Prevalence Of Testosterone Deficiency Research Articles

016 Testosterone Deficiency in Men being Treated for Primary Pancreatic Cancer

Few studies have investigated testosterone deficiency in non-prostate cancers. Previously, inflammation and opiod use has been associated with hypogonadism and shorter survival in advanced pancreatic cancer. Furthermore, a significant proportion of these patients note a lack of sexual interest or enjoyment in the small number of studies conducted on this topic. Despite many of these patients experiencing symptoms of testosterone deficiency such as fatigue, weakness, cognitive dysfunction, and decreased lean muscle mass, there exists sparce literature on testosterone testing patterns in practice and the prevalence of testosterone deficiency in this population.

The Epidemiological Characteristics of Late-Onset Hypogonadism in Chinese Middle-Aged and Elderly Men: Two Cross-Sectional Studies in the Same Community.

The purpose of this study was to investigate the prevalence and epidemiological characteristics of late-onset hypogonadism (LOH) in middle-aged and elderly Chinese men. Two cross-sectional studies were conducted at 5-year intervals in community-dwelling men living in the same area. A total of 1472 (Study 1, S1) and 944 (Study 2, S2) men aged 40–69 years old were recruited as subjects. Subjects were evaluated through combining serum reproductive hormone levels with the Androgen Deficiency in Aging Males (ADAM) questionnaire and the Aging Males’ Symptoms (AMS) scale. A significant difference was found in mean testosterone deficiency (TD) prevalence between S1 and S2, using either serum total testosterone (TT; 14.02% vs. 6.36%) or serum calculated free testosterone (cFT; 43.69% vs. 16.53%) cutoff values. According to the S1 or S2 data, the mean prevalence of LOH was 37.85%/15.47% in the positive ADAM test and 15.42%/9.43% in the positive AMS test (p < .01). According to classifications of TD based on gonadal status, the prevalence of secondary TD (27.34%) was higher than the primary (16.36%) and compensated (15.42%) TD in S1 (p < .01). However, there were significant differences among the prevalence of primary (6.89%), secondary (9.64%), and compensated (27.65%) TD in S2 (p < .05). Different types of testosterone levels, TD cutoff values, and questionnaires influenced the prevalence of TD and LOH. The serum FT cutoff value was an optimal threshold for evaluating and diagnosing TD and LOH, whose prevalence increased gradually with male aging.

Prevalence of testosterone deficiency among aging men with and without morbidities

In this cross-sectional study 1852 men aged 40–70 years attending primary health care were invited to fill out the aging male symptoms (AMS) scale. Out of these, 1222 men were found positive for the AMS and agreed to provide blood samples for the general blood test, lipid profile, glucose levels, and assessment of both total and free testosterone (T) levels. Men were screened for the following morbidities and syndromes: dyslipidemia, arterial hypertension, obesity, type II diabetes, metabolic syndrome, and chronic obstructive pulmonary disease (COPD). Testosterone deficiency was diagnosed if total T ≤ 3.46 ng/mL or free T ≤ 72 pg/mL. Among all 1222 men with positive AMS, decreased blood testosterone levels were detected in 669 men (55%). A total of 402 men were found healthy and 820 men were detected with different morbidities. Out of 669 men with testosterone deficiency, only 2.8% had no co-morbidities and 97.2% were men with co-morbidities. Testosterone levels were found significantly higher among healthy men (median 4.7 ng/mL) as compared to the men with morbidities (median 2.55 ng/mL, p<.001), adjusted for age. Testosterone deficiency was detected in significantly lower proportion of 402 men without co-morbidities as compared to the 820 men with co-morbidities: in 19 men (4.7) and in 650 men (79.3%, p<.05), respectively.

The association between body mass index and testosterone deficiency in aging Chinese men with benign prostatic hyperplasia: results from a cross-sectional study

Background and objectives Evidence has supported obesity as a risk factor for both benign prostate hyperplasia (BPH) and hypogonadism. In this paper, we performed a retrospective study and discussed the prevalence of testosterone deficiency (TD) and its relationship to body mass index (BMI) in aging Chinese men with BPH who have surgical intervention. Material and methods We reviewed the clinical data by age, BMI, medical history, serum prostate-specific antigen (PSA) levels, serum total testosterone (TT) levels, biochemical analysis, and transrectal ultrasound. BMI and other variables were considered to be independent variables in an effort to evaluate any potential associations between these factors and TD status using non-adjusted and multivariate-adjusted regression models. Results Of the 795 BPH participants, 27.2% (216) patients had TD. After adjusting for all potential covariates, there was a similar J-shaped relationship between BMI and TD, with an inflection point of 19.2 kg/m2. The effect sizes and the confidence intervals on the left and right sides of this inflection point were 0.6 (0.4–1.0) (p = .043) and 1.2 (1.1–1.3) (p < .001), respectively. Conclusion Nearly one-third of the aging Chinese BPH patients had TD in this study. The association between BMI and TD is not simple. A J-shaped curve correlation was detected. BMI was positively correlated with TD when it was over 19.2 kg/m2 and inversely correlated with TD when it was below 19.2 kg/m2. Long-term prospective studies are needed to confirm these findings.

SUN-232 Testosterone Deficiency among Thai Men with Type 2 Diabetes: Prevalence and Associated Factors

Objective: The aim of this study is to determine the prevalence and associated factors of hypogonadism among Thai men with type 2 diabetes mellitus (T2DM). Methods: We have conducted a cross-sectional study to determine the prevalence of low testosterone level and its associated factors among 200 Thai men with T2DM who attended at Diabetes Clinic, King Chulalongkorn Memorial Hospital, Bangkok, Thailand between January 2014 and October 2017. The patient characteristics were collected and their symptoms about androgen deficiency, aging male symptoms, erectile dysfunction, and depression and quality of life were evaluated by using Thai version of ADAM, AMS, IIEF-15, PHQ-9 and WHOQOL BREF-THAI questionnaires, respectively. Blood tests for their total testosterone (TT), sex hormone binding globulin (SHBG), free testosterone (cFT) and bioavailable testosterone (cBT) were calculated using Vermeulen’s method were performed. TT < 10 nmol/L, cFT < 0.23 nmol/L or cBT< 5.3 nmol/L were defined as testosterone deficiency. Results: Overall, 11.8 % of men with T2DM had testosterone deficiency (TT < 10 nmol/L). The prevalence of testosterone deficiency was similar among all three criteria. Of noted, 88.2% had secondary hypogonadism and all of them had mild symptoms of androgen deficiency. Waist circumference was significantly positive correlated with testosterone deficiency (OR 1.06, 95%CI) while SHBG levels was significantly negative correlated with testosterone deficiency (OR 0.95, 95% CI). There was no relationship between serum TT level and duration of diabetes, FPG and A1C. Conclusion: Testosterone deficiency among Thai men with T2DM was prevalent. Clinicians should beware of clinical manifestations of hypogonadism to detect and supplement testosterone accordingly.

Hepatocyte Nuclear Factor-4α P2 Promoter Variants Are Associated With the Risk of Metabolic Syndrome and Testosterone Deficiency in Aging Taiwanese Men

BackgroundHepatocyte nuclear factor-4α (HNF4A) can influence the risk of insulin resistance that is postulated to be an important link between metabolic syndrome (MetS) and testosterone deficiency (TD) in men. AimTo investigate the relationship between single-nucleotide polymorphisms (SNPs) of HNF4A and the risk of developing MetS and TD in a population of aging Taiwanese men. MethodsA free health screening of men over 40 years of age was conducted in a medical center in Kaohsiung City, Taiwan. All participants underwent a physical examination, answered a questionnaire on demographics and medical history, completed the Androgen Deficiency in The Aging Male questionnaire to assess clinical symptoms of TD, and provided 20-mL whole blood samples for biochemical, hormonal, and genetic evaluation. Main Outcome Measure3 common SNPs (rs11574736, rs1884613, and rs2144908) of HNF4A were selected and identified using a TaqMan 5’ allelic discrimination assay. Results559 men were enrolled for this study (mean age, 55.8± 4.9 years). Prevalence of TD was significantly higher (P = .031) in subjects with MetS (16.8%) than those without MetS (10.1%). In SNP rs1884613 of HNF4A, subjects with the C allele carried a 1.31- and 1.50-times higher risk of developing MetS and TD, respectively, compared to those with the G allele, after adjusting for potential covariates. In addition, subjects with the CC genotype were exposed to a 1.91- and 2.20-times higher risk of developing MetS and TD, respectively, compared to those with the GG genotype. Clinical ImplicationsOur findings may point to the importance of the role played by insulin resistance in the link between MetS and TD. Strength & LimitationsOur current work is the first report with adequate sample size to evaluate the role of genetic variants of HNF4A on the risk of both MetS and TD in men. The limitations included subjects enrolled from a free health screening and single measurement of serum testosterone levels. ConclusionThe rs1884613 SNP marker of HNF4A is significantly associated with an increased risk for developing both MetS and TD in aging Taiwanese men. Further population-based studies utilizing larger samples of different ethnicities may be needed to confirm these preliminary results.Liu C-C, Lee Y-C, Hung S-P. Hepatocyte Nuclear Factor-4α P2 Promoter Variants Are Associated With the Risk of Metabolic Syndrome and Testosterone Deficiency in Aging Taiwanese Men. J Sex Med 2018;15:1527–1536.

Testosterone in renal transplant patients: effect on body composition and clinical parameters.

Clinical studies have demonstrated that, after renal transplantation (TX), testosterone deficiency (TD) at the time of the procedure is independently associated with lower survival of the patient and graft. However, data between TD and the functional CAG polymorphism of the androgen receptor promoter (AR) are discordant. We investigated the prevalence of TD and its association with body composition, biochemical parameters, the Aging Males' Symptoms rating scale (AMS) domains and AR polymorphism. In 112 TX patients, we assessed the AMS, biochemical/hormonal (FSH/LH/TT) anthropometric/bioimpedance analysis parameters, and AR CAG polymorphism of AR by gene sequencing. Median values of total testosterone (TT) were 340ng/dl and 52% of TX patients were affected by TD. Significant correlations between TT and FSH and FSH and LH (p = 0.005, p < 0.0001, respectively) were found. TD patients had lower estimated glomerular filtration rate (eGFR) and hemoglobin (Hb) (p = 0.034, p = 0.022 respectively) and showed higher values of C-reactive protein (p = 0.023) and fat tissue index/adipose tissue mass (p = 0.034 and p = 0.021, respectively), and lower values of serum albumin (p = 0.003) and high-density lipoprotein-cholesterol (p = 0.038) levels. Significant differences were found in the number of patients on mammalian target of rapamycin inhibitors immunosuppressant therapy (p = 0.045). Logistic regression analysis did not show any correlation between age, AMS scores, TT or CAG repeat length, gonadotropins, time of the transplant, and dialysis. Our results suggest that in TX recipients an appropriate sexual hormonal evaluation should be performed, as we found a high prevalence of TD. However, further studies are needed to clarify the association between TD and patient and graft survival.

MP91-08 COMBINATION OF METABOLIC SYNDROME COMPONENTS TO PREDICT TESTOSTERONE DEFICIENCY IN MEN

You have accessJournal of UrologySexual Function/Dysfunction: Medical, Hormonal & Non-surgical Therapy I1 Apr 2017MP91-08 COMBINATION OF METABOLIC SYNDROME COMPONENTS TO PREDICT TESTOSTERONE DEFICIENCY IN MEN Eduardo P Miranda, Carina Oliveira, Evanilda Carvalho, Alessandra Rabelo, Aline Xavier, Ricardo Tiraboschi, Victor Paschoalin, Jose Murillo Bastos-Netto, Cristiano Gomes, and Jose Bessa Junior Eduardo P MirandaEduardo P Miranda More articles by this author , Carina OliveiraCarina Oliveira More articles by this author , Evanilda CarvalhoEvanilda Carvalho More articles by this author , Alessandra RabeloAlessandra Rabelo More articles by this author , Aline XavierAline Xavier More articles by this author , Ricardo TiraboschiRicardo Tiraboschi More articles by this author , Victor PaschoalinVictor Paschoalin More articles by this author , Jose Murillo Bastos-NettoJose Murillo Bastos-Netto More articles by this author , Cristiano GomesCristiano Gomes More articles by this author , and Jose Bessa JuniorJose Bessa Junior More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2848AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Studies have demonstrated that metabolic syndrome (MetS) is associated with low testosterone (T) levels. However the incremental effect of every MetS component in predicting testosterone deficiency (TD) has not been well explored in the literature. The primary goal of this study was to investigate the association of MetS and low T levels in men from 40 to 80 years of age, while investigating the cumulative effect of the syndrome components METHODS We reviewed records of all men who presented to our men's health clinic from January 2014 to August 2016. We evaluated age, presence of hypertension, waist circumference (WC), blood glucose level and the serum lipid profile (HDL and triglycerides - TGL), and MetS was considered present when 3 or more factors were present. TD was defined as serum total T <300 ng/dL. Univariable analyses were performed to assess the association variables and T levels. ROC curves analyses were performed to evaluate diagnostic accuracy of each MetS component in predicting TD. RESULTS The study comprised 902 men with a mean age of 57.2 ± 9.85 years. The overall prevalence of low T levels was 23.4% and it was similar across all age subgroups: age 40-49 years (y) 22.7%, 50-59y 23.1%, 60-69y 23.8%, and 70-79y 24.4%, p=0.25. The diagnosis of MetS was established in 27.9% of subjects and was associated with TD (OR=3.1, 95%CI 1.2-4.0, p<0.001). The prevalence of each MetS components was: hypertension = 43.6%, increased WC (>102) = 34.5%%, elevated glucose levels (>100 ng/dl) =33,8%, low HDL (< 40 mg/dL) = 25%, and high TGL (> 150 mg/dL) = 53.2%. Median T levels for patients with 5 MetS components was 293 ± 147 ng/dL, 4 = 306 ± 173 ng/dL, 3 = 356 ± 154 ng/dL, 2 = 387 ± 184 ng/dL, 1 = 421 ± 215 ng/dL, 0 = 460 ± 222 ng/dL. Accordingly, TD prevalence for subjects with none MetS components was 9.6%, 1 = 15.4%, 2 = 24%, 3 = 29%, 4= 48%, and 5= 52%. Increased WC was the most accurate predictor of TD in our population. The overall accuracy estimates by area under ROC curve was 0.716(0.686-0.745)95%CI. Diagnostic accuracy measurements of cumulative MetS components are demonstrated in Table 1. CONCLUSIONS There is an increased prevalence of TD with increasing number of MetS components. WC was the best predictor of TD in our population and age was not associated with lower T levels © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1221 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Eduardo P Miranda More articles by this author Carina Oliveira More articles by this author Evanilda Carvalho More articles by this author Alessandra Rabelo More articles by this author Aline Xavier More articles by this author Ricardo Tiraboschi More articles by this author Victor Paschoalin More articles by this author Jose Murillo Bastos-Netto More articles by this author Cristiano Gomes More articles by this author Jose Bessa Junior More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Prevalence of testosterone deficiency in HIV-infected men under antiretroviral therapy.

BackgroundThe prevalence of hypogonadism in HIV-infected patients is still a matter of debate as there is no standardized consensual diagnostic method. In addition, the etiology and endocrine/metabolic implications of hypogonadism in this population remain controversial. This study aims to determine the prevalence of testosterone deficiency in a single-site hospital and to evaluate its association with potential risk factors, lipodystrophy, metabolic syndrome, and cardiovascular risk.MethodsThis study analyzed 245 HIV-infected men on combined antiretroviral therapy. Patients with low total testosterone (TT) levels (<2.8 ng/mL) and/or low calculated free testosterone (FT) levels (<6.5 ng/dL) were considered testosterone deficient. According to their LH and FSH levels, patients were classified as having hypogonadotropic or hypergonadotropic dysfunction. Other clinical, anthropometric, and analytic parameters were also collected and analyzed.ResultsThe prevalence of testosterone deficiency in our population was 29.4 %. Among them, 56.9 % had hypogonadotropic dysfunction and 43.1 % presented with hypergonadotropic dysfunction. Patients with testosterone deficiency were older (p < 0.001), had higher HbA1c levels (p = 0.016) and higher systolic blood pressure (p = 0.007). Patients with lower testosterone levels had higher prevalence of isolated central fat accumulation (p = 0.015) and had higher median cardiovascular risk at 10 years as measured by the Framingham Risk Score (p = 0.004) and 10-Year ASCVD risk (p = 0.002).ConclusionsThe prevalence of testosterone deficiency in this HIV population is high, with hypogonadotropic dysfunction being responsible for the majority of cases. Testosterone deficiency might predispose to, or be involved, in the pathogenesis of HIV-associated lipodystrophy. Patients with low testosterone levels have higher cardiovascular risk, highlighting the importance of early diagnosis of this condition.

MP47-06 CHARACTERISTICS OF SECONDARY, PRIMARY, AND COMPENSATED HYPOGONADISM IN CAUCASIAN-EUROPEAN MEN PRESENTING FOR NEW ONSET ERECTILE DYSFUNCTION - RESULTS OF A CROSS-SECTIONAL SURVEY

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation1 Apr 2016MP47-06 CHARACTERISTICS OF SECONDARY, PRIMARY, AND COMPENSATED HYPOGONADISM IN CAUCASIAN-EUROPEAN MEN PRESENTING FOR NEW ONSET ERECTILE DYSFUNCTION - RESULTS OF A CROSS-SECTIONAL SURVEY Eugenio Ventimiglia, Paolo Capogrosso, Luca Boeri, Andrea Russo, Silvia Ippolito, Donatella Moretti, Roberta Scano, Rayan Matloob, Lina Bua, Luca Villa, Franco Gaboardi, Francesco Montorsi, and Andrea Salonia Eugenio VentimigliaEugenio Ventimiglia More articles by this author , Paolo CapogrossoPaolo Capogrosso More articles by this author , Luca BoeriLuca Boeri More articles by this author , Andrea RussoAndrea Russo More articles by this author , Silvia IppolitoSilvia Ippolito More articles by this author , Donatella MorettiDonatella Moretti More articles by this author , Roberta ScanoRoberta Scano More articles by this author , Rayan MatloobRayan Matloob More articles by this author , Lina BuaLina Bua More articles by this author , Luca VillaLuca Villa More articles by this author , Franco GaboardiFranco Gaboardi More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Andrea SaloniaAndrea Salonia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.325AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES An association between erectile dysfunction (ED) and testosterone deficiency (TD) has been variously described in the literature, with mixed results in terms of effectiveness of the combination therapy for both conditions. We sought whether different forms of hypogonadism can be distinguished among Caucasian-European men presenting for new-onset ED. METHODS Complete demographic, clinical and laboratory data from the last 303 consecutive patients seeking medical help for ED at the same academic outpatient clinic were analyzed. Four groups of individuals were defined according to Tajar et al. (J Clin Endocrinol Metab. 2010;95:1810-8): eugonadal [normal testosterone (T ≥ 3.03 ng/mL) and normal LH (≤9.4 mUI/mL)], secondary (low T and low/normal LH), primary (low T and elevated LH), and compensated (normal T and elevated LH) hypogonadism. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI; categorized 0 vs 1 vs ≥2). Testicular volume was assessed with a Prader orchidometer. Patients were invited to complete both the IPSS and the IIEF questionnaires. Descriptive statistics tested differences among the aforementioned groups. RESULTS Of all, eugonadism, secondary, primary, and compensated hypogonadism were found in 233 (76.4%), 45 (14.8%), 8 (2.6%), and 19 (6.2%) men, respectively. Despite being younger, primary hypogonadal men were the least healthy (CCI defined) group, having higher BMI, waist circumference, IPSS score, and lower IIEF sexual desire score (all p<0.03). Overall, health status, waist circumference, BMI, and CCI worsened according to the defined gonadal status, with a less favorable profile in primary and secondary hypogonadal men as compared to compensated ones (all p<0.01). Among IIEF domains, sexual desire was the only one negatively influenced by the gonadal status (p=0.03); conversely, erectile function domain did not vary significantly among the analyzed groups. Interestingly, LUTS severity (as for IPSS scores) worsened according to the gonadal status (p=0.01). CONCLUSIONS Overall, the prevalence of TD was 23.6% within our cohort of Caucasian-European men presenting for new-onset ED. Clinical, endocrine and metabolic characteristics significantly worsen according to the defined gonadal status. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e628-e629 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Eugenio Ventimiglia More articles by this author Paolo Capogrosso More articles by this author Luca Boeri More articles by this author Andrea Russo More articles by this author Silvia Ippolito More articles by this author Donatella Moretti More articles by this author Roberta Scano More articles by this author Rayan Matloob More articles by this author Lina Bua More articles by this author Luca Villa More articles by this author Franco Gaboardi More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Relationship between Testosterone and Sex Hormone Binding Globulin Concentrations with Cardiometabolic Parameters and Macrovascular Disease in Afro-Caribbean Men with Type 2 Diabetes

Introduction: Low testosterone concentrations have been reported in type 2 diabetes (T2D) and Coronary Artery Disease (CAD). Contrary to diabetes, the prevalence of CAD is lower in Afro-Caribbean (AC) from French West Indies islands than in people from mainland France. However, CAD is a frequent complication of T2D. To evaluate this paradoxical situation, we investigated the prevalence of sex steroids deficiency that might be associated with CAD in AC men with T2D and the relationships with metabolic parameters. Methods: We performed a cross-sectional study in the Department of Diabetology of the University Hospital of Guadeloupe. Clinical and biological data were collected from men with T2D. Total Testosterone (TT) and Sex Hormone Binding Globulin (SHBG) concentrations were measured using electrochemiluminescence and immunoradiometric assays. Results are expressed as mean ± SD or percentages. The data were analyzed using the Mann–Whitney and chi-squared tests, Pearson correlations and logistic regression. P values<0.05 were considered significant. Results: One hundred thirty-three AC men with T2D were included. Prevalence of testosterone deficiency was 43.5%. The mean TT and SHBG concentrations were 12.06 ± 6.24 and 35.9 ± 17.54 nmol/l respectively. Low TT concentrations were more frequently found in obese subjects compared to subjects with normal weight and low SHBG concentrations were high rather in subjects with overweight. Both sex steroids levels were higher in subjects with dyslipidemia than subjects without dyslipidemia. TT deficiency was more frequent in subjects with macrovascular disease including CAD, peripheral artery disease or stroke than subjects without macrovascular disease. Conclusion: Testosterone deficiency and low SHBG concentrations occur frequently in AC men with T2D and are associated with metabolic profile that may promote the development of macrovascular disease. In this population, it may be necessary to systematically apply a testosterone replacement in case of deficiency, to improve cardiometabolic profiles without forget the risk of prostate cancer.

Prevalencia del síndrome de déficit de testosterona entre varones con disfunción sexual: de la sospecha a la realidad. Un estudio descriptivo transversal

ObjectiveThe main objective was to assess the prevalence the testosterone deficiency syndrome (TDS) in males attending conferences included in the campaign «Men change as they age. Over 40 it is time for a check up»” based on sexual signs/symptoms as warning signals. The secondary objective was to assess the relationship of testosterone deficiency with age, obesity, co-morbidities, erectile dysfunction (ED) and symptoms. Results of the pilot study are presented. Material and methodDescriptive, crossover study among men aged≥18 years. Anthropometric, clinical and laboratory data, including total testosterone values, were collected. The ED and TDS symptoms were assessed using the International Index of Erectile Function (IIEF-5) score and the Aging Males’ Symptoms (AMS) scale, respectively. Logistic regression analyses were performed to calculate the odds ratio for testosterone deficiency (total testosterone≤12nmol/L). ResultsA total of 450 men participated in the study. Mean age was 54.3±9.3 years, and ED was present in 53.7%. Prevalence of testosterone deficiency was 19.8%, and that of TDS (biochemical and symptomatic) was 15%. Having obesity or ED doubled the likelihood of testosterone deficiency, while diabetes, depression/anxiety or cardiac disease tripled it. Testosterone deficiency was significantly associated with lower HDL-cholesterol, higher fasting glucose and triglyceride values, higher global and sub-domain AMS scores, and the presence of global and somatic symptoms. Ten out of the 17 AMS symptoms were also more prevalent. ConclusionPrevalence of TDS among men aged ≥30 with a suspicion of sexual dysfunction was 15%. Both TDS and ED were under-diagnosed. Men with testosterone deficiency presented worse health status and more symptoms. Awareness campaigns are needed.

Erectile Dysfunction and Epilepsy: What is the Link?

Testosterone deficiency (TD) imposes a substantial public health burden in the U.S. We modeled the costs associated with TD‐related sequelae including cardiovascular disease (CVD), diabetes mellitus (DM), and osteoporosis‐related fractures (ORFs).To quantify the incremental cost burden imposed by TD's cardiometabolic sequelae.Incidence, prevalence, and mortality of these conditions were collected for men ages 45–74 from six national databases and large cross‐sectional studies. Relative risk (RR) rates were determined for these sequelae in patients with T < 300 ng/dL. The prevalence of TD was determined for this cohort of men.Adjusted incidence and prevalence were determined. Annual costs for the three TD‐related sequelae were inflated at a real rate of 3% for 20 years.Actual and adjusted (normalized for T deficiency) rates of CVD, DM, and ORFs in U.S. men aged 45–74 assuming a TD prevalence of 13.4% were calculated. We determined that, over a 20‐year period, T deficiency is projected to be involved in the development of approximately 1.3 million new cases of CVD, 1.1 million new cases of DM, and over 600,000 ORFs. In year 1, the attributed cost burden of these diseases was approximately $8.4 billion. Over the entire 20‐year period, T deficiency may be directly responsible for approximately $190–$525 billion in inflation‐adjusted U.S. health care expenditures.TD may be a significant contributor to adverse public health. Further study is needed to definitively describe the whether TD is a modifiable risk factor for CVD, DM, and ORFs. This may represent an opportunity for nationwide public health initiatives aimed at preventive care. Moskovic DJ, Araujo AB, Lipshultz LI, and Khera M. The 20‐year public health impact and direct cost of testosterone deficiency in U.S. men. J Sex Med **;**:**–**.

The 20-Year Public Health Impact and Direct Cost of Testosterone Deficiency in U.S. Men

Testosterone deficiency (TD) imposes a substantial public health burden in the U.S. We modeled the costs associated with TD-related sequelae including cardiovascular disease (CVD), diabetes mellitus (DM), and osteoporosis-related fractures (ORFs). To quantify the incremental cost burden imposed by TD's cardiometabolic sequelae. Incidence, prevalence, and mortality of these conditions were collected for men ages 45-74 from six national databases and large cross-sectional studies. Relative risk (RR) rates were determined for these sequelae in patients with T < 300 ng/dL. The prevalence of TD was determined for this cohort of men. Adjusted incidence and prevalence were determined. Annual costs for the three TD-related sequelae were inflated at a real rate of 3% for 20 years. Actual and adjusted (normalized for T deficiency) rates of CVD, DM, and ORFs in U.S. men aged 45-74 assuming a TD prevalence of 13.4% were calculated. We determined that, over a 20-year period, T deficiency is projected to be involved in the development of approximately 1.3 million new cases of CVD, 1.1 million new cases of DM, and over 600,000 ORFs. In year 1, the attributed cost burden of these diseases was approximately $8.4 billion. Over the entire 20-year period, T deficiency may be directly responsible for approximately $190-$525 billion in inflation-adjusted U.S. health care expenditures. TD may be a significant contributor to adverse public health. Further study is needed to definitively describe the whether TD is a modifiable risk factor for CVD, DM, and ORFs. This may represent an opportunity for nationwide public health initiatives aimed at preventive care.

The high prevalence of testosterone deficiency in population of Polish men over 65 years with erectile dysfunctions

Objectives: Erectile dysfunctions (EDs) are in part caused by hormonal causes; but in men over 65 years of age, testosterone deficiency seems to play an important role. However, in population of Polish men over 65 years of age with relative poor health status, the prevalence of testosterone deficiency in patients with ED is unknown. Material and methods: 286 men over 65 years of age with EDs were invited to complete an erectile function questionnaire (IIEF-5), as a diagnostic tool for EDs. Serum total testosterone (TT) levels were measured. Linear regression model was used to analyze the factors that are associated with testosterone deficiency. Results: The prevalence of testosterone deficiency was 17, 33, 42 and 57% for testosterone levels of less than 200, 250, 300 and 350 ng/dL, respectively. Only 47% patients had testosterone levels in the normal range (>350 ng/dL). The degree of ED was significantly higher in men with lowest testosterone levels (p < 0,002), and it was mild in 39.5% of cases, mild-to-moderate in 26.2%, moderate in 18.2% and severe in 16%. There was significant inverse relationship between age and TT (r = −0.3328, p < 0.05), IIEF-5 score and TT (r = −0.3149, p < 0.05) and IIEF-5 score and age (r = −0.3463, p < 0.05). The most common metabolic disorders were: obesity (68% in men with TT levels >350 ng/dL and 91% in men with TT levels <350 ng/dL) and dyslipidemia (54 and 95%, respectively). Obesity, age and hyperlipidemia all correlated with significantly decreased testosterone levels. Impaired fasting glucose did not affect the testosterone levels. Conclusions: Testosterone deficiency was very common in population of Polish men presenting with EDs and correlated negatively with age, obesity and dyslipidemia. These results can be associated with relative poor health status of Polish population.

Testosterone deficiency in male heart failure patients and its effect on endothelial progenitor cells

Background: Endothelial progenitor cells (EPCs) are thought to contribute to reendothelialization and neoangiogenesis. Since it is known that EPCs express a testosterone receptor, we wanted to assess the prevalence of testosterone deficiency in patients with CHF and its impact on circulating EPCs. Methods: 137 male patients with chronic heart failure (CHF) were included (age 61 ± 13 years; BMI 29 ± 5 kg/m2; New York Heart Association classification (NYHA) I: n = 47, NYHA II: n = 51, NYHA III: n = 39). Numbers of different populations of circulating EPCs were quantified using flow cytometry. Levels of free testosterone and EPC-regulating cytokines were determined using ELISA. Results: The prevalence of testosterone deficiency in our University CHF clinic was 39%. However, there was no difference between patients with and without testosterone deficiency regarding their levels of EPCs. Testosterone levels were inversely correlated with age (R2 = −0.32, p = 0.001) and NYHA status (R2 = 0.28, p = 0.001) and correlated with cardiorespiratory capacity (R2 = 0.26, p = 0.03). Conclusion: Testosterone deficiency is frequent in male patients with CHF but does not appear to impact the regenerative EPCs.

Poster 428 Prevalence of Testosterone Deficiency After Spinal Cord Injury

Poster 428 Prevalence of Testosterone Deficiency After Spinal Cord Injury

Prevalence and clinical implications of testosterone deficiency in men with end-stage renal disease

Abnormally low serum testosterone levels were recently associated with an increased mortality risk in male dialysis patients. However, the prevalence of testosterone deficiency in end-stage renal disease (ESRD) is not well defined. We hereby explore the prevalence and correlates of clinical testosterone deficiency in a large cohort of ESRD male patients. Two hundred and sixty ESRD men [median age 59 (25th-75th percentile 48-67) years] were included. Testosterone concentration and testosterone deficiency (<10 nmol/L) were studied in relation to clinically evident cardiovascular disease and markers of inflammation at baseline as well as deaths registered during the following 36 months. Testosterone deficiency was present in 44% of the patients, while 33% showed testosterone insufficiency (10-14 nmol/L), and only 23% had normal testosterone values (>14 nmol/L). Testosterone was strongly and inversely correlated to inflammatory markers (CRP, IL-6 and fibrinogen), even after correction for age and sex hormone-binding globulin. In a crude spline curve, low testosterone concentrations were associated with worse outcome. A clinical condition of testosterone deficiency was independently associated with cardiovascular co-morbidity [odds ratio (OR) 2.51; 95% confidence interval (CI) 1.32-4.76] and death (OR 2.00; 95% CI 1.01-3.97) in logistic regression analyses. Testosterone deficiency is a common finding among male ESRD patients, and it is independently associated with inflammation, cardiovascular co-morbidity and outcome. Future studies are needed to determine the potential adverse effects of male hypogonadism in ESRD and the possibility of improving risk profile, quality of life, and ultimately outcome with testosterone supplementation in these patients.

Prevalence, incidence and risk factors of testosterone deficiency in a population-based cohort of men: results from the study of health in Pomerania

Objective. Low total testosterone levels (TT) have been associated with increased morbidity and mortality. However, the prevalence and incidence of testosterone deficiency (TD) in association with its risk has not been assessed systematically to date.Methods. Data from the prospective population-based Study of Health in Pomerania were used. From the 2117 men aged 20–79 years at baseline, 1490 men with complete TT data were analysed. Crude and age-specific prevalence and incidence rates of TD were estimated by TT levels below the age-specific 10th percentile. Analysis of covariance and Poisson regression models were used to assess the association of socio-demographic characteristics, health-related lifestyle, as well as somatometric, medical and laboratory measures with risk of incident TD.Results. TD baseline prevalence was 10.4% (N = 155) and incidence 11.7 per 1000 person-years. TT levels showed a significant age-related decline with an unadjusted rate of 0.05 nmol/l per year. Obesity, metabolic syndrome, diabetes and dyslipidaemia were identified as risk factors of incident TD. Subpopulations of men without the revealed risk factors at both examinations maintained constant TT levels over time.Conclusions. Besides aging alone, lifestyle and different comorbidities were associated with TT level decline, suggesting that the age-related TT decline may be at least partly prevented through the management of potentially modifiable risk factors and health related behaviour.

ORIGINAL RESEARCH—PEYRONIE'S DISEASE: Testosterone Deficiency and Peyronie's Disease: Pilot Data Suggesting a Significant Relationship

As testosterone (T) has been shown to influence wound healing, and serum T declines in the age group at risk for Peyronie's disease (PD), we explored the possibility that low serum T may be associated with PD. The purpose of this study was to evaluate the relationship between serum T concentrations and features of PD. Medical records were reviewed for 121 consecutive patients with PD seen over a 2-year period. All patients were assessed for sociodemographic data, medical history, comorbid medical conditions, findings on physical examination, and severity of curvature. Laboratory testing included serum concentrations of total testosterone (TT) and free testosterone (FT). Testosterone deficiency (TD) was defined as TT values less than 300 ng/dL and/or FT less than 1.5 ng/dL. Prevalence of TD in men with PD and correlation of TT and FT with severity of curvature and plaque size. Mean patient age was 53.9 +/- 10.6 years (range 28-77). Penile curvature was 50.2 +/- 23.6 degrees (range 10-120). Mean TT was 411.6 +/- 203.6 ng/dL (range 69-877), and mean FT was 1.12 +/- 0.58 ng/dL (range 0.13-5.06). Low T was identified in 29.5% by TT alone and in 74.4% overall. Severity of curvature was greater for men with TD compared with men with normal T (54.3 vs. 37.1 degrees, P = 0.006). Men with low FT had greater penile curvature than men with normal FT (37.5 vs. 55.9 degrees, respectively, P = 0.003). Severity of penile curvature correlated significantly with FT (r = -0.314, P = 0.016) and estradiol/T (r = 0.476, P = 0.0001) but not TT (r = -0.199, P = 0.138). This pilot study suggests a possibly important relationship between low T and PD. Further prospective studies are needed to confirm this relationship.