Characteristics of androgen deficiency in late-onset hypogonadism: results from the European Male Aging Study (EMAS)
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CONTEXT: Late-onset hypogonadism (LOH) has been defined as a syndrome in middle-aged and elderly men reporting symptoms in the presence of low testosterone (T). OBJECTIVE: The objective of the study was to seek objective biochemical and end-organ evidence of androgen deficiency in men classified as having LOH according to our previously published criteria. DESIGN, SETTING, AND PARTICIPANTS: The design of the study included cross-sectional data from the European Male Aging Study on 2966 community-dwelling men aged 40-79 years in eight European countries. MAIN OUTCOME MEASURE(S): Waist circumference, body mass index, muscle mass, estimated heel bone mineral density (eBMD), hemoglobin, insulin sensitivity, physical activity, metabolic syndrome, insulin resistance index, and cardiovascular disease were measured. RESULTS: Sixty-three men (2.1%) were classified as having LOH: 36 moderate and 27 severe. They were older and more obese than eugonadal men and had, in proportion to the graded T deficiency, lower muscle mass, eBMD, and hemoglobin, with poorer general health. Both moderate and severe LOH was associated with lower hemoglobin, mid-upper arm circumference, eBMD, physical function (measured by the Short Form-36 questionnaire), slower gait speed and poorer general health. Only men with severe LOH showed significant associations with larger waist circumference (β=1.93 cm; 0.04-3.81), insulin resistance (β=2.81; 1.39-4.23), and the metabolic syndrome (odds ratio 9.94; 2.73-36.22) after adjustments for confounders. Men with low testosterone only (irrespective of symptoms) showed lesser magnitudes of association with the same end points. CONCLUSIONS: LOH is associated with multiple end-organ deficits compatible with androgen deficiency. These data support the existence of a syndrome of LOH in only a minority of aging men, especially those with T below 8 nmol/liter.
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Low testosterone levels are associated with reduced bone mineral density and with increased fracture risk.
“Low testosterone levels are associated with reduced bone mineral density (44) and with increased fracture risk (45).”
From A Perspective on Middle-Aged and Older Men With Functional Hypogonadism: Focus on Holistic Management (2017) · cites this paper as [44]
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- Authors
- Tajar, A., Huhtaniemi, I. T., O'Neill, T. W., Finn, J. D., Pye, S. R., Lee, D. M., Bartfai, G., Boonen, S., Casanueva, F. F. F., Forti, G., Giwercman, A., Han, T. S., Kula, K., Labrie, F., Lean, M. E. J., Pendleton, N., Punab, M., Vanderschueren, D., Wu, F. C. W., & the EMAS Group
- Affiliations
- Manchester Academic Health Science Centre (GB)
- Imperial College London (GB)
- KU Leuven (BE)
- Universidade de Santiago de Compostela (ES)
- University of Florence (IT)
- Lund University (SE)
- University College London (GB)
- Medical University of Lodz (PL)
- Université Laval (CA)
- University of Glasgow (GB)
- University of Manchester (GB)
- Tartu University Hospital (EE)
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2012-05
- Volume
- 97
- Issue
- 5
- Pages
- 1508-1516
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W1991614042
- Cited by
- 318
- References
- 43
- Citations by year
- 2026: 11 · 2025: 10 · 2024: 17 · 2023: 22 · 2022: 17 · 2021: 27 · 2020: 20 · 2019: 21 · 2018: 18 · 2017: 29 · 2016: 28 · 2015: 29 · 2014: 34 · 2013: 28 · 2012: 6
- FWCI
- 24.88
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Florence Research (University of Florence) (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion, other-oa)
- RUNA. Repositorio Institucional del Sergas (Servicio Gallego de Salud (SERGAS)) (submittedVersion, other-oa)
- Funders
- Vlaamse regering
- Versus Arthritis
- 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, androgen deficiency, older men, muscle mass, bone mineral density, hemoglobin, insulin resistance, metabolic syndrome, obesity, physical function, walking speed, health-related quality of life
- MeSH terms
- Adult, Aged, Aging, Androgens, Cross-Sectional Studies, Humans, Hypogonadism, Insulin Resistance, Male, Middle Aged, Obesity, Sexual Dysfunction, Physiological, Bone Density, Waist Circumference
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