Abstract
Over the past two decades several large cohort studies have been performed to disclose the changes of sex hormone in elderly and their clinical significance. Beyond the decline of total testosterone, aging is accompanied by a sex hormone binding globulin (SHBG) increase, a steeper free testosterone decline, while gonadotropins may be increased or inappropriately normal, with important contribution of comorbidities (e.g., obesity) to these changes. Actually, it has become firm the concept that the biochemical finding of testosterone deficiency alone is not sufficient for diagnosing hypogonadism in older men. The definition of late-onset hypogonadism (LOH) includes low serum testosterone levels coupled with signs and symptoms related to hypogonadism. Indeed, the combination of multiple factors all contributing to the testosterone decline, with other concurrent comorbidities further overlapping, makes the clinical correlates of LOH highly heterogeneous. For all these reasons both the diagnosis and the therapeutic management of LOH, especially the decision about starting testosterone replacement treatment, remain challenging.
Highlights
Aging is associated with changes in the physiological functioning of the endocrine system.[1]
How much gender differences in the exposure to sex steroids at any age are involved in determining longevity and the response to stress remains to be established in detail.[202,204]
In men physiological changes should be differentiated from pathological low serum T and the coupling low serum T with hypogonadism-related signs and symptoms is a good strategy to diagnose late-onset hypogonadism (LOH) and to identify patients who might beneficiate from T replacement
Summary
Aging is associated with changes in the physiological functioning of the endocrine system.[1]. In discordance with other studies,[27] the comparison between serum total T measurements by using IAs or MS, which represents the gold standard for T levels measurement, has shown similar, highly-correlated results in the EMAS cohort.[32] This means that IAs could be considered a good method for the evaluation of total serum T in clinical practice for distinguishing between eugonadism and hypogonadism in the clinical setting.[32]. Techniques for the measurement of bioavailable serum T are based on previous precipipation and separation of SHBG-bound T For this reason, these methods are not simple and are not routinely employed in clinical laboratories.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
