Prevalence, incidence and risk factors of testosterone deficiency in a population-based cohort of men: results from the study of health in Pomerania

Häring, R.; Ittermann, Till; Völzke, Henry; Krebs, Alexander; Zygmunt, Marek; Felix, Stephan B.; Grabe, Hans J.; Nauck, Matthias; Wallaschofski, Henri

doi:10.3109/13685538.2010.487553

Cited by 90 publications

(75 citation statements)

References 49 publications

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“…The decline in FT with age is exaggerated by the concurrent rise in SHBG. The magnitude of the observed change in testosterone (K0.1 nmol/l per year) was modest and similar to that in previous longitudinal studies (3,14,30,32).…”

Section: Discussionsupporting

confidence: 67%

“…More recently, longitudinal studies have also confirmed that these findings have fuelled a substantial worldwide increase in testosterone prescription (10,11,12,13). Testosterone decline may not be an inevitable part of ageing, being related to adverse health and lifestyle factors, such as obesity; it may, therefore, be potentially preventable and reversible (5,6,7,14).…”

Section: Introductionmentioning

confidence: 99%

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Age-associated changes in hypothalamic–pituitary–testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing Study

Camacho

Huhtaniemi

O'Neill

et al. 2013

European Journal of Endocrinology

328

232

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Objective: Health and lifestyle factors are associated with variations in serum testosterone levels in ageing men. However, it remains unclear how age-related changes in testosterone may be attenuated by lifestyle modifications. The objective was to investigate the longitudinal relationships between changes in health and lifestyle factors with changes in hormones of the reproductive endocrine axis in ageing men. Design: A longitudinal survey of 2736 community-dwelling men aged 40-79 years at baseline recruited from eight centres across Europe. Follow-up assessment occurred mean (GS.D.) 4.4G0.3 years later. Results: Paired testosterone results were available for 2395 men. Mean (GS.D.) annualised hormone changes were as follows: testosterone K0.1G0.95 nmol/l; free testosterone (FT) K3.83 G16.8 pmol/l; sex hormone-binding globulin (SHBG) 0.56G2.5 nmol/l and LH 0.08G0.57 U/l. Weight loss was associated with a proportional increase, and weight gain a proportional decrease, in testosterone and SHBG. FT showed a curvilinear relationship to weight change; only those who gained or lost R15% of weight showed a significant change (in the same direction as testosterone). Smoking cessation was associated with a greater decline in testosterone than being a non-smoker, which was unrelated to weight change. Changes in number of comorbid conditions or physical activity were not associated with significant alterations in hypothalamic-pituitary-testicular (HPT) axis function. Conclusions: Body weight and lifestyle factors influence HPT axis function in ageing. Weight loss was associated with a rise, and weight gain a fall, in testosterone, FT and SHBG. Weight management appears to be important in maintaining circulating testosterone in ageing men, and obesity-associated changes in HPT axis hormones are reversible following weight reduction.

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Section: Discussionsupporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Age-associated changes in hypothalamic–pituitary–testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing Study

Camacho

Huhtaniemi

O'Neill

et al. 2013

European Journal of Endocrinology

328

232

View full text Add to dashboard Cite

show abstract

“…In prospective studies, the metabolic syndrome predicts low testosterone (Laaksonen et al 2005). Several large prospective studies have shown that weight gain or development of type 2 diabetes is major drivers of the age-related decline in testosterone levels (Travison et al 2007, Haring et al 2010. Indeed, there is increasing evidence that healthy ageing by itself is generally not associated with marked reductions in testosterone (Sartorius et al 2012).…”

Section: Evidence That Low Testosterone Is a Consequence Of Dysglycaementioning

confidence: 99%

“…This is supported by observational studies showing that weight gain and development of diabetes accelerate the age-related decline in testosterone. This suggests that this decline may be decelerated through management of health and lifestyle factors (Travison et al 2007, Haring et al 2010.…”

Section: Testosterone and Insulin Resistance: A Bilateral Relationshipmentioning

confidence: 99%

Testosterone and glucose metabolism in men: current concepts and controversies

Grossmann¹

2013

Journal of Endocrinology

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A wealth of observational studies show that low testosterone is associated with insulin resistance and with an increased risk of diabetes and the metabolic syndrome. Experimental studies have identified potential mechanisms by which low testosterone may lead to insulin resistance. Visceral adipose tissue is an important intermediate in this relationship. Actions of testosterone or its metabolite oestradiol on other tissues such as muscle, liver, bone or the brain, and body composition-independent effects may also play a role. However, definitive evidence from randomised controlled trials (RCTs) to clarify whether the association of low testosterone with disordered glucose metabolism is causative is currently lacking. It therefore remains possible that this association is due to reverse causation, or simply originates by association with common health and lifestyle factors. RCTs of testosterone therapy in men with or without diabetes consistently show modest metabolically favourable changes in body composition. Despite this, testosterone effects on glucose metabolism have been inconsistent. Recent evidence suggests that the hypothalamic-pituitary-testicular axis suppression in the majority of obese men with metabolic disorders is functional, and may be, at least in part, reversible with weight loss. Until further evidence is available, lifestyle measures with emphasis on weight reduction, treatment of comorbidities and optimisation of diabetic control should remain the first-line treatment in these men. Such measures, if successful, may be sufficient to normalise testosterone levels in men with metabolic disorders, who typically have only modest reductions in circulating testosterone levels.

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“…Based on the findings from various prospective epidemiological studies (Morley et al 1997, Zmuda et al 1997, Harman et al 2001, Feldman et al 2002, Haring et al 2010, it is now well established that total testosterone (TT) concentration shows an age-related decline, with mean serum TT concentration at the age of 75 years being approximately two-thirds of that at age 25 years (Vermeulen et al 1996). Over and above this established age-related decline at the population level, a considerably larger inter-individual variability of TT concentrations can be observed at any age.…”

Section: Journal Of Endocrinology (2012) 215 3-16mentioning

confidence: 99%

Perspectives for metabolomics in testosterone replacement therapy

Häring

2012

Journal of Endocrinology

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Testosterone is the major circulating androgen in men but exhibits an age-related decline in the ageing male. Late-onset hypogonadism or androgen deficiency syndrome (ADS) is a ‘syndromic’ disorder including both a persistent low testosterone serum concentration and major clinical symptoms, including erectile dysfunction, low libido, decreased muscle mass and strength, increased body fat, decreased vitality or depressed mood. Given its unspecific symptoms, treatment goals and monitoring parameters, this review will outline the various uncertainties concerning the diagnosis, therapy and monitoring of ADS to date. Literature was identified primarily through searches for specific investigators in the PubMed database. No date or language limits were applied in the literature search for the present review. The current state of research, showing that metabolomics is starting to have an impact not only on disease diagnosis and prognosis but also on drug treatment efficacy and safety monitoring, will be presented, and the application of metabolomics to improve the clinical management of ADS will be discussed. Finally, the scientific opportunities presented by metabolomics and other -omics as novel and promising tools for biomarker discovery and individualised testosterone replacement therapy in men will be explored.

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Prevalence, incidence and risk factors of testosterone deficiency in a population-based cohort of men: results from the study of health in Pomerania

Abstract: Besides aging alone, lifestyle and different comorbidities were associated with TT level decline, suggesting that the age-related TT decline may be at least partly prevented through the management of potentially modifiable risk factors and health related behaviour.

Cited by 90 publications

References 49 publications

Age-associated changes in hypothalamic–pituitary–testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing Study

Age-associated changes in hypothalamic–pituitary–testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing Study

Testosterone and glucose metabolism in men: current concepts and controversies

Perspectives for metabolomics in testosterone replacement therapy

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