Cited by 318Hormonal and reproductive studiesMenopause: Health Impacts and TreatmentsAdrenal Hormones and Disorders

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Characteristics of Androgen Deficiency in Late-Onset Hypogonadism: Results from the European Male Aging Study (EMAS)

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Tajar, Abdelouahid, Huhtaniemi, Ilpo T., O'Neill, Terence W., Finn, Joseph D., Pye, Stephen R., Lee, David M., Bartfai, György, Boonen, Steven, Casanueva, Felipe F. F., Forti, Gianni, Giwercman, Aleksander, Han, Thang S., Kula, Krzysztof, Labrie, Fernand, Lean, Michael E. J., Pendleton, Neil, Punab, Margus, Vanderschueren, Dirk, Wu, Frederick C. W., the EMAS Group·2012·The Journal of Clinical Endocrinology & Metabolism

DOI 10.1210/jc.2011-2513

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Abstract

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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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: Huhtaniemi, Ilpo T.
Pye, Stephen R.
Lee, David M.
Casanueva, Felipe F. F.
Giwercman, Aleksander
Han, Thang S.
Lean, Michael E. J.
Pendleton, Neil
Punab, Margus
Vanderschueren, Dirk
Wu, Frederick C. W.
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
DOI: 10.1210/jc.2011-2513
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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Characteristics of Androgen Deficiency in Late-Onset Hypogonadism: Results from the European Male Aging Study (EMAS)

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