Hormone profiles, body mass index and aging male symptoms: results of the Androx Vienna Municipality study

Abstract

Aging in the male is accompanied by steroid hormonal decline, and men may develop symptoms associated with hypogonadism. Increased awareness of 'andropause' in recent years has led to greater demand for hormonal assessments, resulting in a rising burden for health economics. We conducted a cross-sectional study to define men at risk for hypogonadism, in whom further hormonal investigation should be performed. We examined 664 blue-collar workers aged 40-60 years at their workplace and determined hormonal status and body mass index (BMI). Men with an abnormal urogenital status and those on medication that might affect endocrine status were excluded from the study. All participants completed the validated Aging Male Symptom (AMS) questionnaire and obtained scores for psychological symptoms, somatovegetative symptoms, and sexual symptoms. Multiple logistic regression analyses revealed a significantly increased risk (represented by the odds ratio) of psychological symptoms for men with low levels of testosterone and/or bioavailable testosterone (BAT). Increased BMI as well as low testosterone levels and/or low BAT levels raised the risk of somatovegetative symptoms. Each decrease of BAT by 1 ng/ml caused an approximately 1.8-fold increase of the risk (odds ratio = 1.832, p = 0.005). Additional independent risk factors were increased age and low luteinizing hormone (LH) level. Men aged 55 years with BMI > 28 kg/m2 and with somatovegetative symptoms and moderate or severe psychological symptoms had a 7.2-fold increase in the risk of a BAT level < 1.5 ng/ml compared to men without these risk factors (p < 0.001). Sensitivity and specificity were 75% and 71%, respectively. The AMS score combined with age and BMI provides an easy and convenient method to identify men with probable androgen deficiency who require hormonal assessment.

Survey for late-onset hypogonadism among old and middle-aged males in Shanghai communities

“…It is widely accepted with high authority around the world and has been translated into at least 17 languages. Kratzik et al 10 from Austria studied 664 middle-aged males (40-60 years in age). In that study, the sensitivity and specificity of AMS were 75% and 71%, respectively.…”

Oral testosterone replacement in symptomatic late-onset hypogonadism: effects on rating scales and general safety in a randomized, placebo-controlled study

“…Although the authors stated that it was unclear whether the AMS scale had relevance for diagnosis of LOH, the AMS rating scale became often used and was culturally and linguistically validated in different languages (27). However, most subsequent studies failed to find an association between total AMS score and testosterone levels (28-32), whereas, weak correlations were reported between AMS scale sub-domains (psychological, somatic, sexual) and testosterone levels (32,33). Moreover, the validity of the AMS rating scale as an instrument to measure clinical efficacy is unknown since the tool has not been evaluated in a randomized clinical trial in LOH, although it has been empirically demonstrated in open-label studies of truly hypogonadal men (34,35).…”

Does Late-Onset Hypogonadism Occur by Aging? The Evaluation of IIEF, Ams-Q and Biochemical Parameters

“…[21][22][23][24] We did not find any re la ti ons hip bet we en AMS-Q to tal sco res and total, fre e and bi o a va i lab le tes tos te ro ne le vels (p= 0.95). On the other hand, when we eva lu a ted subgro up sco res, we fo und that se xu al sco res in cre ased while the fre e and bi o a va i lab le tes tos te ro ne levels decreased.…”