Prevalence Of Late-onset Hypogonadism Research Articles

The Prevalence of Late-Onset Hypogonadism in Middle-Aged Men and Cardiovascular Risk Factors

Background: Life expectancy has increased dramatically worldwide, resulting in a sharp rise of age-associated diseases, including late-onset hypogonadism (LOH) in men. Aim: To assess the prevalence of LOH and to determine its relationships with cardiovascular risk factors in healthy middle-aged men. Material and Methods: A total of 200 men aged 44–55 (median 48.44, interquartile range 45.02–52.50) undergoing regular medical examinations were enrolled in a study. All participants were asked to complete the International Index of Erectile Dysfunction, Aging Male's Symptoms, and Beck Depression Inventory questionnaires. Sex and gonadotropin hormones were measured in all participants. Cardiovascular diseases (CVD) risk was assessed in all participants by using the Systematic Coronary Risk Evaluation scale, and additional risk factors were recommended in the 2019 European Society of Cardiology and European Atherosclerosis Society guidelines for the management of dyslipidemias: lipid modification to reduce cardiovascular risk. Results: Ninety-eight (49%) men suffered from LOH. Men with total testosterone (TT) of <12 nmol/L were considered testosterone-deficient. The mean TT level was 8.9 ± 2.4 nmol/L in the LOH group. Clinical signs and symptoms of LOH were associated with lower TT levels: 7.78 ± 2.49 and 10.15 ± 1.32 in the groups with and without LOH, respectively (p = 0.004). The prevalence of obesity, metabolic syndrome, and depression was significantly higher among men with LOH, compared with men without it. High cardiovascular risk was found only in those participants present with LOH (p = 0.003). After collecting other risk factors, we found that 94.9% of participants assigned to the LOH group had high cardiovascular risk. Conclusion: The prevalence of LOH is high among healthy middle-aged men. Moreover, it is associated with an increased cardiovascular risk. Early measurement of TT levels in this population group may predict the development of CVD and allow the introduction of timely primary prevention measures to reduce cardiovascular morbidity and mortality.

Prevalence of late-onset hypogonadism among middle-aged and elderly males in China

This study aimed to propose an operational definition of late-onset hypogonadism (LOH) that incorporates both clinical symptoms and serum testosterone measurements to evaluate the prevalence of LOH in aging males in China. A population-based sample of 6296 men aged 40 years–79 years old was enrolled from six representative provinces in China. Serum total testosterone (TT), sex hormone-binding globulin (SHBG), and luteinizing hormone (LH) were measured and free testosterone (cFT) was calculated. The Aging Males' Symptoms (AMS) scale was used to evaluate the LOH symptoms. Finally, 5078 men were included in this analysis. The TT levels did not decrease with age (P = 0.59), and had no relationship with AMS symptoms (P = 0.87 for AMS total score, P = 0.74 for ≥ 3 sexual symptoms). The cFT levels decreased significantly with age (P < 0.01) and showed a negative association with the presence of ≥ 3 sexual symptoms (P = 0.03). The overall estimated prevalence of LOH was 7.8% (395/5078) if a cFT level <210 pmol l−1 combined with the presence of ≥ 3 sexual symptoms was used as the criterion of LOH. Among them, 26.1% (103/395) and 73.9% (292/395) had primary and secondary hypogonadism, respectively. After adjustment for confounding factors, primary and secondary hypogonadism was positively related to age and comorbidities. Body mass index was an independent risk factor for secondary hypogonadism. The results suggest that the AMS total score is not an appropriate indicator for decreased testosterone, and that the cFT level is more reliable than TT for LOH diagnosis. Secondary hypogonadism is the most common form of LOH.

Lipid accumulation product and late-onset hypogonadism in middle-aged and elderly men: results from a cross-sectional study in China

ObjectivesHypogonadism in men is related to the deterioration of general health. However, the association between lipid overaccumulation and ageing-related hypogonadism remains an undetermined concept. We aimed to provide an insight...

AB018. Androgen receptor CAG repeat length polymorphism as a risk factor of late onset hypogonadism/metabolic syndrome in a Korean male population

BackgroundAndrogen receptor (AR) CAG polymorphism modulates the effect of testosterone in target organs. However, correlation between AR CAG repeat length and clinical features of late onset hypogonadism (LOH) is unclear and there are only few studies from Asian population. In this study, we explored the relationship of AR CAG repeat length polymorphism with LOH and metabolic syndrome (MS) in Korean male population.MethodsThe association between AR CAG repeat length and LOH, MS were studied in a total of 600 Korean men from 2013 to 2015. LOH was diagnosed by serum testosterone level of <3.5 ng/mL and ADAM questionnaire. AR CAG repeat length was determined by microsatellite fragment sizing. MS was diagnosed with NCEP criteria ATP III. Clinical factors and questionnaire related with LOH [patient health questionnaire-9 (PHQ), aging male symptom scale (AMS), and international index of erectile function (IIEF-5)] were analyzed with AR CAG repeat length.ResultsMean age of the patients was 61.2±10.9 years and mean AR CAG repeat length was 22.2±5.1. Mean serum testosterone levels was 2.6±0.7 in men with LOH and 6.0±2.0 in men without LOH, respectively. A total of 33 men (12.5%) were diagnosed with LOH. Men with LOH showed significant longer AR CAG repeat length compared with men without LOH (26.1 vs. 21.6, P<0.001). As CAG repeat length increased, AMS total and AMS psychotic/somatic/sexual subscore increased (r=0.219, r=0.168, r=0.160, r=0.241) (P=0.001, P=0.006, P=0.001, P=0.001) and IIEF-5 score decreased, significantly (r=−0.187, P=0.002). In multivariate analysis showed that CAG and total AMS score were independently associated with LOH. (OR =1.3, 0.9, P<0.001, 0.005, respectively) Men with MS showed significant longer AR CAG repeat length compared with men without MS (26.2 vs. 21.4, P<0.001). As CAG repeat length increased, number of components of NCEP criteria increased, significantly (R2 =0.119, P=0.001). AR CAG repeat length showed significant correlation with HDL (r=−0.244, P<0.001), triglyceride (r=0.276, P<0.001), HbA1c (r=0.201, P<0.001). In multivariate analysis, CAG repeat length, waist circumference and HDL were independent risk factors of MS.ConclusionsIn conclusion, AR CAG repeat length was associated with prevalence of LOH and clinical symptoms of LOH in a Korean male population. Longer CAG repeat length was identified as one of the risk factor of LOH and MS in Korean male.

MP81-19 ANDROGEN RECEPTOR CAG REPEAT LENGTH AS A RISK FACTOR OF LATE ONSET HYPOGONADISM IN A KOREAN MALE POPULATION

You have accessJournal of UrologySexual Function/Dysfunction: Basic Research & Pathophysiology II1 Apr 2017MP81-19 ANDROGEN RECEPTOR CAG REPEAT LENGTH AS A RISK FACTOR OF LATE ONSET HYPOGONADISM IN A KOREAN MALE POPULATION Sun Tae Ahn, Hyeong Guk Jeong, Ji Yun Chae, Jong Wook Kim, Mi Mi Oh, Hong Seok Park, Je jong Kim, and Du Geon Moon Sun Tae AhnSun Tae Ahn More articles by this author , Hyeong Guk JeongHyeong Guk Jeong More articles by this author , Ji Yun ChaeJi Yun Chae More articles by this author , Jong Wook KimJong Wook Kim More articles by this author , Mi Mi OhMi Mi Oh More articles by this author , Hong Seok ParkHong Seok Park More articles by this author , Je jong KimJe jong Kim More articles by this author , and Du Geon MoonDu Geon Moon More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2545AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Androgen receptor (AR) CAG polymorphism that modulates the effect of testosterone has been found to influence sexual function. However, correlation between AR CAG repeat length and clinical factors of late onset hypogonadism is unclear and there are only few studies from Asian population. In this study we explored the relationship between AR CAG repeat length polymorphism and late onset hypogonadism (LOH) in a Korean male population. METHODS The association between AR CAG repeat length was analyzed in a total 263 Korean men from 2014 to 2015. LOH was diagnosed by serum testosterone level of <3.5ng/mL and androgen deficiency in the aging male questionnaire positive. AR CAG repeat length was determined by microsatellite fragment sizing. Clinical factors and questionnaire related with LOH (patient health questionnaire-9 (PHQ), aging male symptom scale (AMS), and international index of erectile function (IIEF-5)) were analyzed with AR CAG repeat length. RESULTS Mean age of the patients was 61.2±10.9 years and mean AR CAG repeat length was 26.2±5.1. Mean serum testosterone levels was 2.6±0.4 in men with LOH and 6.0±2.0 in men without LOH, respectively. A Total of 33 men (12.5%) were diagnosed with LOH. Men with LOH showed significant longer AR CAG repeat length compared with men without LOH (30.1 vs 25.6, p<0.001). As CAG repeat length increased, AMS total and AMS psychotic/somatic/sexual subscore increased(r=0.219 r=0.168, r=0.160, r=0.241) (p=0.001,p=0.006 p=0.001, p=0.001) and IIEF-5 score decreased, significantly (r=-0.187 p=0.002). In multivariate analysis showed that CAG was independently associated with LOH. (OR=1.3, P<0.001) CONCLUSIONS AR CAG repeat length was associated with prevalence of LOH and clinical symptoms of LOH in a Korean male population. Longer CAG repeat length was identified as a risk factor of LOH in Korean male. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1096 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Sun Tae Ahn More articles by this author Hyeong Guk Jeong More articles by this author Ji Yun Chae More articles by this author Jong Wook Kim More articles by this author Mi Mi Oh More articles by this author Hong Seok Park More articles by this author Je jong Kim More articles by this author Du Geon Moon More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Prevalence of Late-Onset Hypogonadism in Men with Localized and Metastatic Renal Cell Carcinoma

Background: Cancer-related fatigue is a common symptom in patients with renal cell carcinoma (RCC) and can be similar to the fatigue found in late-onset hypogonadism (LOH). The aim of this study was to investigate the prevalence of LOH in patients with localized RCC (loRCC) and metastatic RCC (mRCC) disease under targeted therapy (TT) and compare the results to findings of epidemiologic studies. Methods: A total of 51 mRCC patients under TT and 33 patients with loRCC undergoing nephrectomy were included. Total testosterone (tT) levels and clinical signs of LOH were recorded (testicular volume, body-mass index (BMI), hip-to-waist ratio, International Index of Erectile Function, IIEF-5, Androgen Deficiency in the Aging Male, ADAM, and quality of life questionnaire-C30). LOH was defined according to current guidelines. Results: Morning tT and calculated free testosterone levels showed no significant difference in patients with mRCC and loRCC (p = 0.551 and p = 0.430). A significant difference was found for clinical signs and symptoms including the ADAM score (p = 0.003), hip-to-waist ratio (p = 0.017) and testicular volume (p < 0.001). IIEF-5 score and BMI were not significantly different. The prevalence of LOH according to the current EAU definition was 13.7 and 15.2% for the mRCC and loRCC cohort, respectively (p = 0.302). Conclusions: LOH was present in a significant proportion of RCC patients. Prevalence rates of LOH were higher in patients with RCC compared to patients without cancer.

Age-Related Testosterone Decline: Whom Do We Treat and Why?

Late-onset hypogonadism (LOH) is characterized by hypogonadal symptoms, together with low serum testosterone values, in men of advancing age. For a variety of reasons, LOH has become popular in both the lay press and the scientific community. While the overall prevalence of LOH is relatively low, the potential sequelae of untreated LOH can be considerable for affected men. The diagnosis of LOH can be challenging, as symptoms are generally nonspecific and overlap with a variety of medical and psychological problems. Testosterone therapy (TTh) for affected men has become increasingly controversial after several recent observational studies observed an increased cardiovascular risk associated with TTh. However, prior studies have observed little or no cardiovascular risk associated with TTh, and recent studies also support a low cardiovascular risk in men on TTh. In this review, we discuss the LOH patient and controversy surrounding this condition and outline potential risks and benefits of treatment.

Identification of late-onset hypogonadism in middle-aged and elderly men from a community of China

In this study, we investigated the essential criteria for late-onset hypogonadism (LOH) syndrome based on the presence of symptoms associated with low testosterone levels in Han Chinese men. Blood tests for total testosterone (TT) and sex hormone–binding globulin (SHBG) were performed, and the aging male symptoms (AMS) questionnaire was conducted in a randomly selected cohort composed of 944 Chinese men aged 40 to 79 years from nine urban communities. Three sexual symptoms (decreased ability/frequency of sexual activity, decreased number of morning erections, and decreased libido) were confirmed to be related to the total and free testosterone levels. The thresholds for TT were approximately 12.55 nmol l−1 for a decreased ability/frequency to perform sex, 12.55 nmol l−1 for decreased frequency of morning erections, and 14.35 nmol l−1 for decreased sexual desire. The calculated free testosterone (CFT) thresholds for these three sexual symptoms were 281.14, 264.90, and 287.21 pmol l−1, respectively. TT <13.21 nmol l−1 (OR = 1.4, 95%CI: 1.0–1.9, P = 0.037) or CFT <268.89 pmol l−1 (OR = 1.5, 95%CI: 1.1–20, P = 0.020) was associated with an increase in the aforementioned three sexual symptoms. The prevalence of LOH was 9.1% under the criteria, including all three sexual symptoms with TT levels <13.21 nmol l−1 and CFT levels <268.89 pmol l−1. Our results may improve the diagnostic accuracy of LOH in older men.

Late-onset hypogonadism among old and middle-aged males with prediabetes in Polish population

Objectives: Around 40% of diabetic men have lowered testosterone and symptoms of hypogonadism but the prevalence of hypogonadism among prediabetic men is unknown. The aim of this study was to investigate the prevalence of late-onset hypogonadism (LOH) in population of Polish men with prediabetes.Methods: This study was performed in 196 prediabetic men and in 184 normoglycemic, control group. Prediabetes was defined as impaired fasting glucose, impaired glucose tolerance and/or HbA1c 5.7–6.4%. LOH was defined as low libido, diminished frequency of morning erections and erectile dysfunctions in men with total testosterone <12 nmol/l.Results: Total testosterone (TT) level in prediabetes group was 11.78 ± 1.76 and 16.37 ± 1.6 nmol/l in control group (p < 0.001). LOH was diagnosed in 30% prediabetic men and in 13.6% control men. There were negative relationships between calculated free testosterone (cFT) and HbA1c (r = −0.3856; p < 0.005). In prediabetic group, TT and cFT levels were lower in patients with impaired glucose tolerance than impaired fasting glucose (p < 0.05 and p < 0.02, respectively). We showed inverse relationships between IIEF-5 score and cFT (r = −0.414, p < 0.005) and between IIEF-5 and HbA1c (r = −0.395, p < 0.002).Conclusions: In population of Polish men with prediabetes we observed high prevalence of LOH. Routine testosterone screening should be performed in all prediabetic men.

Prevalence of late-onset hypogonadism in men with type 2 diabetes mellitus

Late-onset hypogonadism (LOH) or age-associated testosterone deficiency syndrome is defined as a clinical and biochemical syndrome associated with advancing age and characterised by symptoms and a deficiency in serum testosterone levels. This condition may result in significant detriment in the quality of life and adversely affect the function of multiple organ systems. It has been suggested that sex steroid hormones may play a causal role in the development of insulin resistance and type II diabetes. This comparative study was aimed at determining the prevalence of LOH in diabetic men with erectile dysfunction and investigating the effect of testosterone replacement therapy on erectile function and on glycaemic control.

UP-3.105: Prevalence of Late Onset Hypogonadism and the Evaluation of Its Association with Other Co-Morbidities in Non-Urological Clinic Attendees

UP-3.105: Prevalence of Late Onset Hypogonadism and the Evaluation of Its Association with Other Co-Morbidities in Non-Urological Clinic Attendees

Vascular risk factors and their association to serum androgen levels in a population-based cohort of 75-year-old men over 5 years: results of the VITA study

In contrast to the high prevalence of late onset hypogonadism, little is known regarding correlates for low androgen levels in aging men. We investigated participants of the Vienna Transdanube Aging study and assessed the relationship between vascular risk factors and hormonal status over 5 years. A total of 247 men with a mean age of 75.8 years were analyzed. Despite a tendency for lower testosterone levels in men with vascular risk factors and vascular diseases, none of these associations reached statistical significance. Men with low DHEA-S levels had a lower risk of hypercholesterinemia (-55.2%; P = 0.01) yet an increased prevalence of diabetes (+95.7%; P = 0.02) and coronary heart disease (+47.6%; P = 0.05). Testosterone and DHEA-S remained stable over 5 years of follow-up. While reduced levels of total testosterone did not show an association to vascular disease, low DHEA-S was linked to hypercholesterinemia, diabetes, and coronary heart disease.