Association of specific symptoms and metabolic risks with serum testosterone in older men.

Full Abstract

CONTEXT:
Although attention and concern about health disorders in aging men have been growing, the structure of psychological and somatic complaints of actual patients, not population-based cohorts, has not been elucidated in relation to sex hormone patterns and metabolism.

OBJECTIVE:
The objective of the study was investigation of factors influencing complaint structures in aging male patients.

DESIGN:
This was a cross-sectional cohort study.

SETTING:
The study was conducted in an andrological outpatient department.

PATIENTS:
Subjects included 434 consecutive male patients aged 50-86 yr.

MAIN OUTCOME MEASURES:
The following hypotheses were measured:
1) psychosomatic complaints and metabolic factors in aging male patients are related to sex hormone levels in a symptom-specific manner, and 2) patients form subcohorts.

RESULTS:
A clear-cut threshold for late-onset hypogonadism was not found; rather, prevalence of psychosomatic symptoms and metabolic risk factors accumulated with decreasing androgen levels. For example, androgen-induced prevalence of loss of libido or vigor increased below testosterone concentrations of 15 nmol/liter (P < 0.001), whereas depression and diabetes mellitus type 2 (also in nonobese men) were significantly more present in men with testosterone concentrations below 10 nmol/liter (P < 0.001). Erectile dysfunction was identified as a composite pathology of metabolic risk factors, smoking, and depressivity, whereas only testosterone concentrations below 8 nmol/liter contributed to that symptom (P = 0.003). Cluster analysis revealed aging men to present within three independent groups characterized by psychosomatic complaints, metabolic disorders, and sexual health problems. These subgroups of patients exhibit distinct features in terms of androgen levels, age, and body mass index.

CONCLUSIONS:
There is no evidence that a uniform structure of testosterone concentrations and complaints exists within the cohort of elderly male patients. Rather, in aging male patients, psychosomatic complaints and metabolic risk relate to testosterone in a symptom-specific manner.

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Author information

Author/s: Zitzmann, Michael (M); Faber, Stephanie (S); Nieschlag, Eberhard (E);

Affiliation: Institute of Reproductive Medicine of the University, Domagkstr. 11, D-48129 Münster, Germany.

Journal and publication information

Publication Type: Journal Article

Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab), published in United States. (Language: eng)

Reference: 2006-Nov; vol 91 (issue 11) : pp 4335-43

Dates: Created 2006/11/07; Completed 2007/01/12;

PMID: 16926258, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Aged, 80 and over
Aging - blood; metabolism
Andropause
Cohort Studies
Cross-Sectional Studies
Depression - epidemiology; etiology
Humans

Hypogonadism - blood; epidemiology; metabolism
Male
Metabolic Syndrome X - epidemiology
Middle Aged
Psychophysiologic Disorders - blood; epidemiology
Risk Factors
Sexual Dysfunctions, Psychological - epidemiology
Testosterone - blood

Associated Chemicals: Testosterone (58-22-0)

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