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Symptomatic androge...
Symptomatic androgen deficiency develops only when both total and free testosterone decline in obese men who may have incident biochemical secondary hypogonadism : Prospective results from the EMAS
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- Rastrelli, Giulia (author)
- University of Florence
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- O'Neill, Terence W. (author)
- University of Manchester
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- Ahern, Tomas (author)
- University of Manchester
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- Bártfai, György (author)
- University of Szeged
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- Casanueva, Felipe F. (author)
- Carlos III Health Institute,Complejo Hospitalario Universitario de Santiago
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- Forti, Gianni (author)
- University of Florence
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- Keevil, Brian (author)
- University Hospital of South Manchester NHS Foundation Trust
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- Giwercman, Aleksander (author)
- Lund University,Lunds universitet,Reproduktionsmedicin, Malmö,Forskargrupper vid Lunds universitet,Reproductive medicine, Malmö,Lund University Research Groups,Skåne University Hospital
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- Han, Thang S. (author)
- Royal Holloway University of London
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- Slowikowska-Hilczer, Jolanta (author)
- Medical University of Lodz
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- Lean, Michael E.J. (author)
- University of Glasgow
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- Pendleton, Neil (author)
- Manchester Academic Health Science Centre
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- Punab, Margus (author)
- Tartu University Hospital
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- Antonio, Leen (author)
- Catholic University of Leuven
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- Tournoy, Jos (author)
- Catholic University of Leuven
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- Vanderschueren, Dirk (author)
- Catholic University of Leuven
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- Maggi, Mario (author)
- University of Florence
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- Huhtaniemi, Ilpo T. (author)
- Imperial College London
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- Wu, Frederick C.W. (author)
- University of Manchester
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(creator_code:org_t)
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- 2018-07-23
- 2018
- English 11 s.
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In: Clinical Endocrinology. - : Wiley. - 0300-0664. ; 89:4, s. 459-469
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http://dx.doi.org/10...
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Abstract
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- Objective: Limited evidence supports the use of free testosterone (FT) for diagnosing hypogonadism when sex hormone–binding globulin (SHBG) is altered. Low total testosterone (TT) is commonly encountered in obesity where SHBG is typically decreased. We aimed to assess the contribution of FT in improving the diagnosis of symptomatic secondary hypogonadism (SH), identified initially by low total testosterone (TT), and then further differentiated by normal FT (LNSH) or low FT (LLSH). Design: Prospective observational study with a median follow-up of 4.3 years. Patients: Three thousand three hundred sixty-nine community-dwelling men aged 40-79 years from eight European centres. Measurements: Subjects were categorized according to baseline and follow-up biochemical status into persistent eugonadal (referent group; n = 1880), incident LNSH (eugonadism to LNSH; n = 101) and incident LLSH (eugonadism to LLSH; n = 38). Predictors and clinical features associated with the transition from eugonadism to LNSH or LLSH were assessed. Results: The cumulative incidence of LNSH and LLSH over 4.3 years was 4.9% and 1.9%, respectively. Baseline obesity predicted both LNSH and LLSH, but the former occurred more frequently in younger men. LLSH, but not LNSH, was associated with new/worsened sexual symptoms, including low desire [OR = 2.67 (1.27-5.60)], erectile dysfunction [OR = 4.53 (2.05-10.01)] and infrequent morning erections [OR = 3.40 (1.48-7.84)]. Conclusions: These longitudinal data demonstrate the importance of FT in the diagnosis of hypogonadism in obese men with low TT and SHBG. The concurrent fall in TT and FT identifies the minority (27.3%) of men with hypogonadal symptoms, which were not present in the majority developing low TT with normal FT.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Keyword
- androgen deficiency
- free testosterone
- obesity
- secondary hypogonadism
- sex hormone–binding globulin
- sexual symptoms
- total testosterone
Publication and Content Type
- art (subject category)
- ref (subject category)
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Rastrelli, Giuli ...
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O'Neill, Terence ...
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Ahern, Tomas
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Bártfai, György
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Casanueva, Felip ...
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Forti, Gianni
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show more...
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Keevil, Brian
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Giwercman, Aleks ...
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Han, Thang S.
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Slowikowska-Hilc ...
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Lean, Michael E. ...
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Pendleton, Neil
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Punab, Margus
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Antonio, Leen
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Tournoy, Jos
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Vanderschueren, ...
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Maggi, Mario
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Huhtaniemi, Ilpo ...
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Wu, Frederick C. ...
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MEDICAL AND HEAL ...
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Clinical Endocri ...
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Lund University