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Late-onset hypogonadism and mortality in aging men
S R Pye1, I T Huhtaniemi, J D Finn
1Andrology Research Unit (S.R.P., J.D.F., F.C.W.W.) and Manchester Diabetes Centre (M.K.R.), The University of Manchester, and Arthritis Research UK Epidemiology Unit (S.R.P., D.M.L., T.W.O., A.T.), Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9WL, United Kingdom; Department of Surgery and Cancer (I.T.H.), Imperial College London, Hammersmith Campus, London W12 ONN, United Kingdom; Department of Obstetrics, Gynaecology, and Andrology (G.B.), Albert Szent-György Medical University, H-6721 Szeged, Hungary; Departments of Geriatric Medicine (S.B.) and Andrology and Endocrinology (D.V.), Catholic University of Leuven, Leuven B-3000, Belgium; Department of Medicine (F.F.C.), Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, and Centro de Investigación Biomédica en Red de Fisiopatologia Obesidad y Nutricion (CB06/03), Instituto Salud Carlos III, 15705 Santiago de Compostela, Spain; Endocrinology Unit (G.F.), Department of Clinical Physiopathology, University of Florence, 50121 Florence, Italy; Reproductive Medicine Centre (A.G.), Skåne University Hospital, University of Lund, SE-22 184 Lund, Sweden; Department of Endocrinology (T.S.H.), University College London, London W1T 3AA, United Kingdom; Department of Andrology and Reproductive Endocrinology (K.K.), Medical University of Łódź, 90-419 Łódź, Poland; Department of Human Nutrition (M.E.L.), University of Glasgow, Glasgow G12 8TA, United Kingdom; School of Community-Based Medicine (N.P.), University of Manchester, Salford Royal National Health Service Trust, Salford M6 8HD, United Kingdom; and Andrology Unit (M.P.), United Laboratories of Tartu University Clinics, 51014 Tartu, Estonia.
Severe late-onset hypogonadism (LOH) significantly increases mortality risk in aging men. Detecting low testosterone (T) and sexual symptoms can identify high-risk individuals.
Area of Science:
- Endocrinology
- Gerontology
- Public Health
Background:
- Late-onset hypogonadism (LOH) is defined as a syndrome in middle-aged and elderly men with sexual symptoms and low testosterone (T).
- The relationship between LOH and mortality has not been previously established.
Purpose of the Study:
- To investigate the association between LOH, low T, sexual symptoms, and mortality in men.
Main Methods:
- Prospective data from the European Male Aging Study (EMAS) included 2599 men aged 40-79 years.
- Mortality (all-cause, cardiovascular, cancer-related) was assessed over a median follow-up of 4.3 years.
- Statistical adjustments were made for age, center, BMI, smoking, and general health.
Main Results:
- Severe LOH was associated with a 5-fold increased risk of all-cause mortality.
- Low testosterone levels (T < 8 nmol/L) were linked to a 2-fold higher mortality risk.
- Three sexual symptoms independently increased mortality risk by 3-fold.
- Similar associations were found for cardiovascular mortality.
Conclusions:
- Severe LOH significantly elevates risks for all-cause and cardiovascular mortality.
- Both testosterone levels and the presence of sexual symptoms independently contribute to mortality risk.
- Identifying men with low T and sexual symptoms can help detect aging men at high risk.
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