Identification of late-onset hypogonadism in middle-aged and elderly men from a community of China

Abstract

In this study, we investigated the essential criteria for late-onset hypogonadism (LOH) syndrome based on the presence of symptoms associated with low testosterone levels in Han Chinese men. Blood tests for total testosterone (TT) and sex hormone–binding globulin (SHBG) were performed, and the aging male symptoms (AMS) questionnaire was conducted in a randomly selected cohort composed of 944 Chinese men aged 40 to 79 years from nine urban communities. Three sexual symptoms (decreased ability/frequency of sexual activity, decreased number of morning erections, and decreased libido) were confirmed to be related to the total and free testosterone levels. The thresholds for TT were approximately 12.55 nmol l−1 for a decreased ability/frequency to perform sex, 12.55 nmol l−1 for decreased frequency of morning erections, and 14.35 nmol l−1 for decreased sexual desire. The calculated free testosterone (CFT) thresholds for these three sexual symptoms were 281.14, 264.90, and 287.21 pmol l−1, respectively. TT <13.21 nmol l−1 (OR = 1.4, 95%CI: 1.0–1.9, P = 0.037) or CFT <268.89 pmol l−1 (OR = 1.5, 95%CI: 1.1–20, P = 0.020) was associated with an increase in the aforementioned three sexual symptoms. The prevalence of LOH was 9.1% under the criteria, including all three sexual symptoms with TT levels <13.21 nmol l−1 and CFT levels <268.89 pmol l−1. Our results may improve the diagnostic accuracy of LOH in older men.

Reference Ranges and Association of Age and Lifestyle Characteristics with Testosterone, Sex Hormone Binding Globulin, and Luteinizing Hormone among 1166 Western Chinese Men

“…Study exclusion criteria were based on reports from previous studies [ 16 ]. Additionally, criteria for this study are identical to other, ongoing studies in China [ 31 ]; this intentional design will improve our ability to compare results across the entire country in the future. Inclusion criteria were male sex, age between 20–89 years, and residence in one of the communities selected for inclusion in this study.…”

The Epidemiological Characteristics of Late-Onset Hypogonadism in Chinese Middle-Aged and Elderly Men: Two Cross-Sectional Studies in the Same Community

“…The overall prevalence of LOH in the EMAS study population would be 2.1% (1.2% moderate LOH and 0.9% severe LOH) and increased with age from 0.1% to 5.1%. A study ( Liu et al, 2016 ) identified that TT levels <13.21 nmol/L or cFT <268.89 pmol/L were associated with an increase in the three sexual symptoms (decreased ability/frequency of sexual activity, decreased number of morning erections, and decreased libido). The prevalence of LOH was 9.1% under these criteria, including all three sexual symptoms with the aforementioned TT and cFT cutoff.…”

“…However, several studies on LOH in Chinese subjects over the past decade still had some shortcomings. For example, statistical analyses of data were lacking as well as reports on classification of TD ( He et al, 2012 ; Li et al, 2005 ; Liu et al, 2016 ; Sun et al, 2012 ; Wu et al, 2013 ; Zhou et al, 2010 ).…”

Association of Alcohol Consumption with Markers of Prostate Health and Reproductive Hormone Profiles: A Multi-Center Study of 4535 Men in China

“…It is commonly accepted that LUTS in older men are more prevalent than younger men [ 11 ]. With aging, a significant percentage of men develop late-onset hypogonadism (LOH), which is characterized by a deficiency in testosterone levels [ 40 ]. Taken together, higher level of TT and FT in older men may play a protective role for LUTS status in a complex way which is still unclear and need further investigation.…”