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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 (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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Metadata
- 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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