Characteristics of androgen deficiency in late-onset hypogonadism: results from the European Male Aging Study (EMAS)

Tajar, A. et al. (2012) Characteristics of androgen deficiency in late-onset hypogonadism: results from the European Male Aging Study (EMAS). Journal of Clinical Endocrinology and Metabolism, 97(5), pp. 1508-1516. (doi:10.1210/jc.2011-2513)

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Publisher's URL: http://dx.doi.org/10.1210/jc.2011-2513

Abstract

<b>Context:</b> Late-onset hypogonadism (LOH) has been defined as a syndrome in middle-aged and elderly men reporting symptoms in the presence of low testosterone (T).<p></p> <b>Objective:</b> The objective of the study was to seek objective biochemical and end-organ evidence of androgen deficiency in men classified as having LOH according to our previously published criteria.<p></p> <b>Design, Setting, and Participants:</b> The design of the study included cross-sectional data from the European Male Aging Study on 2966 community-dwelling men aged 40-79 years in eight European countries.<p></p> <b>Main Outcome Measure(s):</b> Waist circumference, body mass index, muscle mass, estimated heel bone mineral density (eBMD), hemoglobin, insulin sensitivity, physical activity, metabolic syndrome, insulin resistance index, and cardiovascular disease were measured.<p></p> <b>Results:</b> Sixty-three men (2.1%) were classified as having LOH: 36 moderate and 27 severe. They were older and more obese than eugonadal men and had, in proportion to the graded T deficiency, lower muscle mass, eBMD, and hemoglobin, with poorer general health. Both moderate and severe LOH was associated with lower hemoglobin, mid-upper arm circumference, eBMD, physical function (measured by the Short Form-36 questionnaire), slower gait speed and poorer general health. Only men with severe LOH showed significant associations with larger waist circumference (+¦= 1.93cm; 0.04-3.81), insulin resistance (+¦= 2.81; 1.39-4.23), and the metabolic syndrome (odds ratio 9.94; 2.73-36.22) after adjustments for confounders. Men with low testosterone only (irrespective of symptoms) showed lesser magnitudes of association with the same end points.<p></p> <b>Conclusions:</b> LOH is associated with multiple end-organ deficits compatible with androgen deficiency. These data support the existence of a syndrome of LOH in only a minority of aging men, especially those with T below 8 nmol/liter.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lean, Professor Michael
Authors: Tajar, A., Huhtaniemi, I. T., O'Neill, T. W., Finn, J. D., Pye, S. R., Lee, D. M., Bartfai, G., Boonen, S., Casanueva, F. F. F., Forti, G., Giwercman, A., Han, T. S., Kula, K., Labrie, F., Lean, M.E.J., Pendleton, N., Punab, M., Vanderschueren, D., and Wu, F. C. W.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Journal of Clinical Endocrinology and Metabolism
ISSN:0021-972X
ISSN (Online):1945-7197
Published Online:14 March 2012

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