Characteristics and Predictors of Primary Hypogonadism in Ageing Men: Longitudinal Data from the European Male Ageing Study
http://www.endocrine-abstracts.org/ea/0037/ea0037GP.08.01.htm
Introduction: Primary hypogonadism (PHG, testosterone <10.5 nmol/l and LH >9.5 U/l) without a recognisable cause affects ~2% of community-dwelling middle-aged and older men. We sought to identify the clinical significance of, and risk factors for, this apparently age-related hypogonadal state.
Methods/Design: The European Male Ageing Study (EMAS) is a prospective observational cohort survey of 3.369 community-dwelling men aged 40–79 in eight European countries who underwent follow up assessment an average of 4.3 years later.
Men were classified as
incident (i) PHG (Eugonadal (EUG) at baseline, PHG at follow-up) or
persistent (p) PHG (PHG at baseline and at follow-up),
and were compared to those with pEUG (EUG at baseline and at follow-up).
Differences in clinical and laboratory parameters between the groups and potential risk factors for iPHG were assessed using descriptive statistics and regression models.
Results: Of the 1.996 men comprising the analytical sample, 1.946 (97.5%) had pEUG, 23 (1.15%) had iPHG, 22 (1.10%) pPHG, and 5 (0.25%) reverted to EUG. The incidence of PHG was 0.27%/year.
At baseline, iPHG (compared to pEUG) men were on average 9 years older (P<0.001), more likely to be smokers (OR 5.9 (1.8–18.6); P=0.003) and tended to have more illnesses (OR 2.8 (0.9–8.5); P=0.069). Their baseline total and free T levels were lower, and gonadotropin levels higher than in pEUG men.
Upon transition from EUG to PHG, the characteristics which worsened significantly included erectile dysfunction, walking limitation, haemoglobin, self-rated physical function and frequency of >2 illnesses.
Clinical parameters in iPHG and pPHG at follow-up were in the main similar.
Conclusion: PHG is a relatively rare condition in ageing men. The major risk factors for its development include older age, smoking and chronic illness. PHG in ageing men is characterised by clinical features compatible with both androgen deficiency and deteriorating functional health.
http://www.endocrine-abstracts.org/ea/0037/ea0037GP.08.01.htm
Introduction: Primary hypogonadism (PHG, testosterone <10.5 nmol/l and LH >9.5 U/l) without a recognisable cause affects ~2% of community-dwelling middle-aged and older men. We sought to identify the clinical significance of, and risk factors for, this apparently age-related hypogonadal state.
Methods/Design: The European Male Ageing Study (EMAS) is a prospective observational cohort survey of 3.369 community-dwelling men aged 40–79 in eight European countries who underwent follow up assessment an average of 4.3 years later.
Men were classified as
incident (i) PHG (Eugonadal (EUG) at baseline, PHG at follow-up) or
persistent (p) PHG (PHG at baseline and at follow-up),
and were compared to those with pEUG (EUG at baseline and at follow-up).
Differences in clinical and laboratory parameters between the groups and potential risk factors for iPHG were assessed using descriptive statistics and regression models.
Results: Of the 1.996 men comprising the analytical sample, 1.946 (97.5%) had pEUG, 23 (1.15%) had iPHG, 22 (1.10%) pPHG, and 5 (0.25%) reverted to EUG. The incidence of PHG was 0.27%/year.
At baseline, iPHG (compared to pEUG) men were on average 9 years older (P<0.001), more likely to be smokers (OR 5.9 (1.8–18.6); P=0.003) and tended to have more illnesses (OR 2.8 (0.9–8.5); P=0.069). Their baseline total and free T levels were lower, and gonadotropin levels higher than in pEUG men.
Upon transition from EUG to PHG, the characteristics which worsened significantly included erectile dysfunction, walking limitation, haemoglobin, self-rated physical function and frequency of >2 illnesses.
Clinical parameters in iPHG and pPHG at follow-up were in the main similar.
Conclusion: PHG is a relatively rare condition in ageing men. The major risk factors for its development include older age, smoking and chronic illness. PHG in ageing men is characterised by clinical features compatible with both androgen deficiency and deteriorating functional health.
