Análisis Preliminar del Cuestionario 'Potenziani' para la Validación Diagnóstica del Hipogonadismo de Comienzo Tardío y su Concordancia con los Cuestionarios de Heinemann (AMS) y de Morley (ADAM). Premio Vargas 2010 por Academia Nacional de Medicina de Venezuela

ABSTRACT Hipogonadismo de comienzo tardío, es una condición que afecta 6%
al 12% de hombres entre 40 y 70 años y aun así, está subdiagnosticada,
por lo que se propone un cuestionario de validación diagnóstica, teniendo
como objetivo lograr mayor sensibilidad, especificidad y predictividad que
los cuestionarios ya existentes.
Se analizaron 107 hombres entre 45 y 70 años, con disminución de
la líbido, trastornos de erección, disminución del entusiasmo en actividad
diaria, cansancio fácil, menor productividad en su trabajo, cambios del
humor con propensión a la irritabilidad, disminución de su masa magra
muscular, con tendencia al sobrepeso y afectación en actividades
recreativas y deportivas.
Se hizo interrogatorio exhaustivo, examen físico y pruebas de
laboratorio (perfil 20, perfil hormonal urológico masculino, antígeno
prostático específico total, libre y relación libre/total, examen de orina y
urocultivo). Se le hizo contestar al paciente tres cuestionarios de
validación diagnóstica del hipogonadismo de comienzo tardío: Heinemann
AMS (Ageing Males Survey-1999, St. Louis University/, Androgen
Deficiency in Aging Male Morley ADAM-2000 y el cuestionario de
validación diagnóstica del hipogonadismo de comienzo tardío-Potenziani-
2007, para ser comparados y demostrar su validez con pruebas de
especificidad y sensibilidad, índice de Youden, pruebas de concordancia
con intervalos de confianza del 95%, en relación al diagnóstico bioquímico
del hipogonadismo de comienzo tardío.
Los resultados arrojaron que el cuestionario ‘Potenziani’ fue más
sensible (88,57%), fué más especifico (43,06%), tuvo el índice de validez
más alto (57,94%) y el valor predictivo positivo más alto de los tres
cuestionarios con el 43,06%. Por tal motivo se ha demostrado que el
cuestionario propuesto es más adecuado que Heineman-AMS y el Morley
ADAM en la aproximación diagnostica del síndrome de hipogonadismo de
comienzo tardío.

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