Practical consequences of the validation of a mathematical model in assessment of partial androgen deficiency in the aging male using bioavailable testosterone

Tremblay, Roland R.

doi:10.1080/tam.4.1.23.29

Cited by 10 publications

(3 citation statements)

References 17 publications

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“…However, plasma total testosterone might not be the ideal measure for hypogonadism in symptomatic men, since the age-associated increase of the carrier protein SHBG results in increased binding of testosterone. BAT, the testosterone fraction available for bioactivity in aging males, has been proposed as a more accurate marker of hypogonadism 26 . For assessing the prevalence and severity of a variety of symptoms associated with aging in men, the 17-item AMS score is widely used as a validated, standardized, patient-administered instrument.…”

Section: Discussionmentioning

confidence: 99%

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

Kratzik

Riedl

et al. 2004

The Aging Male

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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.

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Section: Discussionmentioning

confidence: 99%

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

Kratzik

Riedl

et al. 2004

The Aging Male

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“…Bioavailable testosterone (BT) was evaluated using the ammonium-sulphate (asBT) method (50% saturation) [4]. The remaining testosterone in the supernatant was directly measured with the DPC method.…”

Section: Methodsmentioning

confidence: 99%

Can we get away from serum total testosterone in the diagnosis of andropause?

Tremblay

Gagné²

2005

DAGM

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Because of its multifactorial origin, andropause is usually considered as a clinical entity whose diagnosis is difficult. Practitioners sometimes distrust the symptoms and the diagnostic tools. The clinical manifestations are however the reflection of a lack of anabolism commonly associated with a decreased production of testosterone which is translated in decreased serum values of total testosterone, bioavailable testosterone and calculated values of testosterone. Because of the similarity between the age of the control group and of andropausal men in this study, the Sex Hormone Binding Globulin dogma postulating a modest increase of the glycoprotein with age is evacuated from the argument and therefore it is proposed to rely on total testosterone as a first line assay to support the diagnosis of andropause; however the presence of confounding factors to the diagnosis sometimes require an easy access to calculated values of free or bioavailable testosterone.

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“…Serum plasma testosterone declines at an average rate of approximately one per cent per year starting around the age of forty. Due to the concomitant increase of sex hormone binding globulin (SHBG), free testosterone levels decrease even more steeply (Vermeulen et al, 1996;Harman et al, 2001;Thorner, 2001;Tremblay, 2001). These changes, however, are highly variable between individuals and they are influenced by general health related factors (Feldman et al, 2002;Schatzl et al, 2003).…”

Section: Introductionmentioning

confidence: 96%

Hypogonadism-related symptoms: development and evaluation of an empirically derived self-rating instrument (HRS ‘Hypogonadism Related Symptom Scale’)

et al. 2009

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While self-report screening instruments are highly sensitive to hypogonadism in the ageing male, they have lacked specificity as evidenced by low or absent correlations with testosterone. The purpose of this paper was to develop an economical and specific screening instrument for identifying hypogonadal ageing men. Based on a comprehensive study of physical, somatoform and affective complaints, sexual behaviour and function and hormonal parameters of 263 outpatients aged 40 years and above (M = 56.2; 40-84 years) recruited from six andrological outpatient departments in Germany, we identified those items correlating significantly with testosterone. By factor analyses, five factors were identified: 'reduced activity', 'dissatisfaction with sexual function', 'negative self-concept of physical fitness', 'reduced sexual desire' and 'hot flushes'. The corresponding scales were reliable and only moderately inter-correlated. Consistent correlations were found with the level of testosterone, ageing male scales (Androgen Deficiency in the Aging Male, Aging Male Survey), specific affective, somatoform and sexual functioning scales and potential determinants of low testosterone (body mass index, physical inactivity, etc.). While further validation is needed, the new Hypogonadism Related Symptoms Scale appears to be a promising hypogonadism screening tool.

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Practical consequences of the validation of a mathematical model in assessment of partial androgen deficiency in the aging male using bioavailable testosterone

Cited by 10 publications

References 17 publications

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

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

Can we get away from serum total testosterone in the diagnosis of andropause?

Hypogonadism-related symptoms: development and evaluation of an empirically derived self-rating instrument (HRS ‘Hypogonadism Related Symptom Scale’)

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