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Late-Onset Hypogonadism and Mortality in Aging Men

Open access
Pye, S. R., Huhtaniemi, I. T., Finn, J. D., Lee, D. M., O'Neill, T. W., Tajar, A., Bartfai, G., Boonen, S., Casanueva, F. F., Forti, G., Giwercman, A., Han, T. S., Kula, K., Lean, M. E., Pendleton, N., Punab, M., Rutter, M. K., Vanderschueren, D., Wu, F. C. W., the EMAS Study Group·2014·The Journal of Clinical Endocrinology & Metabolism

Abstract

CONTEXT: Late-onset hypogonadism (LOH) has recently been defined as a syndrome in middle-aged and elderly men reporting sexual symptoms in the presence of low T. The natural history of LOH, especially its relationship to mortality, is currently unknown. OBJECTIVE: The aim of this study was to clarify the associations between LOH, low T, and sexual symptoms with mortality in men. DESIGN, SETTING, AND PARTICIPANTS: Prospective data from the European Male Aging Study (EMAS) on 2599 community-dwelling men aged 40-79 years in eight European countries was used for this study. MAIN OUTCOME MEASURE(S): All-cause, cardiovascular, and cancer-related mortality was measured. RESULTS: One hundred forty-seven men died during a median follow-up of 4.3 years. Fifty-five men (2.1%) were identified as having LOH (31 moderate and 24 severe). After adjusting for age, center, body mass index (BMI), current smoking, and poor general health, compared with men without LOH, those with severe LOH had a 5-fold [hazard ratio (HR) 5.5; 95% confidence interval (CI) 2.7, 11.4] higher risk of all-cause mortality. Compared with eugonadal men, the multivariable-adjusted risk of mortality was 2-fold higher in those with T less than 8 nmol/L (irrespective of symptoms; HR 2.3; 95% CI 1.2, 4.2) and 3-fold higher in those with three sexual symptoms (irrespective of serum T; compared with asymptomatic men; HR 3.2; 95% CI 1.8, 5.8). Similar risks were observed for cardiovascular mortality. CONCLUSIONS: Severe LOH is associated with substantially higher risks of all-cause and cardiovascular mortality, to which both the level of T and the presence of sexual symptoms contribute independently. Detecting low T in men presenting with sexual symptoms offers an opportunity to identify a small subgroup of aging men at particularly high risk of dying.

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Metadata

Authors
Pye, S. R., Huhtaniemi, I. T., Finn, J. D., Lee, D. M., O'Neill, T. W., Tajar, A., Bartfai, G., Boonen, S., Casanueva, F. F., Forti, G., Giwercman, A., Han, T. S., Kula, K., Lean, M. E., Pendleton, N., Punab, M., Rutter, M. K., Vanderschueren, D., Wu, F. C. W., & the EMAS Study Group
Venue
The Journal of Clinical Endocrinology & Metabolism
Published
2014-04-01
Volume
99
Issue
4
Pages
1357-1366
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
OpenAlex
W2000380456
Cited by
201
References
14
FWCI
17.22
Type
journal article
Language
en
Open access
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Pye, S. R., Huhtaniemi, I. T., Finn, J. D., Lee, D. M., O'Neill, T. W., Tajar, A., Bartfai, G., Boonen, S., Casanueva, F. F., Forti, G., Giwercman, A., Han, T. S., Kula, K., Lean, M. E., Pendleton, N., Punab, M., Rutter, M. K., Vanderschueren, D., Wu, F. C. W., & the EMAS Study Group. (2014). Late-Onset Hypogonadism and Mortality in Aging Men. The Journal of Clinical Endocrinology & Metabolism. https://doi.org/10.1210/jc.2013-2052

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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