inahaneloang
SELELEKELA:
Thobalano tlhekefetso joalo ka ha ho khothalelitsoe ho kenyeletsoa ho Diagnostic and Statistical Manual of Mental Dis shida-5 e kenyelletsa likarolo tsa ho tebela takatso ea thobalano, ho susumetsoa le ho qobelloa. Leha ho le joalo, ha ho tsejoe hore na e ama joang ts'ebetso ea gonadal le ts'ebetso ea li-axis tsa hypothalamus-pituitary-gonadal (HPG).
SEBELE:
Morero oa thuto ena e ne e le ho etsa lipatlisiso tsa litekanyetso tsa testosterone le luteinizing hormone (LH) ho Hypersexual banna ha ba bapisoa le taolo e phetseng hantle. Ho feta moo, re fuputse litloaelano lipakeng tsa matšoao a epigenetic le li-hormone.
LITLHAHISO:
Litlhahlobo tsa plasma ea hoseng ea testosterone, LH, le li-globulin tse tlamang tsa thobalano li ile tsa hlahlojoa ka 67 Hypersexual banna (ba bolela lilemo tse 39.2; lilemo tse 39) ha li bapisoa le taolo e 37.5 ngoe e lekanang ea lilemo tse XNUMX (bolela lilemo: lilemo tse XNUMX). Lebaka la ho Kopanela Liphate ka Thobalano le Thobalano Bothata: Sekala sa Tlhahlobo sa hajoale se sebelisitsoe bakeng sa ho hlahloba Hypersexual Boitšoaro, sekhahla sa boithati ba Montgomery-Åsberg se ile sa sebelisoa bakeng sa khatello ea maikutlo, 'me Questionnaire ea bongoaneng ba bongoana (CTQ) e sebelisitsoe ho lekola nalane ea mathata a bongoaneng. Mefuta ea methylation e pharalletseng ea libaka tsa marang-rang tse fetang 850 K CpG e ne e lekantsoe ka mali a felletseng ho sebelisoa Illumina Infinium Methylation EPIC BeadChip. Libaka tsa CpG tse fumanehang kahare ho 2,000 bp ea sebaka sa qalo sa transcriptional sa hypothalamus pituitary adrenal (HPA) le liphatsa tsa lefutso tsa HPG axis li kenyelelitsoe.
LITLHAHISO TSE LING TSA HO FUMANA:
Litekanyetso tsa plasma tsa testosterone le LH ha li kopana le litekanyetso tsa tleliniking mme sephetho sa bobeli e ne e le profil ea epigenetic ea libaka tsa HPA le HPG axis-couped CpG tse nang le maemo a testosterone le LH.
LIKOTSO:
Litekanyetso tsa plasma ea LH li ne li phahame haholo ho bakuli ba Hypersexual ho hloka taolo ho feta ho baithaopi ba phetseng hantle. Ha ho phapang e kholo ea plasma testosterone, li-hormone tsa follicle tse matlafatsang, prolactin, le maemo a SHBG li fumanoe pakeng tsa lihlopha. Ho ne ho se na likamano tse bohlokoa pakeng tsa methapo ea methapo ea DNA ea HPA le HPG axis-e kopantsoeng le lipalo tsa testosterone kapa LH kamora ho khalemeloa hangata.
CONCLUSIONS:
Tekanyetso e poteletseng ea axis ea HPG, ka litekanyetso tsa plasma tse ngata tsa LH empa ha ho na phapang ea litekanyetso tsa testosterone e ka bang teng ho Hypersexual banna. Chatzittofis A, Boström AE, Öberg KG, le al. Testosterone e tloaelehileng empa e le Luteinizing Hormone Plasma ea Hormone e Phahameng ho Banna ba nang le Thobalano Tsietsi. Thobalano Med 2020; XX: XXX-XXX.
Copyright © 2020. E hatisoa ke Elsevier Inc.
LINKOTSO:
Psychology ea Biological; Epigenetics; HPG Axis; Thobalano Tsietsi; Testosterone
- PMID 32173350
- DOI: 10.1016 / j.esxm.2020.02.005
Selelekela
Hypersexual disorder (HD) e hlalosoa e le bothata ba takatso ea thobalano e seng papiso le likarolo tse kopaneng tsa takatso ea thobalano, bokhoba ba thobalano, tlhotlheletso le khatello.1 HD e ne e khothalletsoa hore e be tlhahlobo ea mafu empa e sa kenyelelitsoe ho Buka ea Boholo ba Phatlalatso ea Ts'oaetso ea Maikutlo 5, haholo ka lebaka la ho tšoenyeha ka bonnete ba lefu lena.2 Lithuto tse latelang li ile tsa ts'epa ho ts'epahala le ho nepahala ha mekhoa e boletsoeng3 mme qosong e se e rarollotsoe.4 Ho fana ka maikutlo a bohlokoa ba tlhahlobo ea bongaka ke litlamorao tse mpe bakeng sa bophelo bo nang le khatello ea maikutlo le ts'ebetso e holofetseng bakeng sa motho eo,1,5 mme hajoale, tlhekefetso ea boitšoaro bo tlamang ea thobalano e kenyellelitsoe ho Sehlopha sa machaba sa mafu a 11 sehlopheng sa mathata a taolo ea ts'usumetso.6
Taolo ea boitšoaro ba thobalano e rarahane haholo ho kenyelletsa le litsamaiso tsa neuroendocrine, tsamaiso ea limbic le litlamorao tsa lobe tsa kapele.7,8 Testosterone e na le tšusumetso ho boitsoaro ba thobalano, empa kamano e hlakileng e rarahane mme mehlala e fapaneng e khothalletsoa ho hlalosa litlamorao tsa testosterone ho kenyelletsa ho lemoha, maikutlo, likarabo tsa boikemelo le tšusumetso.9 Ka kakaretso, maemo a tlase a testosterone a amana le ho fokotseha ha mesebetsi e mengata ea thobalano 'me a na le kamano e habeli le boits'oaro bo ka fetolang maemo a lihormone tsa thobalano.9,10 Boholo ba lithuto tse mabapi le testosterone le hypersexuality li se li entsoe ho basenyi ba botona le botšehali maemong a forensic, mme litekanyetso tse phahameng tsa testosterone li kanna tsa amana le litšobotsi tsa bohanyetsi le mabifi ho fapana le hypersexuality.11 Leha ho na le ho haelloa ke tsebo mabapi le ts'ebetso ea gonadal mabapi le bosodoma, ke praxis e tloaelehileng bakeng sa lilemo tse fetang 30 ho sebelisa kalafo ea antiandrogen ho lebisa matšoao a hypersexual ho bakuli ba paraphilic le batlōli ba molao ba thobalano.11,12 Kahoo ho bohlokoa ho hlakisa kamano lipakeng tsa ts'ebetso ea hypersexourse le androgen, haholoholo mabapi le testosterone maemong a seng tlolo ea molao.
Ho tsebo ea rona, ha ho na lithuto tse mabapi le tšusumetso ea gonadal ho HD. Morero oa thuto ena e ne e le ho hlahloba litekanyetso tsa testosterone le luteinizing hormone (LH) ho banna ba nang le HD ha ba bapisoa le sehlopha sa taolo sa banna ba phetseng hantle. Morero oa bobeli e ne e le ho etsa lipatlisiso tsa mekhatlo ea "epigenetic profil" ea hypothalamus pituitary adrenal (HPA) le hypothalamus-pituitary-gonadal (HPG) -axis e kopantsoeng le libaka tsa CpG tse nang le maemo a testosterone le LH.
Lintho tse bonahalang le mekhoa
Ethics
Liprotheine tsa ho ithuta li amohetsoe ke boto ea tlhahlobo ea melao ea boitšoaro tikolohong e Stockholm (Dnr: 2013 / 1335-31 / 2), mme barupeluoa ba ile ba fana ka tumello e ngotsoeng e fanoeng mabapi le thuto.
Batho ba ithutoang
Bakuli
Bakuli ba 67 ba banna ba nang le HD ba ile ba hloa Setsi sa Andrology le Bongaka ba Thobalano, ka papatso mecheng ea litaba le ho fetisetsoa Setsing. Bakuli ba ne ba batla kalafo ea kalafo le / kapa psychotherapeutic e ileng ea fanoa kamora litlhahlobo. Baahi ba lipatlisiso ba 'nile ba hlalosoa ka mokhoa o qaqileng pele.13 Mekhoa ea ho kenyelletsa e ne e le tlhahlobo ea HD, tlhaiso-leseling e fumanehang, le lilemo tse 18 kapa ho feta. Tlhatlhobo e thehiloe ka ts'ebeliso ea Diagnostic and Statistical Manual of Mental Disorders-5- lits'ebetso tse hlahisitsoeng ke HD, 'me bankakarolo ba hloka litekanyetso tsa 4 ho tse 5 ho kenyeletsoa.4
Sehlopha sa bakuli se sebelisitse litšoantšo tsa bootsoa haholo (bakuli ba 54), ho ipholla litho tsa botona kapa botšehali (49 bakuli), thobalano le batho ba baholo ba lumellang (bakuli ba 26), le cybersex (bakuli ba 27). Motsoako o neng o tloaelehile haholo e ne e le ho ipholla litho tsa botona kapa botšehali le ho tsuba (bakuli ba 49), ho bolelang hore motho e mong le e mong ea sebelisang ho ipholla litho o boetse o sebelisa litšoantšo tsa bootsoa. Ho feta moo, bakuli ba 29 ba ne ba e-na le mekhoa e meraro ea bootsoa kapa e fapaneng.
Ho hlahlojoa ha HD le tlhahlobo e 'ngoe ea mafu a kelello e thehiloe ke ngaka e koetlisitsoeng ea kelello le setsebi sa kelello se sebelisang Mini International Neuropsychiatric Puisano.14 Bakuli ba nang le bokuli ba kelello ba morao-rao, joala ba hona joale kapa lithethefatsi, bokuli bo bong ba kelello bo ka hlokang kalafo e potlakileng joalo ka khatello ea maikutlo e kholo e nang le kotsi e kholo ea ho ipolaea, le bokuli bo tebileng ba 'mele joalo ka lefu le matla la hepatic kapa renal ha lea kenyelletsoa.
Baithaopi ba phetseng hantle
Baithaopi ba 39 mele ba phetseng hantle ba hapuoe ba sebelisa database tsa Karolinska Trial Alliance (KTA). Karolinska Trial Alliance ke setsi sa tšehetso se thehiloeng ke Lekhotla la Setereke sa Stockholm le Karolinska Institutet mme se sebetsa joalo ka Setsi sa Patlisiso ea Clinical Sepetlele sa Karolinska University ho tsamaisa lithuto tsa kliniki. Baithaopi ba kenyelelitsoe haeba ba ne ba e-na le tse latelang: ha ho na bokuli bo tebileng ba 'mele, ha ho na bokuli bo fetileng ba kelello kapa bokuli ba kelello, ha ho na motho ea amanang le lefu la kelello kapa la ho akheha kapa la ho ipolaea,' me a sa pepesehetsoe ke koluoa e kholo (koluoa ea tlhaho kapa tlhaselo ea tlhaho). Baithaopi ba phetseng hantle ba ile ba hlahlojoa ka lisebelisoa tse tšoanang tsa psychometric joaloka banna ba matla. Batho ka bo bona ba nang le tšoaetso ea tšoaetso ea lefu la pelo le bona ba ile ba qheleloa ka thoko.
Ho tsoa ho baithaopi ba 40 ba phetseng hantle, e mong o ile a qheleloa ka thoko ka lebaka la bokuli bo neng bo bonahala liphatsong tsa laboratori. Ho entsoe boiteko ba ho lekana le baithaopi ba phetseng hantle ho bakuli ba nang le HD le nako e ts'oanang ea sampole ea mali ho tloha nakong ea selemo kapa hoetla ho entsoe ho fokotsa phapang ea nako ea selemo.
Litekanyetso
Barupeluoa bohle ba lipatlisiso ba ile ba etsoa lipatlisiso ka lisebelisoa tse latelang tse hlophisitsoeng:
The Puisano ea Neuropsychiatric ea Mini-International (MINI 6.0) ke tlhahlobo ea tlhahlobo ea bongaka e netefalitsoeng, e hlophisitsoeng bakeng sa ho hlahloba psychopathology haufi le axis I.14
The Hypersexual disorder screening tlhaiso (HDSI) ka lintho tse 7 li latetse litekanyetso (5A le 2B litekanyetso) tsa HD. Kakaretso ea lintlha ho tloha ho 0 ho isa ho 28 ka lintlha tse tlase tsa 3 tse hlokahalang ho 4 ho 5 A-litekanyetso le 3 kapa 4 lintlha ka bonyane ba 1 B-litekanyetso, ka hona ho hlokahala lintlha tse tlase tsa 15 bakeng sa tlhahlobo ea HD.3
The Tekano ea ho qobella ho kopanela liphate (SCS) e kenyelletsa lintho tse 10 mabapi le boitšoaro bo qobelloang ho tsa thobalano, litakatso tsa thobalano, le menahano e tsosang takatso ea thobalano ho lintlha tse 4. E ile ea etsoa bakeng sa ho lekola boits'oaro bo botle ba thobalano. Lipalo kaofela li tloha ho 10 ho isa ho 40, sekhahla se ka tlase ho 18 se bonts'a ho hloka thobalano, 18-23 e bonts'a boikobello bo bobebe ba thobalano, 24-29 e bonts'a tekano, 'me e kholo ho feta kapa e lekanang le 30 e bonts'a boemo bo phahameng ba khatello ea thobalano.15
The Khatello ea Hypersexual: Sekala sa Tlhahlobo sa hajoale (HD: CAS) Ho hlahloba matšoao libekeng tse peli tse fetileng pele ho ketelo ea bongaka. HD: CAS e na le lipotso tse 2 le ea pele (A7) e botsang mofuta le palo ea boits'oaro bo tlalehiloeng. Lipotso tse 1 tse latelang (A6-A2) li hlalosa matšoao ana nakong ea libeke tse peli tsa moraorao. Potso e ngoe le e ngoe (A7-A2) e lekantsoe ka tekanyo e matla ea lintlha tse 2 (7–5) ka lintlha tse felletseng 0 ho isa ho 4.
The Tekanyetso ea boemo bo phahameng ba Montgomery-bergsberg (EMRS-S) Ho lekola ho teba ha khatello ea maikutlo.16 Sekala sa lintlha se kenyelletsa lipotso tse 9 mabapi le matšoao a sithabetsang, a lekantsoeng ho tloha ho 0 ho isa ho lintlha tse 6 ka lintlha tse felletseng ho tloha 0 ho ea 54.
The Potso ea Boemo ba Bana ba Ho Rona bakeng sa koluoa e ikemetseng ea bongoana e na le lintho tse 28 tsa tlhahlobo le lihlahisoa tse 5 tse lekanyang ho hlekefetsoa maikutlong, tlhekefetso ea 'mele, tlhekefetso ea thobalano, khatello ea maikutlo le ho se tsotelle. Tjhelete e 'ngoe le e' ngoe e fumaneha lipakeng tsa 5 le 25 (ho se sebetse hampe).17
Bakeng sa lintlha tse mabapi le barupeluoa ba thuto, ka kopo bona Tafole 1.
| Litšobotsi tsa Kliniki | Bakuli N = 67 | Baithaopi ba phetseng hantle N = 39 | Lipalopalo (t-Khethehileng, Kruskall-Wallis), P boleng |
|---|---|---|---|
| Lilemo (lilemo) | |||
| E bolelang | 39.2 | 37.5 | EA-45-T |
| Range | 19-65 | 21-62 | |
| STD | 11.5 | 11.9 | |
| Ho tepella maikutlo | n = 11, 16.4% | - | - |
| Lefu la ho tšoenyeha ka mathata | n = 12, 17.9% | - | - |
| Tseba tse ling | n = 1, (ADHD) | - | - |
| Ho tepella maikutlo | n = 11, 16.4% | - | - |
| HDSI | |||
| E bolelang | 19.6 | 1.6 | P <.001 |
| Range | 6-28 | 0-9 | |
| STD | 5.7 | 2.2 | |
| SCS | |||
| E bolelang | 27.8 | 11.1 | P <.001 |
| Range | 12-39 | 10-14 | |
| STD | 6.9 | 1.2 | |
| HD: CAS | |||
| E bolelang | 10.3 | 0.38 | P <.001 |
| Range | 1-22 | 0-4 | |
| STD | 5.4 | 0.88 | |
| MAHALA | |||
| E bolelang | 18.9 | 2.4 | P <.001 |
| Range | 1-50 | 0-12 | |
| STD | 9.7 | 2.9 | |
| Kakaretso ea CTQ (n = 65) | |||
| E bolelang | 39.95 | 32.53 | P <.001 |
| Range | 25-80 | 25-70 | |
| STD | 11.48 | 8.75 |
ADHD = khaello ea hloko ea moea oa ho fokola; CTQ = Potso ea ngoana ea ho sithabela maikutlo ka bongoana; HD: CAS = hypersexual disorder: tekanyetso ea hona joale ea tlhahlobo; HDSI = tlhahlamano ea tlhaiso-leseling ea hypersexual.
Pokello ea Mohlala oa Mali le Tlhatlhobo
Disampole tsohle tsa mali li nkuoe hoseng hoo e ka bang lihora tse 08.00. Ho etsa sampole ea mali bakeng sa bakuli le baithaopi ba phetseng hantle ho ile ha etsoa ka ho lekana lipakeng tsa selemo le ho oa lipakeng tsa lihlopha ho fokotsa phapang ea linako tsa linako tsa sampling. Teko ea khatello ea dexamethasone e nang le dexamethasone 0.5 mg e entsoe ka liphetho tse tlalehiloeng pejana.13 Kakaretso ea mali a testosterone, LH, le SHBG a ile a hlahlojoa ke sethala sa electrochemiluminescence immunoassay COBAS (Roche, Basel, Switzerland) Lefapheng la Clinical Chemistry, Karolinska University Hospital, Huddinge. Mefuta ea tlhahlobo ea testosterone e ne e le 0.087-52 nmol / L e nang le li-coefficients tsa li-coefficients tsa variability (CVs) tsa 2.2% ho 3.0 nmol / L le 2.0% ho 18.8 nmol / L le li-CV tsa li-interassay tsa 4.7% ho 3.0 nmol / L le 2.5% ho 18.8 nmol / L. Lethathamo la tlhahlobo ea liteko tsa LH e ne e le 0.1-200 E / L e nang le li-CV tsa 0.6% ho 4.0 E / L le 0.6% ho 26 E / L le li-CV tsa li-interassay tsa 1.5% ho 4.0 E / L le 2.0% ho 26 E / L. Mefuta ea tlhahlobo ea SHBG e ne e le 0.35-200 nmol / L e nang le li-CV tsa 1.7% ho 17 nmol / L le 2.2% ho 42 nmol / L le li-CV tsa li-interassay tsa 0.3% ho 17 nmol / L le 0.9% ho 42 nmol / L. Follicle e hlasimollang li-hormone (FSH) le prolactin li ile tsa metoa ho latela mekhoa e emeng laboratoring ea Univesithi ea Karolinska (www.karolinska.se).
Litlhahlobo tsa Epigenetic
Lintlha tse mabapi le profilation ea methylation le ts'ebetso ea data li phatlalalitsoe pele.18 Bakeng sa litlhaloso tsa ho khetholloa ha sampole, litlatsetso tsa sebaka sa CpG, le khetho ea HPA le HPG axis-coupes e kopantsoeng, ka kopo sheba ho Boitsebiso bo Eketsehileng.
Tlhahlobo ea Litekanyetso
Litlhahlobo tsohle tsa lipalo li ile tsa etsoa ho sebelisoa software ea Statistical Package JMP 12.1.0 (SAS Institute Inc, Cary, NC). Skewness le kurtosis tsa phetisetso ea mefuta e tsoelang pele li ile tsa hlahlojoa ke liteko tsa Shapiro-Wilk. Litekanyetso tsa LH hangata li ne li ajoa ho bakuli ba nang le HD le baithaopi ba phetseng hantle, athe litekanyetso tsa testosterone, SHBG, FSH, le prolactin li ne li sa atisoe ka tloaelo ho baithaopi ba phetseng hantle le bakuli, ka ho latellana. Seithuti se sa Felloang t-Test le tlhahlobo ea Wilcoxon-Mann-Whitney li ile tsa sebelisoa hamorao ho batlisisa liphapang tsa sehlopha lipapatsong tse tsoelang pele lipakeng tsa bakuli ba nang le HD le baithaopi ba phetseng hantle. Litlhahlobo tsa Correlational li sebelisitsoe ho fumana mekhatlo lipakeng tsa mefuta e fapaneng ea kliniki le ea biologic hammoho le ho lekola ba ka ferekanyang. Liteko tsa likamano tse seng tsa parametric kapa parametric li ile tsa etsoa ho sebelisoa Spearman's rho kapa Pearson's r. Liteko tsohle tsa lipalo-palo li ne li le mehatla e 'meli. The P boleng ba bohlokoa ke <0.05.
Litlhahlobo tsa lipalo tsa sampuli ea epigenetic li entsoe ka lipalo tsa R (The R Foundation for Statistical Computing, Vienna, Austria), version 3.3.0. Kamora mehato e ntlafalitsoeng, sampole tse 87 li ile tsa sala li kenyeletsoa tlhahlobisong e latelang ea li-axis tsa 221 HPA le HPG tse kopantsoeng. Tlhahlobo ea chi-squared e sebelisitsoe ho fumana ho se tšoane ka mefuta ea mekhahlelo, mohlala, bong, khatello ea maikutlo le boemo ba khatello ea khatello ea dexamethasone. Bakeng sa li-covariate tse nepahetseng le tlhahlobo ea botsoalle sampole ea epigenetic, ka kopo sheba Boitsebiso bo Eketsehileng.
Results
Testosterone, LH, FSH, Prolactin, le SHBG Plasma Levels ho li-HD le Baithaopi ba phetseng hantle
Bakuli ba ne ba e-na le lipalo tsa plasma tse phahameng haholo ho feta baithaopi ba phetseng hantle, empa ho ne ho se na phapang e kholo lipakeng tsa plasma testosterone, FSH, prolactin, le maemo a SHBG ho bakuli ba nang le HD ha ba bapisoa le baithaopi ba phetseng hantle, Setšoantšo sa 1, Tafole 2. Testosterone e ne e amana hantle haholo le SHBG le LH (r = 0.56, P <.0001; r = 0.33, P = .0005) ho bankakarolo bohle ba boithuto. Bakuli ba 11 ba ile ba phekoloa ka li-anti-depressing. Ho ne ho se na phapang e kholo maemong a LH a mali a pakeng tsa bakuli ba noang le bakuli ba sa noeng meriana (P = .7). Bakuli ba noang meriana ea ho imeloa kelellong ba ne ba na le maemo a phahameng a testosterone ea plasma ho feta bakuli ba sa alafshoang ka ho imeloa kelellong (P = .04).
Setšoantšo sa 1
LH (luteinizing hormone) maemo a plasma ho banna ba hypersexual le taolo e phetseng hantle.
| Litekanyo tsa Endocrine | Bakuli (N = 67) Bolela (SD) | Baithaopi ba phetseng hantle (N = 39) Bolela (SD) | Lipalopalo (t-test, Teko ea Wilcoxon-Mann-Whitney), P boleng |
|---|---|---|---|
| Testosteron (nmol / L) | 15.09 (4.49) | 14.34 (4.29) | .313 |
| SHBG (nmol / L) | 32.59 (11.29) | 35.15 (13.79) | .6 |
| LH (E / L) | 4.13 (1.57) | 3.57 (1.47) | .035 ∗ |
| Prolactin (mIU / L) | 173.67 (71.16) | 185.21 (75.79) | .34 |
| FSH (E / L) | 4.12 (2.49) | 4.24 (2.53) | .92 |
FSH = hormone e susumetsang; LH = hormone ea luteinizing; SHBG, hormone ea thobalano e tlamang globulin.
E na le mehatla e 'meli P-value <.05 ∗ e nkuoa e le bohlokoa.
Litekanyetso tsa Clinical le Hormone Plasma Levels
Likamano lipakeng tsa mehato ea bosodoma (SCS le HD: CAS) le maemo a mali a LH li ne li se bohlokoa. Khokahano ea maemo a testosterone ea plasma le mehato ea bosodoma (SCS le HD: CAS) e ne e se bohlokoa sehlopheng sohle (rho = 0.24, P = .06; r = 0.24, P = .05), Tafole 3.
| Tekanyo ea endocrine | CTQ | MADRS-S | SCS | HD: CAS |
|---|---|---|---|---|
| Testosterone | 0.0713 (0.5726) | -0.0855 (0.4916) | 0.2354 (0.0551)* | 0.24 (0.0505) ∗ |
| LH | -0.1112 (0.3777) | 0.1220 (0.3253) | -0.0078 (0.9501) | -0.17 (0.1638) |
| SHBG | -0.0179 (0.8877) | -0.1421 (0.2514) | 0.1331 (0.2830) | -0.04 (0.7703) |
CTQ = lipotso tsa lipotso tsa khatello ea maikutlo ea bongoaneng; HD: CAS = lefu la hypersexual: sekala sa tlhahlobo ea hajoale; LH = hormone ea luteinizing; MADRS-S = Tekanyo ea khatello ea maikutlo ea Montgomery-bergsberg; SCS = sekhahla sa khatello ea thobalano; SHBG = hormone ea thobalano e tlamang globulin. Mongolo o tšekaletseng o bolela Pearson r e ne e sebelisoa.
*P <.1.
Testosterone e ne e amana haholo le SCS ho bakuli ba nang le HD (rho = 0.28, P = .02). Ho ne ho se likamano tsa bohlokoa lipakeng tsa maemo a mali a testosterone le LH, matšoao a sithabetsang a lekantsoeng ke litekanyetso tsa MADRS kapa CTQ, Tafole 3.
Patlisiso ea Litloaelano Lipakeng tsa 221 HPA le HPG Axis-Li-CpG tse Kopaneng le Li-testosterone tsa Plasma le LH
Ha ho sebaka se le seng sa CpG se neng se le bohlokoa kamora hore ho etsoe khalemelo bakeng sa liteko tse ngata ho sebelisoa mokhoa oa ho sibolla lintho tsa leshano, ho fumana lintlha Boitsebiso bo Eketsehileng.
Puisano
Thutong ena, re fumane hore bakuli ba batona ba nang le HD ha ba na phapang e kholo maemong a testosterone ea plasma ha ba bapisoa le baithaopi ba phetseng hantle. Ho fapana le moo, ba ne ba e-na le litekanyetso tse phahameng haholo tsa LH. Mefuta e bolelang ea testosterone le LH ea lihlopha tsena ka bobeli e ne e le ka har'a sebaka sa litšupiso. Ho latela tsebo ea rona, ena ke tlaleho ea pele ea ts'oaetso ea HPG ho banna ba nang le HD. LH e na le karolo ea bohlokoa ho taolo ea thobalano haholo-holo ka tlhahiso e latellanang ea li-androgens. Liphuputso tse fetileng tsa maemo a LH a plasma le ho tsosa takatso ea thobalano li fane ka liphetho tse hanyetsanang, tse ka hlalosoang ka mokhoa o itseng ke lithuto tse ikhethileng mabapi le ho ts'oaroa ha LH le bioactivity. Stoleru le al19 e tlaleha hore ho tsosa takatso ea thobalano ho bahlankana ho na le phello ea lets'oao la LH le emisang ho chechisa tlhoro ea bobeli kamora ho tsosa le ho eketsa bophahamo ba eona.19 Ho kanna ha ba hore ho na le liphapang lipakeng tsa bioactive / immunoactive ratio ea LH. Carosa le al20 e tlaleha hore bakuli ba nang le bothata ba ho se sebetse hantle ha erectile dysfunction ba ne ba e-na le karolelano ea boleng bo tlase ea LH ho feta banna ba phetseng hantle, mme sena se ile sa khutlisoa kamora ho qala ts'ebetso ea thobalano.
Boholo ba lithuto tsa lihormone le boits'oaro bo hlephileng ba thobalano esale bo le maemong a lipatlisiso a batlisisang batlōli ba molao ba thobalano. Kingston et al21 e tlalehile hore lihormone tsa gonadotrophic, FSH, le LH li ne li hokahane hantle le bora ho baetsi ba thobalano mme e ne e le likhakanyo tse betere tsa ho hlaphoheloa nako e telele ho feta maemo a testosterone phuputsong e latelang batlōli ba thobalano ho fihlela lilemo tse 20. Bangoli ba phehile khang ea hore batloli ba bang ba thobalano ba na le ts'oaetso ea LH ka ho hloleha ha tlolo ea molao e ikemetseng ka maemo a bona a testosterone. Ntle le moo, phuputsong e bapisang banna ba nang le "pedophilia" le "non-pedophilic paraphilia", hammoho le taolo e tloaelehileng ea banna, leha ho ne ho se na phapang lipakeng tsa lihlopha tsa testosterone le LH kamora ho tšeloa ha 100 mcg ea LH e hlahisang "hormone" ea "pedophile". sehlopha se bile le bophahamo bo eketsehileng ba LH, ha se bapisoa le lihlopha tse ling tsa 2.22 Leha ho le joalo, ho thata ho hokahana lipakeng tsa liphumano tsena tse tlalehiloeng maemong a morao-rao le thuto ea rona e shebaneng le banna ba nang le HD ntle le pedophilia kapa nalane ea thobalano.
Kamano lipakeng tsa thobalano le maemo a testosterone e rarahane. Ka sebele, testosterone e amana ka kotloloho le thobalano le ho tsosa takatso ea thobalano le litlamorao ho litsamaiso tse ngata ho kenyelletsa ts'ebetso ea kelello, maikutlo, mekhoa ea boikemelo le tšusumetso.9,10 Litlamorao tsena li ka tsamaisoa ka tsela e sa tobang ka ho fetoloa hoa estradiol le ho tlama li-receptor tse ling. Litekanyetso tsa testosterone le LH li boetse li angoa ke boitšoaro ba thobalano le maikutlo. Ho hlohlelletsa lintho tse tsosang takatso, khafetsa ha li-orgasms ka coitus kapa ho ipholla litho, esita le tebello ea ho etsa thobalano e ka susumetsa maemo a testosterone.9,10 Ho feta moo, mofuta oa mohopolo, taba, le liphihlelo tse fetileng li ka fetolela litlamorao ho maemo a testosterone. Rupp le Wallen23, phuputsong ea banna ba pepesetsoeng erotica ea pono, ba bolela hore litekanyetso tsa testosterone li fetoloa ke boiphihlelo, ba tlaleha hore litekanyetso tsa testosterone li ne li amana haholo le takatso ea thobalano ho banna ba shebang litšoantšo tsa bootsoa ba neng ba pepesetsoa khafetsa ka takatso ea thobalano le ho banna ba nang le boiphihlelo ba pejana ba ho bona litšoantšo tsa bootsoa pele ho thuto. Bangoli ba fana ka maikutlo a hore testosterone e hlokahala ho ntlafatsa ts'usumetso le ts'ebetso ea kelello ha ho lula hoa mohopolo ho bile teng ka ho pepesetsoa khafetsa.23 Le ha maemo a testosterone a ne a sa fapana lipakeng tsa banna ba nang le HD le taolo e phetseng hantle, khokahano lipakeng tsa litekanyetso tsa plasma ea testosterone le mehato ea hypersexourse e bontšitse tšekamelo ea bohlokoa sehlopheng sohle le tlhabollo e nepahetseng ho banna ba nang le HD ba maemong a phahameng a testosterone ho bakuli ba tlalehang boitšoaro bo hatelletsang ho feta ba thobalano, litakatso tsa thobalano, le menahano e tsosang takatso ea thobalano.
Leha ho le joalo, liphuputso tse mabapi le testosterone ho basenyi ba tsa thobalano li tlalehiloe ka liphetho tse fapaneng, mme tlhahlobo ea morao-rao ea meta e fihletse qeto ea hore ha ho na tšehetso ea phapang ea litekanyetso tsa testosterone ho basenyi ba thobalano le hore ho ka ba le phapang ka har'a basomi ba thobalano e le bathahaselli ba bana. e ne e na le testosterone e tlase.24 Empa le mabapi le tlatsetso ea testosterone bakeng sa ts'ebetso ea thobalano, tlhahlobo e hlophisitsoeng ea liteko tse laoloang ka linako tse ling ke Huo et al25 o fihlela qeto ea hore, mabapi le libido, leha ho na le tse ntle ho feta lithuto tse mpe, liphetho li lula li kopane. Ntle le moo, tlatsetso ea testosterone e ne e sa sebetse ka nepo ntlafatsong ea thobalano. Kamora nako, lithuto tse ngata li bile liteko, li ntse li hlahloba litlamorao ho testosterone le LH kamora ts'usumetso ea ts'usumetso e matla ea thobalano, mohlala, filimi e tsosang takatso ea botona kapa ea botšehali, ho ipholla litho tsa botona kapa botšehali kapa coitus19 mme ha a ka a hlahloba litlamorao holima HPG maemong a tšoarellang joalo ka ho bakuli ba nang le HD. Kahoo, ho fumana phapang ea maemo a testosterone ho banna ba makhopho ha a bapisoa le baithaopi ba phetseng hantle ha ho makatse.
Hona le lithuto tse fokolang feela tse etsang lipatlisiso tsa banna ba fetisang hypersexual le li-system tsa endocrine. Safarinejad26 litekanyetso tsa kalafo tsa kalafo ea analog ea nako e telele ea "gonadotropin-releasing hormone", triptorelin, maemong a banna bao e seng paraphilic hypersexual ba tlaleha maemo a tloaelehileng a testosterone ea basement le LH, empa moralo oa lipatlisiso o ne o sa kenyeletse sehlopha sa taolo se phetseng hantle. Phuputsong eo, litekanyetso tsa LH le testosterone hammoho le tlhahiso ea thobalano (palo ea liteko tsa thobalano) ea banna ba hypersexual e fokotsehile ka kalafo e bonts'ang kamano e haufi ea litekanyetso tsa li-hormone le tsa thobalano.
Litekanyetso tsa testosterone li boetse li amana le matšoenyeho le matšoao a nyahamisang ho banna ba hypogonadal.9,10 Ha rea fumana khokahano ea bohlokoa pakeng tsa maemo a testosterone le matšoao a sithabetsang. HD e kenyelletsa litlhalosong ea eona ea hore boitšoaro bo ka bakoa ke maemo a dysphoric le khatello ea maikutlo,1 mme re kile ra tlaleha dysregulation ka hyperactivity ea axero ea HPA13 hammoho le liphetoho tse amanang le epigenetic ho banna ba nang le HD.18
Ho na le tšebelisano e rarahaneng lipakeng tsa HPA le HPG axis, ka bobeli e thabisang hammoho le inhibitory le phapang ho latela sethala sa boko.27 Liketsahalo tse sithabetsang ka lebaka la maqhubu a HPA li ka baka tšitiso ea khatello ea LH le ka lebaka la tlhahiso.27 Litsamaiso tsa 2 li na le litšebelisano tse phetoang, 'me khatello ea maikutlo ea pele e ka fetola likarabo tsa neuroendocrine ka liphetoho tsa epigenetic.28, 29, 30
Lihokelo tsa testosterone ea plasma le litekanyetso tsa hypersexuality (SCS le HD: CAS) li ne li le maemong a maemo sehlopheng sohle, 'me testosterone e ne e amana hantle le SCS ho bakuli ba nang le HD. SCS e lekanya boitšoaro bo qobelloang ka thobalano, litakatso tsa botona le botšehali, le menahano e tsosang takatso ea thobalano mme e ile ea ntlafatsoa bakeng sa ho lekola boits'oaro bo botle ba thobalano.15 Boitšoaro ba batho ba kotsing ea ho etsa thobalano bo kenyelletsa thobalano khafetsa le balekane ba fapaneng, palo e eketsehang ea balekane ba thobalano, thobalano e sa sireletsehang, likamano tsa thobalano tse sa sirelitsoeng, mafu a tšoaetsanoang ka thobalano, le tšebeliso ea lithethefatsi le joala pele ho thobalano.1,31 Testosterone e na le tšekamelo ea ho beha boits'oaro bo botle kotsing hammoho le cortisol, joalo ka hypothesis e kopantsoeng ea li-hormone, ba fetola ho ipeha kotsing.32 Hypothesis ena e likarolo li peli e tiisa hore boitšoaro bo amanang le maemo joalo ka bokhukhuni le bophahamo bo amana hantle le testosterone ha maemo a cortisol a le tlase empa eseng ha maemo a cortisol a le holimo. Leetong lena, re sa tsoa tlaleha hore tekanyo ea CSF testosterone / cortisol e ne e amana hantle le ho ts'oaroa le mabifi ka har'a sehlopha sa batho ba lekang ho ipolaea.33 Ntle le moo, maemo a plasma a cortisol a ne a hokahanngoa hampe le lintlha tsa SCS ho banna ba nang le HD.13 Kahoo, kopanyo e mpe ea litekanyo tsa cortisol le SCS le khokahano e nepahetseng ea litekanyo tsa testosterone le SCS li tsamaellana le hypothesis e kopanetsoeng ea li-hormone. Takatso ea thobalano e boetse e na le lintlha tse ngata tse amanang le eona, le maemo a joalo ka khatello ea maikutlo, bong, le sepheo sa takatso e ka ba litekanyo tse ntle tsa litloaelano le lihormone tse kang testosterone.34,35 Mechini e reriloeng e ka kenyelletsa tšebelisano ea HPA le HPG, marangrang neural network, kapa thibelo ea taolo e mabapi le taolo ea libaka tsa preortal cortex.32
Tlhaloso e 'ngoe e ka ba ea "hypogonadism" e tlamang, eo hangata e hlahisoang ka meeli e tloaelehileng kapa e tlase, litekanyetso tsa plasma tsa testosterone, le holimo kapa maemong a phahameng a maemo a plasma ea LH e le mochine o qobellang. Leha ho le joalo, hypogonadism e tlamang e amana le botsofaling ba botsofali le li-comorbidities tse sa foleng, ho fapana le sampole ea rona, e lekanang le sehlopha sa taolo mme e lokolohile ho li-comorbidities tse ling.
Mabapi le epigenomics, li-chip tsa methylation tsa genome tse nang le libaka tse fetang 850 K CpG li sebelisitsoe, empa re tsepamisitse maikutlo ho liphatsa tsa lefutso tse amanang le axis ea HPA ho latela liphetho tsa rona tse fetileng.18 hammoho le mefuta e tloaelehileng ea HPG e amanang le axis le lipale tse tlalehiloeng tse amanang le boitšoaro ba thobalano joalo ka oxytocin le kisspeptin.36, 37, 38
Mefuteng e mengata ea tsamaiso ea methapo ea methapo ea methapo ea testosterone, libaka tsa 12 tsa CpG li ne li bohlokoa haholo le libaka tsa 20 tsa CpG tsa maemo a plasma LH. Ha ho sebaka se le seng sa CpG se neng se le bohlokoa kamora ho khalemeloa liteko tse ngata. Ena ke thuto ea pele ea epigenetic ea liphatsa tsa lefutso tse amanang le HPG ho HD, 'me pejana re tlalehetse liphetoho tsa epigenetic ho liphatsa tsa lefutso tse amanang le HPAaxis.18 Liphetho tse mpe li lokela ho hlalosoa ka hloko. Ka lebaka la boholo ba sampole e nyane, ho tla ba thata ho bona boholo bo fokolang ba phello, haholo-holo kamora ho khalemeloa liteko tse ngata.
Matla a thuto ke bongata bo khethiloeng ka hloko, bo sa hlakoheng ba banna ba nang le khatello ea maikutlo, ho ba teng ha sehlopha sa taolo se lekanang le lilemo tsa baithaopi ba phetseng hantle, ntle le nalane ea maloetse a kelello kapa a hona joale a kelello, nalane ea lelapa ea mathata a maholo a kelello, le liphihlelo tse bohloko tse bohloko. Ntle le moo, tlaleho ea lichelete bakeng sa bafani ba ka hlahang tlhahlobisong e joalo ka mathata a bongoana, khatello ea maikutlo, matšoao a neuroinfigueatory le liphetho tsa liteko tsa dexamethasone. Meeli e kang ho itlaleha ha mathata a bongoana le sampole e nyane ea tlhahlobo ea epigenetic li tlameha ho boleloa. Matla a mang ke hore methapo ea methyl e itšetleha haholo ka lisele, 'me liphetho tse mpe tsa epigenetic li ka amana le mohloli oa lithane (mali kaofela). Ntle le moo, liketso tsa morao-rao tsa thobalano li kanna tsa baka moferefere ka ho boloka maemo a lihormone39 kaha re ne re sa laole liketso tsa morao-rao tsa thobalano. Leha ho le joalo, ho ne ho se na kamano lipakeng tsa maemo a lihormone le thobalano, libekeng tse 2 tse fetileng, e lekantsoeng le HD: CAS e neng e tla supa phello e joalo. Ho feta moo, testosterone e ne e lekantsoe ke immunoassay ho fapana le mekhoa e nepahetseng ea mokelikeli oa chromatography- mass spectrometry.
Kamora nako, karolo e hlophisitsoeng ea thuto ke tlamo bakeng sa sephetho se sa tloaelehang, 'me ho na le tlhoko ea ho pheta-pheta ka har'a sehlopha se ikemetseng kaha sena ke thuto ea pele ea li-axis tsa HPG le epigenetics ka HD.
Qetellong, re tlaleha ka lekhetlo la pele ho eketseha ha maemo a plasma a LH ho banna ba makhopho ha a bapisoa le baithaopi ba phetseng hantle. Liphumano tsena tsa mantlha li kenya letsoho ho matlafatseng lingoliloeng mabapi le ho kenya letsoho ha litsamaiso tsa neuroendocrine le ho bala ka HD.
Litataiso tsa lipatlisiso tse ling tsa HD li ka bonoa likarolong tse fapaneng. Boholo ba lipatlisiso li se li entsoe ho banna le litsoeng tse ngata tse joalo ka basenyi ba thobalano. Kahoo, litla-morao tsa tlhabollo ea basali ba mofuta oa basali, phapang ea bong le maemo a bongaka a bophelo lia fokola. Li-Comorbidities, haholo-holo tse nang le mafu a mang a kelello ho kenyeletsa le lithethefatsi tsa lithethefatsi le boits'oaro li hloka ho hlakisoa. Mokhoa o mong e ka ba ho ithuta bakuli ba nang le HD / khatello ea boitšoaro bo bobe ba thobalano ntle le li-comorbidities. Qetellong, e tla ba ho khahlisang haholo ho sebelisa sebopeho sa maemo a lipatlisiso. Lithuto tse amanang le lefutso, molek'hule, liphatsa tsa lefutso, hammoho le lithuto tsa epigenetic hammoho le litšobotsi tse kang mabifi, ho hloka matla le boitšoaro bo sa hlonepheng bo ka hlakisa pathophysiology ea lefu lena.
Tlaleho ea bongoli
- Category 1
(a) Mohopolo le Moralo
Lena Chatzittofis; Adrian E. Boström; Katarina Görts Öberg; John N. Flanagan; Helgi B. Schiöth; Stefan Arver; Jussi Jokinen
(b) Ho fumana data
Lena Chatzittofis; John Flanagan; Katarina Görts Öberg
(c) Tshekatsheko le Tlhaloso ya Datha
Lena Chatzittofis; Adrian E. Boström; Helgi B. Schiöth; Jussi Jokinen
- Category 2
(a) Ho ngola sengoloa
Lena Chatzittofis
(b) Ho e nchafatsa bakeng sa litaba tsa bohlale
Lena Chatzittofis; Adrian E. Boström; Katarina Görts Öberg; John N. Flanagan; Helgi B. Schiöth; Stefan Arver; Jussi Jokinen
- Category 3
(a) Kamohelo ea ho qetela ea Sengoloa se Felletseng
Lena Chatzittofis; Adrian E. Boström; Katarina Görts Öberg; John N. Flanagan; Helgi B. Schiöth; Stefan Arver; Jussi Jokinen
lumela hore baa fokola
Profiling ea Methylation e entsoe ke SNP & SEQ Technology Platform e Uppsala (morolo.ru). Setsi sena ke karolo ea Setsi sa Ts'ebetso ea Naha ea Likokoana-hloko (NGI) Sweden le Science for Life Laborator. Sethala sa SNP & SEQ se tšehelitsoe hape ke Lekhotla la Patlisiso la Sweden le Mokhatlo oa Knut le Alice Wallenberg.
Lintlha tse tlatselletsang
Khohlano ea thahasello: Jussi Jokinen o nkile karolo ho Advisory Board of Janssen mabapi le esketamine bakeng sa MDD ka sepheo sa ho ipolaea sa hona joale. Bangoli ba bang kaofela ha ba phatlalatse hore ha ho na khohlano ea phaello.
Lithuso: Lichelete bakeng sa thuto ena li fanoe ke Lekhotla la Lipatlisiso la Sweden le Sweden Brain Research Foundation (Helgi B. Schiöth); ka tumellano ea selekane pakeng tsa Univesithi ea Umeå le Västerbotten County Council (ALF); le ka lithuso tse fanoeng ke Lekhotla la Lebatooa la Stockholm (ALF) (Jussi Jokinen).
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