The DOI matches its Crossref record; 40 of the 41 references it cites were found in a registry or an index.
Age-associated changes in hypothalamic-pituitary-testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European male ageing study
Open accessAbstract
OBJECTIVE: Health and lifestyle factors are associated with variations in serum testosterone levels in ageing men. However, it remains unclear how age-related changes in testosterone may be attenuated by lifestyle modifications. The objective was to investigate the longitudinal relationships between changes in health and lifestyle factors with changes in hormones of the reproductive endocrine axis in ageing men. DESIGN: A longitudinal survey of 2736 community-dwelling men aged 40-79 years at baseline recruited from eight centres across Europe. Follow-up assessment occurred mean (±S.D.) 4.4±0.3 years later. RESULTS: Paired testosterone results were available for 2395 men. Mean (±S.D.) annualised hormone changes were as follows: testosterone -0.1±0.95 nmol/l; free testosterone (FT) -3.83±16.8 pmol/l; sex hormone-binding globulin (SHBG) 0.56±2.5 nmol/l and LH 0.08±0.57 U/l. Weight loss was associated with a proportional increase, and weight gain a proportional decrease, in testosterone and SHBG. FT showed a curvilinear relationship to weight change; only those who gained or lost ≥15% of weight showed a significant change (in the same direction as testosterone). Smoking cessation was associated with a greater decline in testosterone than being a non-smoker, which was unrelated to weight change. Changes in number of comorbid conditions or physical activity were not associated with significant alterations in hypothalamic-pituitary-testicular (HPT) axis function. CONCLUSIONS: Body weight and lifestyle factors influence HPT axis function in ageing. Weight loss was associated with a rise, and weight gain a fall, in testosterone, FT and SHBG. Weight management appears to be important in maintaining circulating testosterone in ageing men, and obesity-associated changes in HPT axis hormones are reversible following weight reduction.
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In the citing paper
“Finally, as discussed in more detail in section 5, weight loss, whether by diet or surgery, increases testosterone levels proportional to the amount of weight lost.1934”
From Lowered testosterone in male obesity: Mechanisms, morbidity and management (2014) · cites this paper as [34]
In the citing paper
“The results of the EMAS in 2736 men (mean age 58.4 years), showed that weight loss of minimal 5% of body weight in obese men resulted in a significant increase in total testosterone levels.”
From Treatment of Men with Central Hypogonadism: Alternatives for Testosterone Replacement Therapy (2020) · cites this paper as [20]
In the citing paper
“Only a weight loss of minimal 15% had significant effects on free testosterone levels.”
From Treatment of Men with Central Hypogonadism: Alternatives for Testosterone Replacement Therapy (2020) · cites this paper as [20]
In the citing paper
“Conversely, weight gain was associated with rising testosterone levels [20].”
From Treatment of Men with Central Hypogonadism: Alternatives for Testosterone Replacement Therapy (2020) · cites this paper as [20]
In the citing paper
“Men who quit smoking showed a greater decrease in testosterone levels than non-smokers.”
From Treatment of Men with Central Hypogonadism: Alternatives for Testosterone Replacement Therapy (2020) · cites this paper as [20]
In the citing paper
“Free T concentrations usually range around 1–2% of total T and are also age-dependent in women (Haring et al., 2012) and men (Camacho et al., 2013, Damgaard-Olesen et al., 2016).”
From Intracrine androgen biosynthesis, metabolism and action revisited (2018) · cites this paper as Camacho et al., 2013
In the citing paper
“In men, the decline can be explained by simultaneous age-related reductions of both adrenal and testicular androgen biosynthesis (Beattie et al., 2015, Camacho et al., 2013, Golan et al., 2015, Labrie et al., 1997b).”
From Intracrine androgen biosynthesis, metabolism and action revisited (2018) · cites this paper as Camacho et al., 2013
In the citing paper
“This results in a decline of circulating T concentrations of approximately 0.1 nmol/L per year (Camacho et al., 2013).”
From Intracrine androgen biosynthesis, metabolism and action revisited (2018) · cites this paper as Camacho et al., 2013
In the citing paper
“While exact mechanisms are unknown, the reversal of HPT axis suppression with weight loss 43,46,47 suggests a pathogenic role for excess adipose tissue.”
From Hypogonadism and male obesity: Focus on unresolved questions (2018) · cites this paper as [43]
In the citing paper
“Longitudinal data from EMAS have reported similar findings in older less obese men (mean age 58 years; BMI, 27.6 kg/m2) (22).”
From A Perspective on Middle-Aged and Older Men With Functional Hypogonadism: Focus on Holistic Management (2017) · cites this paper as [22]
In the citing paper
“This weight loss of 5% was associated with an increase in total testosterone [+2 nmol/L (+58 ng/dL)] but not in free testosterone.”
From A Perspective on Middle-Aged and Older Men With Functional Hypogonadism: Focus on Holistic Management (2017) · cites this paper as [22]
In the citing paper
“During 4.4 years, weight loss of 5% was associated a significant linear rise in serum sex hormone–binding globulin, probably because insulin resistance improved (22).”
From A Perspective on Middle-Aged and Older Men With Functional Hypogonadism: Focus on Holistic Management (2017) · cites this paper as [22]
In the citing paper
“Weight loss > 15% was associated with more marked increases in total testosterone [+5.7 nmol/L (+164 ng/dL)], LH (+2.2 IU/L), and free testosterone [+52 pmol/L (+52 pg/mL)] (22).”
From A Perspective on Middle-Aged and Older Men With Functional Hypogonadism: Focus on Holistic Management (2017) · cites this paper as [22]
In the citing paper
“30% of weight loss after bariatric surgery with the increase of total testosterone by 8.7 nmol/L (3, 20, 22)”
From Effects of liraglutide on obesity-associated functional hypogonadism in men (2019) · cites this paper as [22]
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Self-citation
Metadata
- Authors
- Camacho, E. M., Huhtaniemi, I. T., O'Neill, T. W., Finn, J. D., Pye, S. R., Lee, D. M., Tajar, A., Bartfai, G., Boonen, S., Casanueva, F. F., Forti, G., Giwercman, A., Han, T. S., Kula, K., Keevil, B., Lean, M. E., Pendleton, N., Punab, M., Vanderschueren, D., Wu, F. C. W., & _, _.
- Affiliations
- University of Manchester (GB)
- Imperial College London (GB)
- KU Leuven (BE)
- Universidade de Santiago de Compostela (ES)
- University of Florence (IT)
- Skåne University Hospital (SE)
- University College London (GB)
- Medical University of Lodz (PL)
- University of Glasgow (GB)
- Salford Royal NHS Foundation Trust (GB)
- Tartu University Hospital (EE)
- Corresponding author
- Wu, F C W
- ORCID
- Venue
- European Journal of Endocrinology
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-03
- Volume
- 168
- Issue
- 3
- Pages
- 445-455
- ISSN
- 0804-4643 (ISSN-L)
- 1479-683X
- OpenAlex
- W2132200219
- Cited by
- 392
- References
- 41
- Citations by year
- 2026: 16 · 2025: 24 · 2024: 34 · 2023: 30 · 2022: 30 · 2021: 28 · 2020: 32 · 2019: 26 · 2018: 27 · 2017: 34 · 2016: 33 · 2015: 31 · 2014: 31 · 2013: 15
- FWCI
- 28.84
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- Locations
- European Journal of Endocrinology (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)
- RUNA. Repositorio Institucional del Sergas (Servicio Gallego de Salud (SERGAS)) (submittedVersion, other-oa)
- 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
- hypothalamic-pituitary-testicular axis, testosterone, free testosterone, sex hormone-binding globulin, luteinizing hormone, older men, weight change, weight loss, weight gain, obesity, smoking cessation, comorbidities, physical activity, lifestyle factors, European Male Ageing Study
- MeSH terms
- Adult, Aged, Aging, Europe, Follow-Up Studies, Humans, Hypothalamo-Hypophyseal System, Luteinizing Hormone, Life Style, Longitudinal Studies, Male, Middle Aged, Prospective Studies, Sex Hormone-Binding Globulin, Testis, Testosterone, Cohort Studies, Weight Gain, Weight Loss, Smoking Cessation
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