Association of Specific Symptoms and Metabolic Risks with Serum Testosterone in Older Men
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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Some biological functions, such as erectile function, are composite in nature, and in addition to testosterone, endothelial function and psychological factors are equally relevant.
“Some biological functions, like erectile functions are composite in nature, and next to testosterone, endothelial function and psychological factors are equally relevant (2).”
From Onset of effects of testosterone treatment and time span until maximum effects are achieved (2011) · cites this paper as [2]
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- Authors
- Zitzmann, M., Faber, S., & Nieschlag, E.
- Affiliations
- University of Münster (DE)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2006-11-01
- Volume
- 91
- Issue
- 11
- Pages
- 4335-4343
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2067749656
- Cited by
- 552
- References
- 28
- Citations by year
- 2026: 4 · 2025: 15 · 2024: 18 · 2023: 26 · 2022: 18 · 2021: 19 · 2020: 21 · 2019: 20 · 2018: 23 · 2017: 43 · 2016: 28 · 2015: 36 · 2014: 37 · 2013: 25 · 2012: 44
- FWCI
- 20.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- andropause, serum testosterone, older men, psychosomatic symptoms, metabolic risk factors, erectile dysfunction, depression, type 2 diabetes, low libido, androgen levels, symptom clusters, male sexual health
- MeSH terms
- Aged, Aged, 80 and over, Aging, Cross-Sectional Studies, Depression, Humans, Hypogonadism, Male, Middle Aged, Psychophysiologic Disorders, Risk Factors, Testosterone, Cohort Studies, Sexual Dysfunctions, Psychological, Metabolic Syndrome, Andropause
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