Hypogonadism in Men with Chronic Obstructive Pulmonary Disease

Abstract

We recently reported that hypogonadism does not affect respiratory muscle performance and exercise capacity in men with chronic obstructive pulmonary disease (COPD). In COPD, however, the relationship between exercise capacity and quality of life is controversial, making it unreliable to extrapolate about quality of life from exercise data. Accordingly, we determined prevalence and impact of hypogonadism on health-related quality of life in men with COPD. We enrolled 101 stable outpatient men (FEV1 1.34 +/- 0.04 L) older than 54 years; 38 patients were hypogonadal-a prevalence similar to that reported in the general population. The degree of airflow limitation did not predict levels of free testosterone. Quality of life, as quantified by a disease-specific instrument (St. George's Respiratory Questionnaire) and a general-health instrument (Veterans Short Form-36) were equivalent in the hypogonadal and eugonadal groups. Both groups demonstrated large decrements in perceived physical health and smaller decrements in perceived emotional and mental health. No relationship was found between free testosterone level and physical activity, respiratory symptoms, or quality of life. In conclusion, hypogonadism, although common among men older than 54 years with COPD, does not worsen the severity of respiratory symptoms or quality of life.

Endocrinological derangements in COPD

“…has been confirmed by more recent studies [49,76,78]. SEMPLE et al [85] also reported a correlation between the degree of hypercapnia and testosterone.…”

“…This constellation of signs and symptoms has been termed late-onset hypogonadism, symptomatic late-onset hypogonadism, androgen deficiency in the ageing male or andropause [67]. The observation that many men with COPD fit the profile of late-onset hypogonadism [74][75][76] has spurred a flurry of research on the incidence [76][77][78], functional impact [49,76,78] and possible treatment [45] of this abnormality.…”

“…An important contributor to this decline is a decrease in LH (hypogonadotrophic hypogonadism) [82], the most common presentation of late-onset hypogonadism in men with COPD [45,76]. Whether COPD is a ''chronic illness'' that can cause, by itself, hypogonadism is controversial considering that among ambulatory men with COPD severity of lung disease does not predict the hormonal abnormality [76,78]. Also, the number of comorbid conditions in hypogonadal and eugonadal men with COPD is similar [78].…”

“…While the prevalence of hypogonadism seems to be unaffected by severity of COPD when patients are in a stable clinical condition [76,78], acute exacerbations [83] and, possibly, the need for prolonged mechanical ventilation [84], can (further) decrease testosterone.…”

Réhabilitation respiratoire dans la broncho-pneumopathie chronique obstructive (BPCO) : l’androgénothérapie, pourquoi ? Pour qui ? Comment ?

“…[46]. À l'inverse de l'hypogonadisme lié à l'âge, la diminution de la testostéronémie du patient BPCO est, dans la plupart des cas, associée à une diminution de la sécré-tion hypophysaire en luteinizing hormone (LH) et en follicle stimulating hormone (FSH) [42,47]. La sévérité de la BPCO et de l'hypoxie est corrélée aux basses concentrations plasmatiques en LH et FSH [48].…”