tlhekefetso le eona e bonahala e angoa ke ts'ebeliso e fetelletseng ea litšoantšo tsa bootsoa ho bakuli ba hypersexual, e hlahisang litlaleho tsa mathata a ejaculation ho bakuli ba 33% (12). Ho ejaculation pele ho nako ho etsahala khafetsa ho banna ba lilemong tsa bocha, haholo nakong ea likopano tsa bona tsa pele tsa thobalano (13) mme ea fokotseha ha nako e ntse e feta ha boiphihlelo bo fana ka taolo e eketsehileng. Mekhoa ea taolo ea ho ntša metsi pele ho nako, ho latela Mokhatlo oa Machaba oa Bongaka ba Thobalano, e phethahatsoa ke 4-5% feela ea baahi ba lefats'e ka bophara. Ntle le moo, maikutlo a taolo ea peo ea peo pele ho nako a susumetsoa ke maemo a sechaba ka tšebeliso ea litšoantšo tsa bootsoa (14).
Banna ba tloaetse ho lemalla litšoantšo tsa bootsoa ho feta basali (15). Phuputso e entsoeng Australia e fumane sekhahla sa ho ata sa 4% ho banna ba 9,963 mme ke 1% feela ho basali ba 10,131. Phapang ena e amanang le thobalano e boetse e teng litlamong tse ling tse sa amaneng le lithethefatsi le tse amanang le lithethefatsi, joalo ka papali ea chelete (16), Lipapali tsa inthanete (17, 18), le ts'ebeliso ea joala (19). Ka kakaretso, liphapang tsa thobalano li bakoa ke ho se lekalekane ka thobalano ho li-chromosome tsa X le Y tse khethollang nts'etsopele ea gonadal le sephiri sa morao-rao sa androgens le estrogens. Nakong ea lifensetere tse bobebe (mohlala, bokhachane, bokhachane le pelehi), lihormone tsena tsa thobalano li lebisa liphellong tse sa feleng tsa mokhatlo le boits'oaro tse khetholloang litlamorao tse tobileng le tse ka fetoloang tsa ts'ebetso (20). Kahoo, lithuto li batlisitse karolo ea ponahalo ea bakhachane le androgen e tlisoang ke boits'oaro. Ho joalo, bopaki ba pele ba mokhatlo bo bontšitse hore bokhoba ba papali ea video (21) le ho lemalla joala ke (22, 23Ka bobeli li amana le ponahalo ea prenatal androgen. Hammoho le bopaki ba liphatsa tsa lefutso bo hokahanyang li-hormone tsa thobalano tse supang ho itšetleha (24-28), Sena se fana ka maikutlo a hore ts'ebetso ea androgen e kentse letsoho ts'ebetsong ea bokhoba ba tahi. Ntle le moo, phuputso ea litoeba e fana ka bopaki bo tobileng ba hore mokelikeli oa bakhachane oa "prenatal receptor modulation" o ama tšebeliso ea joala nakong ea bocha.29). Lithuto tsa batho tse ipapisitseng le matšoao a sa tobang a pepesetso ea bakhachane le androgen e ts'ehetsa karolo ea eona ea bakhachane ho nts'etsopele le tlhokomelong ea boits'oaro ba bongoana. Patlisiso e tobileng ea makasine ona ho batho ha e khonehe ka lebaka la mathata a boitšoaro le nako e telele lipakeng tsa nako ea bokhachane le ho ba motho e moholo.
Liphuputso tse ipapisitseng le liteko tsa litoeba le lithuto tsa mekhatlo ea batho li supile matšoao a prenatal androgen level, joalo ka karolelano ea bolelele ba monoana oa bobeli ho isa ho oa bone (2D: 4D) [(30, 31); empa bona hape: (32, 33) le lilemo qalong ejaculation (spermarche) (34, 35). Methati ea testosterone ea mali ea bakhachane e hokahane hampe le palo ea linomoro tsa masea a sa tsoa tsoaloa ka bong ka bobeli (36), 'Me maemo a testosterone ea amniotic fluid a amahanngoa hampe le 2D ea bana ba lilemo li 2: 4D (37). Tlhatlhobo ea morao-rao ea meta e fumane 2D e tlase: 4D (e bontšang ho pepeseha ha prenatal androgen ho pepesehela) ho banna ba nang le boits'oaro bo amanang le lithethefatsi le tse sa amaneng le lithethefatsi (Hedge's g = -0.427) empa eseng bakeng sa basali (Hedge's g = -0.260). Phello ena e ne e le matla tlhahlobisong e nyane e bapisoang le batho ba sa itšetlehang ka bona (Hedge's g = -0.427) ()38), e bonts'ang hore 2D: 4D e amana haholo le tahi ho feta khafetsa kapa bongata ba ts'ebeliso. Ho feta moo, 2D e tlase: 4D e amahanngoa le litlamorao tse matla tsa sebete, mesifa le myelotoxic tsa joala le ho amoheloa sepetlele ho bakuli ba itšetlehileng ka tsona (22). Banna ba itšetlehileng ka joala ba nang le 2D e tlase: 4D le bona ba ikemiselitse ho reka lino tse tahang tse theko e phahameng (23). Ka ho tšoanang, bakuli ba itšetlehileng ka joala (22) le batho ka bomong ba tlaleha boitšoaro ba ho itlopa joala (39) hape e tlaleha lilemo tsa morao ho spermarche. Litaba tsa liteko tsa liphoofolo li bontša hore kalafo ea "prenatal androgen" e eketsa lilemo tsa ho qala ho hlaha nakong ea likhoto tsa banna.35). Ha li kopantsoe hammoho, lintlha tsena li bonts'a hore ponahalo e phahameng ea "prenatal androgen" e beha motho kotsing ea ho holisa le ho boloka mathata a ho lemalla nakong ea bocha. Ho khahlisang ke hore mosebetsi oa morao-rao o fana ka maikutlo a hore khatello ea maikutlo, ho tsuba le ts'ebeliso ea joala nakong ea bokhachane ho eketsa ho pepeseha ha testosterone pele ho bokhachane, joalo ka ha ho bonts'itsoe ke 2D e tlase: 4D ho bana ba motho (22, 40). Kahoo, boitšoaro ba bo-mme e kanna ea ba sepheo se setle sa nalane ea thibelo ea bokhoba hara bana ba hae (41).
Joala ba ts'ebeliso ea joala le ts'ebeliso e mpe ea litšoantšo tse manyala tse hlephisang boitšoaro li etsahala haholo lintlheng tse 'maloa, tse fanang ka maikutlo a mekhoa e tloaelehileng ea etiopathogenetic (42). Meputso e amanang le thobalano ha e fetohe feela tseleng e tšoanang ea neural le meputso ea lithethefatsi, empa e boetse e arolelana le baemeli ba limolek'hule tse tšoanang, mme mohlomong, li-neuron tse tšoanang ho NAc, ho fapana le meputso e meng ea tlhaho joalo ka lijo (43). Mohlala oa tšusumetso ea boikhohomoso o lumellana hantle le karohano e bonoang litlamong tsa bootsoa tsa takatso e eketsehileng ("ho batla") le ho fokotsa thabo ho tsoa ts'ebelisong ("ho rata") (44). Ho khahlisang, haholoholo tebello ea ho ikutloa e phahame kamora tšebeliso ea joala e tsamaellanang le 2D e tlase: 4D (23). Ntle le litakatso tsa limolek'hule tsa bokhoba, tšebeliso ea litšoantšo tsa bootsoa e kanna ea hohela banna ba nang le 2D e tlase: 4D, kaha ba na le mamello e phahameng ea ho itšehla thajana (45), Bontša bohale bo feteletseng kapa boits'oaro maemong a mang (46), 'me ba sekametse ho maemo (47). Leha ho le joalo, karolo ea boemo ba intrauterine androgen maemong a ho qobella batho ho kopanela liphate inthaneteng (OSC) le mathata a amanang le thobalano ha a e-so ithutoe. Ka hona, re lekile likhopolo tsa rona tsa mantlha tsa hore 2D e tlase: 4D le lilemo tse morao spermarche li amana le OSC.
Ntle le litšusumetso tse amanang le moputso oa maemo a androgen a bokhachane, ponahalo ea prenatal androgen e hlahisa litho tsa ho ikatisa; ke hore, 2D e tlase: 4D (testosterone e phahameng ea pelehi) e tsamaellana le bolelele bo boholo ba penile (48) le li-testes tse kholo (49). Testosterone e ka tlase ho bokhachane e etsa hore litho tsa botona kapa tsa botšehali li be le basali50, 51). Ho feta moo, batho ba nang le ejaculation ea bophelo bohle pele ho nako ba na le 2D e tlase: 4D (52). Ka hona, re boetse re batlisitse hore na 2D: 4D le lilemo tsa spermarche li amana le ts'ebetso ea erectile le / kapa taolo ea ejaculatory.
mekhoa
Lintlha tsa Demographic
Lintlha tse hlahlojoang mona li tsoa maqhubu a phuputso ea pele ho isa ho ea boraro ea thuto ea sehlopha sa nako e telele mabapi le ts'ebeliso ea lithethefatsi (C-SURF; www.csurf.ch). Ho tloha 2010 ho isa 2012, banna ba bashanyana ba 7,556 ba neng ba tlameha ho thaothoa sesoleng sa Switzerland ba fane ka tumello e ngotsoeng e nang le tsebo, bao banna ba bona ba 5,987 1 ba nkileng karolo ho Wave 2. Ho Wave 5,036, banna ba 2012 2013 ba phethile lenane la lipotso ho tloha 3 ho isa 2016, mme Wave 2018 e qalile ho tloha 5,160 ho isa XNUMX XNUMX mme e kenyelelitse banna ba XNUMX (bona www.csurf.ch). Lintlha tsohle tse hlahlobiloeng li tsoa ho Wave 3, ntle le taolo ea ejaculatory le mefuta e fapaneng ea ts'ebetso ea erectile, e ileng ea hlahlojoa ho Waves 1 le 2 feela. Re kenyelelitse banna ba batona ba tlalehang ba khahloa ke basali feela, ka mabaka a 'maloa: pele, re ne re batla ho nyolla ho ts'oana ha sampole ea rona ho latela boits'oaro ba thobalano; ea bobeli, ntho e le 'ngoe e entsoe ka kotloloho bakeng sa ho kenella ka botšehaling ka mofuta oa Sejeremane.
2D: 4D
E ts'oana le mekhoa e hlalositsoeng ke (53) le (39), barupeluoa ba ile ba laeloa ho itlhahloba 2D ea bona: 4D (Potso ea lipotso 3 ID: J18). Ba ngotse bolelele ba index le menoana ea lesale ka limilimithara bakeng sa matsoho a bona a letona le a leqeleng ka thoko. Ho felisa litekanyetso tse sa nepahalang, bolelele ba menoana bo ka tlase ho 10 mm le kaholimo ho 100 mm (53), mme kamora moo, 2D: 4D kantle ho liperesente tsa 2.5 le 97.5 (39, 54) ba ile ba qheleloa ka thoko, joalo ka ha ho hlalositsoe pejana. Re khethile moelelo oa letsoho le letona le le letšehali 2D: 4D (Mean2D: 4D) e le sebui sa mantlha le 2D e letsohong le letona: 4D (R2D: 4D), 2D ea letsoho le letšehali: 4D (L2D: 4D), le phapang lipakeng tsa R2D: 4D le L2D: 4D (2D: 4Dr-l) joalo ka lihlahlobi tsa tlhahlobo.
Lilemo tsa Pherekano
Lilemo tsa boithati tse tlalehiloeng ka boithaopo li ne li laoloa bakeng sa nako e fetileng (lilemo tse fetileng ho tloha bohlankaneng) ho sebelisoa tlhaiso-leseling e amanang, joalo ka ha leeme la ho hopola le atile (55), ke hore, phapang ea lilemo tse fapaneng nakong ea bohlankana kapa boroetsana e amanang le lilemo ho tloha bohlankaneng (lilemo tsa hajoale-bohlankana) e ile ea tlosoa. Ho feta moo, likhakanyo tse ka tlase ho tse 9 ha lia kenyelletsoa, ho ipapisitsoe le tlaleho ea pejana (56le tlhahlobo e fetileng ea 2D: 4D le lilemo tsa peleho (22).
OSC
Teko ea ho Lekola Thobalano Inthaneteng (ISST; http://www.recoveryzone.com/tests/sex-addiction/ISST/index.php, e ntlafalitsoeng ke Delmonico, 1997) ke sesebelisoa sa ho itlhahloba se ikemetseng se khethollang boitšoaro bo mabapi le thobalano bo nang le bothata ba thobalano. Tlhatlhobo ea lintlha tsa data ea ISST e supile lintlha tse hlano: OSC, boits'oaro ba inthaneteng ka tsa thobalano-sechabeng, boits'oaro ba thobalano bo fumanehang marang-rang, tšebeliso ea chelete ea inthaneteng, le thahasello ea boits'oaro ba thobalano inthaneteng (57). Subscale ea OSC e kenyelelitsoe lenaneong la lipotso la C-SURF, le nang le lintho tse tšeletseng tsa binary (e / che). Batho ba sa kang ba etela sebaka sa marang-rang sa bootsoa likhoeling tse 12 tse fetileng (22.4%, n = 1,064) ha ba kenyelelitsoe tlhahlobisong. Kaha likhaolo tse khaotsoeng tse amanang le bongaka ha li so be teng mme lipatlisiso tse fokolang li teng mabapi le taba ena, re nkile qeto ea ho sebelisa lintlha kaofela e le phapang e tsoelang pele tlhahlobisong ea rona.
Tšebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro
Lintlha tse tsoang linthong tse peli li ne li fumaneha: e le 'ngoe ka makhetlo a ts'ebeliso (ke hore, matsatsi a ts'ebeliso ka khoeli) le e le' ngoe ka nako ea ts'ebeliso ka ngoe. Ka sehlopha sa rona, mefuta ea li-interquartile (IQR) ea matsatsi a ts'ebeliso e ne e le matsatsi a 3 ho isa ho a 15 ka khoeli. Nako ea ts'ebeliso: ha ho le e 'ngoe, 1 ho <2 h, 2 ho <3 h, 3 ho <4 h, 4 h, kapa ho feta. Re nkile makhetlo a ho ba a rutang haholoanyane mona, kaha phapang ea nako ea ts'ebeliso e ne e le tlase, ka 90% ea ho itlaleha <1 h.
Mosebetsi oa Erectile
International Index of Erectile Function (IIEF-5) Questionnaire e na le lintho tse hlano, tse fumanoeng ho sebelisoa sekala sa Likert se nang le lintlha tse hlano. U lekanya boits'epo ba hau joang hore o ka fumana le ho boloka erection? Ha o ne o e-na le likhetho tse matlafatsang thobalano, li-erections tsa hau li ne li le thata hakae ho kena (ho kena botoneng ka botšehaling)? Nakong ea thobalano, ke makhetlo a makae o khonneng ho boloka moetso oa hau kamora hore o kene kahare ho molekane oa hau? Nakong ea thobalano, ho ne ho le thata hakae ho boloka moaho oa hau o phethela thobalano? Ha o leka ho etsa thobalano, e ne e khotsofatsa ha kae ho uena? Kakaretso ea lintlha e ne e ngotsoe e le phapang e tsoelang pele bakeng sa tlhahlobo ea khokahano.
Taolo ea ho ntšetsa metsi ka ntle
Ho sebelisitsoe ntho e le 'ngoe (litekanyo tse hlano tsa Likert scale) ho tsoa patlisisong ea Premature Ejaculation Prevalence and Attitude (PEPA) (58Nakong ea likhoeli tse 6 tse fetileng, o lekanya taolo ea hau joang mabapi le ejaculation nakong ea thobalano ea thobalano?
Boemo bo amohelehang
Lihlooho tsohle li fane ka tumello e ngotsoeng e nang le tsebo pele li kenngoa thutong ea mantlha. Phuputso ena e amohetsoe ke Komiti ea Boitšoaro ea Patlisiso ea Bongaka ea Sekolo sa Bongaka sa Lausanne University (Protocol No. 15/07).
Lipatlisiso tsa Statistical
Lintlha tsohle li ile tsa hlahlojoa ho sebelisoa mofuta oa 24 oa IBM SPSS Statistics bakeng sa Windows (SPSS Inc., Chicago, IL, USA). Ha lintlha tsa data li ne li le sieo, taba ea boithuto e ne e qheleloa ka thoko tlhahlobisong e itseng (palo ea batho ba kenyellelitsoeng tlhahlobisong ka 'ngoe e tlalehiloe e le N). Lipalo-palo tse hlalosang li hlahisitsoe ka maqhubu, li-medians le li-IQR. Re sebelisitse tlhahlobo ea boemo bo saennweng ba Wilcoxon ho bapisa lihlopha tse itšetlehileng ka tsona. Ho ile ha khetholloa likamano ho sebelisoa mokhoa oa boemo ba Spearman, kaha data e ne e sa ajoe hangata. p <0.05 e ne e nkuoa e le ea bohlokoa lipalo-palo bakeng sa liteko tse mahlakore a mabeli. Likamano tse arohaneng lipakeng tsa masalla li ile tsa etsoa ho senola lihokela tse ikhethileng tse hokahanyang mefuta. Joalokaha ho hlalositsoe ka tlase, re boetse re arotse litlamorao tse amanang le tšebeliso ea maqhubu ho tsoa ho ho qobelloa ho tlalehiloeng ke likamano tse sa fellang joalo ka post-hoc tlhahlobo.
Results
Palo ea Batho ba Cohort
Kamora ho qheleloa ka thoko ho bafo ba sa atlehang ho fihlela litekanyetso tsa boleng ba 2D: 4D (n = 518) le / kapa lilemo tsa ho qala tsa bokhachane (N = 94) le ba neng ba sa khahloe ke basali feela (N = 534), sehlopha sohle se ne se khetholloa ka tsela e latelang: lilemo tse 25 (IQR 25-26, N = 4,370 23.6); boima ba 'mele index ea XNUMX kg / m2 (IQR 21.9-25.5,) N = 4,362); 79.8% ba hiriloe ka katleho (N = 4,369 3.0); thuto: 1.2% thuto ea sekolo se phahameng, 34.9% thuto ea mantlha ea mosebetsi oa matsoho, 4.4% thuto ea mahlale ea mahlale / mahlale a morao-rao, koleche ea sechaba ea 11.1%, 11.3% sekolo se phahameng sa mosebetsi oa matsoho, 23.2% sekolong se phahameng, 5.9% degree ea bachelor (univesithi), 4.7% degree ea masters ( univesithi), XNUMX% tse ling (N = 4,358 82.9); boemo ba lenyalo: 5.3% ba masoha, 0.1% ba nyetsoeng, 11.5% ba hlalane, 0.2% ba sa nyala, ba arohana kapa ba hlalane empa ba lula 'moho le molekane (mohlala, ka kopanelo e ngolisitsoeng), 0.0% ba nyetse empa ba arohane, XNUMX% e le bahlolohali (N = 4,363); 37.5% ba ne ba ntse ba lula le batsoali ba bona. Likhoeling tse 12 tse fetileng, 59.9% e ne e na le molekane a le mong oa thobalano, 5.9% e ne e sena motho, 34.2% e ne e na le ba babeli kapa ho feta. Mean2D: 4D e ne e le 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), 2D: 4Dr-l 0.000 (IQR -0.013-0.012, N = 4,177).
Ho bafo ba jang litšoantšo tse manyala tse hlephisang boitšoaro, 41% e fane ka karabo e le 'ngoe e nepahetseng lipotsong tsa OSC; 18.4% e tlalehile bonyane boits'oaro bo nang le mathata bo tsoang ho OSC. Sehlopheng sa rona, 41.3% e tlalehile bonyane mathata a manyane a ho emisa, mme 5% e tlalehile taolo e mpe ea ho nyoloha nakong ea thobalano.
Matšoao a Prenatal Testosterone le OSC
Taba ea mantlha, re ile ra leka khopolo-taba ea rona ea mantlha, ra re testosterone e eketsehileng ea bakhachane, joalo ka ha ho bonts'itsoe ke Mean2D e tlase: 4D le / kapa lilemo tse phahameng tsa ho qala, e amahanngoa le lintlha tse phahameng tsa OSC sehlopheng sa rona. Le ha Mean2D: 4D e hokahantsoe haholo le tsela e lebelletsoeng, lilemo tsa ho qala tsa bo-pubertal ha lia ka tsa (Lethathamo 1).
Lethathamo 1. Khokahano lipakeng tsa matšoao a testosterone ea pelehi le OSC.
Ka mor'a moo, re laoloa bakeng sa makhetlo a ts'ebeliso ea ts'ebeliso ho OSC ea rona e fapaneng, ka lebaka la ho qobelloa ho matla haholo ho amana le ts'ebeliso e eketsehileng (Rho = 0.184, p <0.001, N = 3,678), lilemo tsa ho qala tsa bongoana li ne li amahanngoa hampe le makhetlo a ts'ebeliso (Rho = -0.124, p <0.001, N = 3,680), empa Mean2D: 4D e ne e se (Rho = 0.008, p = 0.647, N = 3,274) mme re ne re thahasella haholo karolo ea ho qobelloa, re filoe tekanyo e itseng ea ts'ebeliso. Kamora ho lokisa makhetlo a ts'ebeliso, lintlha tsa OSC li hokahane hampe le Mean2D: 4D mme ka nepo le lilemo tsa peleho (ka bobeli li bonts'a boemo bo phahameng ba testosterone ea pelehi), ka hona e ts'ehetsa mohopolo oa rona oa mantlha (Lethathamo 1).
ka post-hoc tlhahlobo, re hlahlobile likamano tsa lintlha tsa OSC le R2D: 4D, L2D: 4D, le 2D: 4Dr-l (Lethathamo 2). L2D: 4D e hokahane haholo le OSC, ha ho ne ho hlokomeloa moetlo feela bakeng sa R2D: 4D.
Lethathamo 2. Post hoc tlhahlobo ea 2D: Matšoao a 4D.
Kaha ts'oaetso ea mathata a maikutlo le litsobotsi tse kang ho batla maikutlo li ka susumetsoa ke ho pepa le ho pepeseha ha androgen ho ka buisanang le tse ling tsa litlamorao, re ile ra etsa tlhahlobo ea lipatlisiso mabapi le lintlha tse fumanehang tsa khatello e kholo ea maikutlo, MDI (59), lefu la ho ferekana kelellong, MDQ (60), le ho batla maikutlo, BSSS (61). Athe Mean2D: 4D ha e amane hantle le mehato ena ka tatellano (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), lilemo tse qalang tsa bohlankana kapa boroetsaneng li ne li amahanngoa le palo e tlase ea matšoao ka ho latellana (Rho = -0.032, p = 0.029, N = 4,717 0.050; Rho = -XNUMX, p = 0.001, N = 4,720) le ho batla maikutlo a fokolang (Rho = -0.118, p <0.001, N = 4,736).
Matšoao a Prenatal Testosterone le ho se sebetse ka thobalano
Ho etsa lipatlisiso tsa tšusumetso ea "testosterone" ea bakhachane mabapi le ho se sebetse hantle litabeng tsa thobalano le ho leka likhopolo tsa rona tsa bobeli, re ile ra qala ho lekola kholo ea taolo ea ho tsoa mali le ts'ebetso ea erectile ha nako e ntse e feta (ke hore, ho tloha Wave 1 ho ea Wave 2, kaha ts'oaetso ea thobalano e ne e sa hlahlojoe ho Wave 3). Ho bile le keketseho e kholo ea ts'ebetso ea erectile ha nako e ntse e feta empa ha ho phetoho ea taolo ea ejaculatory (Z = -5.76, p <0.001; Z = -2.15, p = 0.830). Ka hona, re laotse ts'ebetso ea rona e fapaneng ea erectile (ho tloha Wave 2) ka lilemo. Lilemo tsa ho qala tsa bongoana li amana hampe le ts'ebetso ea erectile (e laoloang) empa eseng ka taolo ea ho tsoa mali; Mean2D: 4D ha e amane hantle le eng kapa eng; bona Lethathamo 3.
Lethathamo 3. Matšoao a testosterone ea pelehi le mesebetsi ea thobalano.
Ho fanoe ka litlhahiso ho lingoliloeng tsa hore ts'ebeliso ea litšoantšo tsa bootsoa e ama ts'oaetso ea thobalano, re ile ra lekola likamano lipakeng tsa ts'ebeliso ea litšoantšo tsa bootsoa, OSC le mesebetsi ea thobalano. Ho khahlisang, litšoantšo tse manyala tse hlephisang boitšoaro li sebelisa makhetlo li ne li sa amane haholo le ts'ebetso ea erectile, athe OSC e ne e etsa joalo, ka matšoao a qobelloang a amanang le taolo e fokolang ea ho tsoa mali le ts'ebetso e tlase ea erectile (Lethathamo 4); ho feta moo, lihora tse sebelisitsoeng litšoantšong tsa bootsoa ketsahalong ka 'ngoe ha lia ka tsa amana haholo le tsona.
Lethathamo 4. Ts'ebeliso ea litšoantšo tsa bootsoa le mesebetsi ea thobalano.
Puisano
Mona re hlalosa bopaki ba pele ba tšusumetso ea pepeso ea prenatal androgen ho boits'oaro ba OSC ho banna nakong ea bocha. Lintlha tsa rona li netefalitse likhopolo-taba tsa rona tsa mantlha tsa hore 2D e tlase le lilemo tsa morao-rao ho spermarche-ka bobeli li bonts'a maemo a phahameng a "prenatal testosterone" li ne li le bohlokoa haholo (leha li na le boholo bo fokolang ba matla) li amanang le OSC e matla, leha ho na le litekanyo tse tšepahalang tsa bolelele ba menoana ho tsoa ho li-raters tse ngata le tlhaiso-leseling ka nako ea ho kena bohlankaneng kapa boroetsaneng ha e fumanehe.
Liphumano tsena li hokahana hantle le tsebo e seng e ntse e le teng. Karabelo ea banna ea thobalano le moputso o amanang le ona oa tlhaho lia kenella dessyecik mesolimbic dopamine e saena ho VTA le NAc (8). Potoloho ena ke motheo oa sistimi ea moputso, ka hona, ha e fane feela ka moputso oa thobalano (62) empa hape e na le makhoba a lithethefatsi, joalo ka botahoa (63). Ho khothalletsoa testosterone ea bakhachane ho ama ts'ebetsong le ts'ebetsong ea ts'ebeliso ea joala (22), 'Me phuputso e entsoeng ho litoeba e fumane hore ho feto-fetoha ha' mele pele ho bokhachane ha li-receptor tsa "prenatal" ho ama "cerebral dopamine", "serotonin" le "noradrenaline neurotransmitter" maemong a ho ba motho e moholo (29). Linkung tse tšehali, testosterone ea bakhachane e amana hantle le palo ea lisele tsa tyrosine hydroxylase-immunoreactive ho VTA (64). Ntle le moo, bokhoba ba methamphetamine bo boetse bo laoloa ke likarolo tse tšoanang tsa neural joalo ka ts'usumetso ea thobalano (65). Boitšoaro bo phetoang ba thobalano le tsamaiso e phetoang ea psychostimulant ka bobeli li hlohlelletsa taolo ea DeltaFosB, ka tsela eo e matlafatsa tsela ea mesolimbic (43). Pontšo ea Gene ea receptor ea mu-opioid, sebapali sa mantlha ho lemalla ho lemalla lithethefatsi, e bonahala e le thobalano-e fetotsoe ka kotloloho ke ho kenella ha testosterone ea pelehi (29). Ho feta moo, mofuta oa A118G oa lefutso la mu-opioid receptor le sebelisana le 2D: 4D ho noha ho itšetleha ka joala (66).
Athe, OSC e ne e amahanngoa le maemo a phahameng a "prenatal testosterone" a bontšitsoeng ke matšoao a mabeli, tšebeliso ea makhetlo e bonts'a kamano e fapaneng le lilemo tsa ho qala ho hlaha, e ka bang karolo ea sehlopha sa lithaka. Tlhatlhobo ea morao-rao ea meta e boetse e fihletse qeto ea hore 2D: 4D e amana haholo le phenotypes ea lithethefatsi ho feta makhetlo kapa ts'ebeliso ea ts'ebeliso (38). Ka bokhutšoanyane, liphetho tsa rona li matlafatsa le ho ntlafatsa kutloisiso ea rona ea ho lemalla lithethefatsi le ho lemalla moputso oa thobalano, e leng hore ba ka arolelana lipotoloho tse tšoanang tsa neural tse kotsing ea maemo a androgen a pelehi.
Khopolo-taba ea rona ea bobeli, e eketsang testosterone ea bakhachane le eona e ka ama ts'ebetso ea thobalano, e ne e ts'ehetsoa feela ke data. Re fumane khokahano ea bohlokoa lipakeng tsa ts'ebetso ea erectile le nako ea bohlankana, 'me hamorao e qala ho amahanngoa le ts'ebetso e nyane; leha ho le joalo, ha rea fumana sehokela sa Mean2D: 4D. Ho se lumellane hona ho ka bakoa ke lifensetere tse fapaneng tsa bakhachane moo ho khethiloeng 2D: 4D le nako ea bokhachane. Lithuto tse peli tse ikemetseng li fane ka bopaki ba 2D: Nts'etsopele ea 4D e etsahala nakong ea bokhachane ba pelehi (67, 68). Ka lehlakoreng le leng, ha nako ea bokhachane e lekantsoe hantle e ntse e sa hlaka, mme ho ka nahanoa hore nako ea pubertal ha se lets'oao feela la pepeso ea prenatal androgen empa hape e susumetsa tlhophiso ea boko nakong ea bocha.
Liphuputso tse ling lia hlokahala ho hlakisa hore na tšusumetso ea mokhatlo ea "prenatal androgen" tsamaisong ea moputso e hokahanya sehokela sena, ebang ke li-receptor tsa pheripheral tsa androgen tse amehang mosebetsing oa erectile (69) e bapala karolo, kapa hore na ho se sebetse ha erectile ke phello ea bobeli ea OSC, ka hona, e hlaha ka lebaka la ts'ebeliso e eketsehang ea litšoantšo tsa bootsoa mme e ama ts'usumetso ea thobalano nakong ea thobalano e arohaneng. dessyecik likarolo tse susumetsang tse susumetsang.
Nakong e tlang, lisebelisoa tse netefalitsoeng tsa ho lekola li hlokahala ho thibela tšimoloho ea ts'oaetso ea thobalano e amanang le bokhoba ba litšoantšo tsa bootsoa ka ho lekola ka nepo maemo a mathata a thobalano, tsoelo-pele ea OSC le ts'ebeliso ea litšoantšo tsa bootsoa ka nako. Hape, lintlha tsa kholo li lokela ho tsotelloa, joalo ka ha potoloho ea moputso le taolo ea eona ea pele e le tlokotsing haholo nakong ea bocha (70). Ntle le moo, liteko tsa ts'ebetso ea liteko tsa ts'ebeliso ea nako, lits'ebetso tsa bongaka tse ipapisitseng le boits'oaro ba bootsoa, le lipatlisiso tsa litlamorao tsa litlhare ka ho se sebetse li lokela ho batlisisoa ka hloko nakong e tlang, ho ntšetsa pele kutloisiso ea etiology ea mantlha.
Taolo ea mantlha ha ea ka ea tsamaellana le letšoao la testosterone ea pelehi. Ho fanoe ka boithuto bo fetileng bo tlalehang khokahano lipakeng tsa testosterone ea bakhachane le ejaculation ea pele ho nako (52), qalong sena se ne se sa lebelloa. Leha ho le joalo, sehlopha se kenang thutong eo se ne se fapane le sa rona ka litsela tse ngata. Pele, Bolat et al. (52) Ho ithuta feela ho kenyelletsa bakuli ba nang le nalane ea bophelo bohle ea mathata a ejaculation pele ho nako. Taba ea bobeli, sehlopha sa bona se ne se tsofetse (lilemo tse bolelang lilemo tse 40). Taba ea boraro, ha re tsebe hore na lithuto tsa thuto ea rona li bile le boiphihlelo bofe ho laola ejaculation nakong ea thobalano, kaha 82% ha e masoha, e thibelang ho ithuta ka boiphihlelo le motho eo o mo phetlelang sefuba. Ea bone, boitšoaro bo amanang le litšoantšo tsa bootsoa ha boa hlahlojoa thutong ea rona.
Likotsi tsa thobalano tse amanang le litšoantšo tse manyala tse hlephisang boitšoaro ha li e-so utloisisoe hantle. Tlhahlobo ea morao-rao e hlalosa litšoantšo tse manyala tse hlephisang boitšoaro, ho fumaneha ha tsona, le mefuta e fapaneng e le tšusumetso e fetang ea tlhaho, eo, kamora nako e telele, e lebisang mathateng a ho fihlela ts'usumetso e lekaneng maemong a tlhaho (a kopaneng). Sena le sona se ka baka mathata a 'maloa, ho tloha ho se sebetse ha erectile nakong ea thobalano e arohaneng le ho lieha ho emisa, ho se khone ho ejaculate ka botlalo nakong ea thobalano e arohaneng (3). Re ne re sena lintlha tse lekaneng thutong ea hajoale ho khetholla pakeng tsa peo ea peo pele ho nako le ho lieha ho emisoa, hobane ka bobeli li koahetsoe ke ntho e mabapi le taolo ea ho tsoa mali, e neng e amahanngoa hampe le OSC. Moetso o sa tsoa phatlalatsoa o hlalosang tlhoko ea basebelisi ea lisebelisoa tse fetelletseng ka nako ho tseba ho ejaculate ha e so netefatsoe (71), Le mamello e ntseng e eketseha hajoale ha e so hlalosoe hantle bakeng sa bokhoba ba litšoantšo tsa bootsoa. Leha ho le joalo, tšebeliso ea litšoantšo tsa bootsoa e ama likhakanyo tse ikhethileng le tse itlalehang tsa linako tse tloaelehileng tsa latency.
Re ho fumana e le ho khahlisang haholo hore OSC, eseng litšoantšo tsa bootsoa tse itšebetsang, e ne e amahanngoa le taolo e fokolang ea ho tsoa peo le ts'ebetso e tlase ea erectile; sena se fana ka maikutlo a kamano e tiileng lipakeng tsa OSC le ho se sebetse ka thobalano dessyecik liphetoho tsamaisong ea moputso ho fapana le mekhoa ea boikopanyo ea sechaba. Hape mona, ho hlokahala lipatlisiso tse ling ho khetholla sesosa le sephetho.
Boithuto ba hajoale bo na le meeli e mengata. 2D: 4D e ne e ikemetse, 'me maqhubu a litšoantšo tse manyala tse hlephisang boitšoaro a sebelisang, ts'ebetso ea erectile, le taolo ea ho tsoa mali li ne li itlaleha. Bokhoba ba litšoantšo tse manyala tse hlephisang boitšoaro ha bo so ananeloe semolao e le bokhoba ba boits'oaro, ka hona, tlhaloso ea bona e fapana (72). Mona, re tsepamisitse maikutlo ho OSC subscale ea ISST, e emelang karolo ea ho qobelloa ha boitšoaro bona bo hlephileng. Ho feta moo, re batlisitse sehlopha se tšoanang sa bacha ba batona le ba batšehali, bao boholo ba bona e neng e le MaCaucasus le masoha; ka hona, liphetho tsa rona li ke ke tsa akaretsoa ho lihlopha tse ling tsa lilemo, litloaelo tsa thobalano, merabe kapa basali. Kamora nako, 2D: 4D le ho kena bohlankaneng li na le matla a lekanyelitsoeng joalo ka matšoao a ponts'oa ea prenatal androgen (33, 38, 73), mme ho kanna ha etsahala hore nako ea bokhachane le eona e ama ka kotloloho tlhophiso ea boko, kaha bohlankana le bona ke nako e thata ea nako (74). Ka hona, ho fumana ha rona setsoalle lipakeng tsa nako ea ho pepa le OSC e kanna ea se be feela phello ea bokhachane empa hape le ho pepeseha ha pubertal androgen.
Qetellong, litekanyetso tse phahameng tsa bakhachane ba "prenatal" (tse bontšitsoeng ke matšoao a mabeli a ikemetseng) li amahanngoa le ts'ebeliso e mpe ea litšoantšo tsa bootsoa. Ts'ebeliso e tlamang e tlamang e amahanngoa le ts'ebetso e tlase ea erectile le taolo e tlase ea ejaculatory ho bahlankana. Ntle le moo, ts'ebetso e tlase ea erectile e ne e amahanngoa le lilemo tse phahameng tsa ho pepa, tse ka supang maemo a phahameng a prenatal androgen. Ka hona, etiology ea ho se sebetse ha erectile le ho phahama ha eona ho matla lilemong tse leshome tse fetileng ho kanna ha kenyelletsa ho sebelisana ha maemo a pelehi ho hlahisa khatello ea thobalano inthaneteng le / kapa ho se sebetse ha erectile le ho fumaneha ho eketsehileng ha litaba tsa bootsoa. Boithuto ba nako e tlang bo khothaletsoa ho qholotsa monehelo o lekanyelitsoeng oa lintlha tsena le ho ntšetsa pele kutloisiso ea boitšoaro bona bo hlephileng le mathata a amanang le thobalano. Leseli lena le ka thusa ho nts'etsapele mananeo a thibelo, ho shebana le lithuto tse kotsing ea ho hlahisa tahi ena kapa bo-mme bao litekanyetso tsa testosterone tsa pelehi li phahameng.
Polelo ea Phumano ea data
Lintlha tsa marang-rang tse hlahisitsoeng bakeng sa boithuto bona li ka fumaneha ka kopo ho mongoli ea tsamaellanang.
Boitšoaro ba Melao
Boithuto bo amang bankakarolo ba batho bo ile ba hlahlojoa le ho ananeloa ke Komiti ea Boitšoaro ea Patlisiso ea Bongaka ea Sekolo sa Bongaka sa Lausanne University (Protocol No. 15/07). Bakuli / barupeluoa ba fane ka tumello ea bona e ngotsoeng e nang le tsebo ea ho nka karolo phuputsong ena.
Litho tsa Phuputso ea Cohort mabapi le Lintho Tse Sebelisang Likotsi
Gerhard Gmel: Lithethefatsi tsa Lithethefatsi, Sepetlele sa Univesithi ea Lausanne CHUV, Univesithi ea Lausanne, Lausanne, Switzerland; Ho lemalla Switzerland, Lausanne, Switzerland; Setsi sa Bokhoba le Bophelo ba Kelello, Toronto, ON, Canada; Univesithi ea West of England, Campus ea Frenchay, Bristol, United Kingdom ([imeile e sirelelitsoe]). Meichun Mohler-Kuo: La Source, Sekolo sa Saense ea Booki, Univesithi ea HES-SO ea Saense e Sebelisitsoeng le Bonono ba Switzerland Bophirima, Lausanne, Switzerland ([imeile e sirelelitsoe]). Simon Foster: Setsi sa thuto ea Epidemiologie, Biostatistik und Prävention, Hirschengraben, Zürich, Switzerland ([imeile e sirelelitsoe]). Simon Marmet: Lithethefatsi tsa Bokhoba, Sepetlele sa Univesithi ea Lausanne CHUV, Univesithi ea Lausanne, Lausanne, Switzerland ([imeile e sirelelitsoe]). Joseph Studer: Lithethefatsi tse lemalloang, Sepetlele sa Lausanne University CHUV, Univesithi ea Lausanne, Lausanne, Switzerland ([imeile e sirelelitsoe]).
Menehelo ea Mongoli
VB le BL ba emola mme ba rala patlisiso, ba sekaseka lintlha, mme ba ngola mongolo o ngotsoeng ka letsoho. GG, MM, SM, SF, le JS ba entse liteko. CM le JK ba ile ba fana ka maikutlo mabapi le buka e ngotsoeng ka letsoho mme ba fana ka maikutlo a kelello. Bangoli bohle ba kentse letsoho ho sengoloa mme ba amohela mofuta o tlisitsoeng.
dithuso tsa ditjhelete
Phuputso ea boraro ea C-SURF e tšehelitsoe ke Swiss National Science Foundation (Grant no. FN 33CS30_148493). Patlisiso ena ea mahlale le eona e khothalelitsoe ke STAEDTLER Foundation, Lefapha la Naha la Thuto le Patlisiso la Jeremane (projeke ea IMAC-Mind: Ho ntlafatsa bophelo bo botle ba kelello le ho fokotsa bokhoba ba bongoana le bocha ka ho ba le kelello: mekhoa, thibelo le kalafo; 2018-2022; 01GL1745C ), le Deutsche Forschungsgemeinschaft (DFG, Jeremane Research Foundation) -Projeke ID 402170461-TRR265 (75). CM ke molekane ea amanang le sehlopha sa koetliso ea lipatlisiso 2162 se tšehelitsoeng ke DFG-270949263 / GRK2162.
Khohlano ea Thahasello
Bangoli ba bolela hore lipatlisiso li ne li etsoa ka ho se be le likamano leha e le life tsa khoebo kapa tsa lichelete tse ka nkoang e le khohlano e ka 'nang ea e-ba le thahasello.
Mohlophisi ea sebetsanang le litaba o phatlalalitse kamano e arolelanoeng le e mong oa bangoli GG nakong ea tlhahlobo.
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