Prevalence of testosterone deficiency among aging men with and without morbidities (original) (raw)
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Relative Testosterone Deficiency in Older Men: Clinical Definition and Presentation
Endocrinology and Metabolism Clinics of North America, 2005
The increased longevity observed in many communities worldwide has created a need to foster healthy aging. Devising safe and effective medical approaches that prolong healthy, independent, and enjoyable living is therefore a priority for health care providers. Androgen replacement therapy for older men holds promise in this regard, because systemic levels of testosterone fall by 1% to 2% each year, creating a state of relative (compared with young men) androgen deficiency [1,2]. Furthermore, many aspects of aging resemble features of organic androgen deficiency in younger men in whom testosterone replacement is an accepted therapy and widely regarded as safe, affordable, and effective [3,4] (Table 1). In contrast, androgen replacement therapy in older men remains controversial for numerous reasons [5,6]. First, rigorous data confirming agespecific benefits over potential long-term adverse effects are limited. Second,
European Journal of Endocrinology, 2007
Objective: An age-related decline in serum total and free testosterone concentration may contribute to ill health in men, but limited data are available for men O70 years of age. We sought to determine the distribution and associations of reduced testosterone concentrations in older men. Design: The Health in Men Study is a community-representative prospective cohort investigation of 4263 men aged R70 years. Cross-sectional hormone data from 3645 men were analysed. Methods: Early morning sera were assayed for total testosterone, sex hormone binding globulin (SHBG) and LH. Free testosterone was calculated using the Vermeulen method. Results: Mean (GS.D.) serum total testosterone was 15.4G5.6 nmol/l (444G162 ng/dl), SHBG 42.4G 16.7 nmol/l and free testosterone 278G96 pmol/l (8.01G2.78 ng/dl). Total testosterone correlated with SHBG (Spearman's rZ0.6, P!0.0001). LH and SHBG increased with age (rZ0.2, P!0.0001 for both). Instead of declining, total testosterone increased marginally (rZ0.04, PZ0.007) whilst free testosterone declined with age (rZK0.1, P!0.0001). Free testosterone was inversely correlated with LH (rZK0.1, P!0.0001). In multivariate analyses, increasing age, body mass index (BMI) and LH were associated with lower free testosterone. Conclusions: In men aged 70-89 years, modulation of androgen action may occur via an age-related increase in SHBG and reduction in free testosterone without a decline in total testosterone concentration. Increasing age, BMI and LH are independently associated with lower free testosterone. Further investigation would be required to assess the clinical consequences of low serum free testosterone, particularly in older men in whom total testosterone may be preserved.
Symptoms of testosterone deficiency in early middle aged men
The Aging Male, 2012
Symptoms of testosterone deficiency and concentrations of testosterone (T) and Bioavailable Testosterone (BT) were studied in 35 and 45 year old men. Methods: A questionnaire, was sent to all 35 and 45 year old men in Linköping, Sweden (n=1998). The questionnaire has earlier been used for 55-75 year old men and included demographic data, medical history, different symptoms possibly of testosterone deficiency and the 10 questions from the "ADAM-questionnaire". Totally 200 men randomly selected among the men who answered the questionnaire were asked to give blood samples for analysis of Tand BT-concentrations. Results: A total of 38.7% of the questionnaires were returned and analysed, and 43.5% of the 200 randomly selected men gave blood samples. The older age group reported more symptoms that may be connected to low B and BT and had lower T-and BT-concentrations. Less strong erections and higher alcohol consumption were associated with lower concentrations of BT in 45 year old men. Conclusions: The burden of symptoms possibly related to low T concentrations were higher in 45 years old men, and BT and T were lower. However, due to the low answer frequency and number of blood samples analyzed no general conclusions can be drawn.
Romanian Journal of Diabetes Nutrition and Metabolic Diseases, 2020
Background and aims: Metabolic syndrome (MetS) is one of the critical health concerns. The relationship of low total testosterone and MetS was reported in some studies. However, the association independent of other related component is not fully known. This study performed to evaluate the prevalence rates of MetS among elderly men with and without hypogonadismin and the related association. Material and method: This cross - sectional study was conducted on all 800 male subjects aged 60 years and older. Anthropometric indices, blood pressure, serum total testosterone and serum lipid profile was determined. Iranian National Committee of Obesity criteria were used to define metabolic syndrome. Results: The mean total testosterone of MetS group was significantly lower than that of non-MetS. Total testosterone showed significant inverse associations with triglycerides and waist circumference. The crude odds ratio for Mets between the low and high total testosterone groups was 1.43 which ...
2013
BACKGROUND: The prevalence of the metabolic syndrome (MetS) increases with age. Among other changes, testosterone levels decline with age. The relationship between testosterone levels and MetS components in older subjects has not been clearly defined until today. OBJECTIVES: The aim of this work was to evaluate the relationship between total serum testosterone levels and MetS and its components. METHODS: The working sample consisted of 467 elderly individuals (mean age 75 ± 6 years old, n = 220 men) from Ikaria Island, Greece. MetS was defined according to the NCEP ATPIII criteria. RESULTS: MetS prevalence was 52% in men and 64% in women. Those with MetS had lower testosterone levels; a 10 ng/dl increase in testosterone was associated with a 3% reduction in odds of having MetS in men (95% CI: 0.95-0.99), but not in women. This remained the result after various adjustments had been made, including daily hours of sleep. Testosterone was inversely associated with abnormal waist circumference, highsensitivity C-reactive protein (hs-CRP), insulin, and HDL cholesterol levels in men only. When lipid categories, hs-CRP, BMI, and insulin resistance levels were taken into account, testosterone lost its significance in predicting MetS (p > 0.20), suggesting that these markers possess a mediating effect. CONCLUSIONS: In elderly men, low serum testosterone was associated with MetS. Lipids, BMI, inflammation, and insulin resistance levels seem to explain this relationship, suggesting a potential mediating effect. This finding may support a research hypothesis relating serum testosterone to cardiovascular disease, which requires further research.
Testosterone deficiency: myth, facts, and controversy
The Canadian journal of urology, 2014
Testosterone deficiency (TD) afflicts approximately 30% of men ages 40-79 years, with an increase in prevalence strongly associated with aging and common medical conditions including obesity, diabetes, and hypertension. There appears to be a strong relationship between TD and metabolic syndrome, though the relationship is not certain to be causal. Several studies have suggested that repletion of testosterone in deficient men with these comorbidities may indeed reverse or delay their progression. While testosterone repletion has been largely thought of in a sexual realm, we discuss its potential role in general men's health concerns: metabolic, body composition, and its association with decreased all-cause mortality. Recent guidelines and studies have suggested variable prevalence statistics and expanded uses of testosterone repletion in certain populations with both biochemical and clinical signs of testosterone deficiency. Yet, this is not done without risk. A recent randomized...
Testosterone Supplementation Therapy for Older Men: Potential Benefits and Risks
Journal of the American Geriatrics Society, 2000
Serum testosterone levels decline gradually and progressively with aging in men. Many manifestations associated with aging in men, including muscle atrophy and weakness, osteoporosis, reduced sexual functioning, and increased fat mass, are similar to changes associated with testosterone deficiency in young men. These similarities suggest that testosterone supplementation may prevent or reverse the effects of aging. A MEDLINE search was performed to identify studies of testosterone supplementation therapy in older men. A structured, qualitative review was performed of placebo-controlled trials that included men aged 60 and older and evaluated one or more physical, cognitive, affective, functional, or quality-of-life outcomes. Studies focusing on patients with severe systemic diseases and hormone deficiencies related to specific diseases were excluded.
The Role of Testosterone in the Elderly: What Do We Know?
International Journal of Molecular Sciences, 2022
Testosterone is the most important hormone in male health. Aging is characterized by testosterone deficiency due to decreasing testosterone levels associated with low testicular production, genetic factors, adiposity, and illness. Low testosterone levels in men are associated with sexual dysfunction (low sexual desire, erectile dysfunction), reduced skeletal muscle mass and strength, decreased bone mineral density, increased cardiovascular risk and alterations of the glycometabolic profile. Testosterone replacement therapy (TRT) shows several therapeutic effects while maintaining a good safety profile in hypogonadal men. TRT restores normal levels of serum testosterone in men, increasing libido and energy level and producing beneficial effects on bone density, strength and muscle as well as yielding cardioprotective effects. Nevertheless, TRT could be contraindicated in men with untreated prostate cancer, although poor findings are reported in the literature. In addition, different ...
Testosterone for the aging male; current evidence and recommended practice
Clinical Interventions in Aging, 2008
An international consensus document was recently published and provides guidance on the diagnosis, treatment and monitoring of late-onset hypogonadism (LOH) in men. The diagnosis of LOH requires biochemical and clinical components. Controversy in defi ning the clinical syndrome continues due to the high prevalence of hypogonadal symptoms in the aging male population and the non-specifi c nature of these symptoms. Further controversy surrounds setting a lower limit of normal testosterone, the limitations of the commonly available total testosterone result in assessing some patients and the unavailability of reliable measures of bioavailable or free testosterone for general clinical use. As with any clinical intervention testosterone treatment should be judged on a balance of risk versus benefi t. The traditional benefi ts of testosterone on sexual function, mood, strength and quality of life remain the primary goals of treatment but possible benefi cial effects on other parameters such as bone density, obesity, insulin resistance and angina are emerging and will be reviewed. Potential concerns regarding the effects of testosterone on prostate disease, aggression and polycythaemia will also be addressed. The options available for treatment have increased in recent years with the availability of a number of testosterone preparations which can reliably produce physiological serum concentrations.