Longitudinal changes in testosterone over five years in community-dwelling men
Abstract
CONTEXT: There are few population-based studies reporting longitudinal changes in total T, LH, FSH, and SHBG levels, and there is limited information on risk factors for their change. OBJECTIVE: The objective of the study was to examine 5-year changes in serum T, LH, FSH, and SHBG levels among Australian men. DESIGN: The study initially included a randomly selected, community-based cohort of 1588 men age 35 years or older at recruitment (mean age, 54 ± 11 y) with available data at 2 visits. Men on medications known to affect, or with established pathology of, the hypothalamo-pituitary gonadal axis were excluded, leaving 1382 for analysis. RESULTS: Mean baseline and follow-up T levels were 16.2 ± 1.4 and 15.6 ± 1.4 nmol/L, a change of -0.13 nmol/L/y. Annualized T changes were associated with obesity, being unmarried, and smoking at baseline, but not with diabetes, hypertension, or cardiovascular disease. T declined in men who had persistent depression or developed chronic disease, and it increased in men who were married, as compared to unmarried, at both time points. In the multivariate analysis, smoking cessation, development of central obesity (waist ≥ 100 cm), or generalized obesity (body mass index ≥ 30 kg/m(2)) resulted in T decreases of 0.36, 0.25, and 0.20 nmol/L/y, respectively. Quitting smoking, developing obesity, and having persisting depression were inversely related to SHBG change. CONCLUSIONS: An age-related decline in T levels is not inevitable but is largely explained by smoking behavior and intercurrent changes in health status, particularly obesity and depression.
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Testosterone levels exhibit time-, sleep-, and age-dependent circadian variations.
“T levels exhibit time, sleep, and age-dependent circadian variations.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [42]
Despite similar daily patterns, elderly males had significant blunting of peak versus trough testosterone levels, with differences of 61-205 ng/dl compared with 141-354 ng/dl in younger men.
“Despite similar patterns of variation throughout the day, elderly males experienced significant blunting of peak versus trough levels, with differences in high and low values of 61–205 ng/dl (2.1–7.1 nmol/L) compared to 141–354 ng/dl (4.9–12.3 nmol/L) in younger men.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [42]
Early studies comparing young men aged 25-27 with elderly men aged 71 found peak testosterone concentrations from 3-8 AM, extended to 2 PM in elderly men, and trough levels from early afternoon to late evening.
“Early studies comparing young (mean age 25–27 years) versus elderly males (mean age 71 years) demonstrated peak T concentrations in the 3–8 AM time period (extended to 2 PM in elderly males), with trough levels noted in the early afternoon to late evening.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [42]
SHBG, free testosterone, and bioavailable testosterone also show similar circadian variations, with SHBG peaking in the afternoon.
“SHBG, fT, and bioavailable T also exhibit similar circadian variations, with SHBG peaking in the afternoon hours.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [42]
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- Authors
- Shi, Z., Araujo, A. B., Martin, S., O'Loughlin, P., & Wittert, G. A.
- Affiliations
- The University of Adelaide (AU)
- Corresponding author
- Shi, Zumin
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2013-08
- Volume
- 98
- Issue
- 8
- Pages
- 3289-3297
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2137939611
- Cited by
- 165
- References
- 53
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 15 · 2023: 13 · 2022: 19 · 2021: 6 · 2020: 13 · 2019: 10 · 2018: 15 · 2017: 12 · 2016: 17 · 2015: 14 · 2014: 18 · 2013: 2
- FWCI
- 13.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Funders
- Eli Lilly and Company
- Medical Research Council
- National Health and Medical Research Council (627227)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Keywords
- testosterone, longitudinal change, community-dwelling men, luteinizing hormone, follicle-stimulating hormone, sex hormone-binding globulin, hypothalamic-pituitary-gonadal axis, obesity, smoking, smoking cessation, depression, marital status, aging
- MeSH terms
- Adult, Aged, Aging, Blood Glucose, Depression, Glycated Hemoglobin, Humans, Life Style, Longitudinal Studies, Male, Middle Aged, Obesity, Sex Hormone-Binding Globulin, Testosterone, Smoking Cessation
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