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Natural history, risk factors and clinical features of primary hypogonadism in ageing men : Longitudinal Data from the European Male Ageing Study

Ahern, Tomás, (författare)
University of Manchester
Swiecicka, Agnieszka, (författare)
University of Manchester
Eendebak, Robert J A H, (författare)
University of Manchester
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Carter, Emma L., (författare)
University of Manchester
Finn, Joseph D., (författare)
University of Manchester
Pye, Stephen R., (författare)
University of Manchester
O'Neill, Terence W., (författare)
University of Manchester
Antonio, Leen, (författare)
Catholic University of Leuven
Keevil, Brian, (författare)
University Hospital of South Manchester NHS Foundation Trust
Bartfai, György, (författare)
Albert Szent-György Medical University
Casanueva, Felipe F., (författare)
University of Santiago de Compostela
Forti, Gianni, (författare)
University of Florence
Giwercman, Aleksander, (författare)
Forskargrupper vid Lunds universitet, Lund University Research Groups, Lunds universitet, Lund University, Reproduktionsmedicin, Malmö, Reproductive medicine, Malmö
Han, Thang S., (författare)
Royal Holloway University of London
Kula, Krzysztof, (författare)
Medical University of Lodz
Lean, Michael E J, (författare)
University of Glasgow
Pendleton, Neil, (författare)
University of Manchester
Punab, Margus, (författare)
University of Tartu
Rastrelli, Giulia, (författare)
University of Florence
Rutter, Martin K., (författare)
Great Ormond Street Hospital
Vanderschueren, Dirk, (författare)
Catholic University of Leuven
Huhtaniemi, Ilpo T., (författare)
University of Turku
Wu, Frederick C W, (författare)
University of Manchester
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EMAS Study Group (aut)
Ingår i: Clinical Endocrinology. - Wiley-Blackwell. - 0300-0664. ; 85:6, s. 891-901
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
  • Objective: In ageing men, the incidence and clinical significance of testosterone (T) decline accompanied by elevated luteinizing hormone (LH) are unclear. We describe the natural history, risk factors and clinical features associated with the development of biochemical primary hypogonadism (PHG, T < 10·5 nmol/l and LH>9·4U/l) in ageing men. Design, Patients and Measurements: A prospective observational cohort survey of 3,369 community-dwelling men aged 40-79 years, followed up for 4·3 years. Men were classified as incident (i) PHG (eugonadal [EUG, T ≥ 10·5 nmol/l] at baseline, PHG at follow-up), persistent (p) PHG (PHG at baseline and follow-up), pEUG (EUG at baseline and follow-up) and reversed (r) PHG (PHG at baseline, EUG at follow-up). Predictors and changes in clinical features associated with the development of PHG were analysed by regression models. Results: Of 1,991 men comprising the analytical sample, 97·5% had pEUG, 1·1% iPHG, 1·1% pPHG and 0·3% rPHG. The incidence of PHG was 0·2%/year. Higher age (>70 years) [OR 12·48 (1·27-122·13), P = 0·030] and chronic illnesses [OR 4·24 (1·08-16·56); P = 0·038] predicted iPHG. Upon transition from EUG to PHG, erectile function, physical vigour and haemoglobin worsened significantly. Men with pPHG had decreased morning erections, sexual thoughts and haemoglobin with increased insulin resistance. Conclusions: Primary testicular failure in men is uncommon and predicted by old age and chronic illness. Some clinical features attributable to androgen deficiency, but not others, accompanied the T decline in men who developed biochemical PHG. Whether androgen replacement can improve sexual and/or physical function in elderly men with PHG merits further study.


MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Obstetrics, Gynecology and Reproductive Medicine (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

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