This Article Full Text Full Text (PDF) Supplemental Data All Versions of this Article: 91/11/4335    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Zitzmann, M. Articles by Nieschlag, E. Search for Related Content PubMed PubMed Citation Articles by Zitzmann, M. Articles by Nieschlag, E. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Metabolic Syndrome Seniors' Health Hazardous Substances DB TESTOSTERONE Related Collections Male Endocrinology Metabolism

Association of Specific Symptoms and Metabolic Risks with Serum Testosterone in Older Men

Institute of Reproductive Medicine of the University, D-48129 Münster, Germany

Address all correspondence and requests for reprints to: Professor Dr. E. Nieschlag, F.R.C.P., Institute of Reproductive Medicine of the University, Domagkstr. 11, D-48129 Münster, Germany. E-mail: eberhard.nieschlag{at}ukmuenster.de.

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.

This article has been cited by other articles:

				C Wang, E Nieschlag, R Swerdloff, H M Behre, W J Hellstrom, L J Gooren, J M Kaufman, J-J Legros, B Lunenfeld, A Morales, et al. Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations Eur. J. Endocrinol., November 1, 2008; 159(5): 507 - 514. [Full Text] [PDF]

				D. Kurbatov, J. Kuznetsky, and A. Traish Testosterone Improves Erectile Function in Hypogonadal Patients With Venous Leakage J Androl, November 1, 2008; 29(6): 630 - 637. [Abstract] [Full Text] [PDF]

				D. Rice, R. E. Brannigan, R. K. Campbell, S. Fine, L. Jack Jr, J. B. Nelson, and J. Regan-Klich Men's Health, Low Testosterone, and Diabetes: Individualized Treatment and a Multidisciplinary Approach The Diabetes Educator, November 1, 2008; 34(Supplement_5): 97S - 112S. [Abstract] [Full Text] [PDF]

				H. E. MacLean, W. S. M. Chiu, C. Ma, J. F. McManus, R. A. Davey, R. Cameron, A. J. Notini, and J. D. Zajac A floxed allele of the androgen receptor gene causes hyperandrogenization in male mice Physiol Genomics, October 8, 2008; 33(1): 133 - 137. [Abstract] [Full Text] [PDF]

				F. Saad, L. J. Gooren, A. Haider, and A. Yassin A Dose-Response Study of Testosterone on Sexual Dysfunction and Features of the Metabolic Syndrome Using Testosterone Gel and Parenteral Testosterone Undecanoate J Androl, January 1, 2008; 29(1): 102 - 105. [Abstract] [Full Text] [PDF]

				A. B. Araujo, G. R. Esche, V. Kupelian, A. B. O'Donnell, T. G. Travison, R. E. Williams, R. V. Clark, and J. B. McKinlay Prevalence of Symptomatic Androgen Deficiency in Men J. Clin. Endocrinol. Metab., November 1, 2007; 92(11): 4241 - 4247. [Abstract] [Full Text] [PDF]

				M. Zitzmann and E. Nieschlag Androgen Receptor Gene CAG Repeat Length and Body Mass Index Modulate the Safety of Long-Term Intramuscular Testosterone Undecanoate Therapy in Hypogonadal Men J. Clin. Endocrinol. Metab., October 1, 2007; 92(10): 3844 - 3853. [Abstract] [Full Text] [PDF]