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

Abstract

This study sought to investigate late-onset hypogonadism (LOH) in old and middle-aged males in Shanghai communities, using symptom score evaluation systems and measurements of sex hormone levels. One thousand cases of males aged 40-70 years were investigated. The aging male symptoms (AMS) scale and androgen deficiency in aging males (ADAM) questionnaire were used at the beginning of the investigation, followed by measurement of the sex hormone-related factors (total testosterone (TT), free testosterone (fT), sex hormone-binding globulin (SHBG) and bioavailability of testosterone (Bio-T)). There were 977 valid questionnaires. The LOH-positive rates shown by AMS and ADAM were 59.88% and 84.65%, respectively; values increased with the age of the patients. There were 946 results related to sex hormone measurements, which showed the following results: TT was not related to aging (P.0.05); levels of SHBG increased with age; and fT and Bio-T decreased with age. There was a significant difference in fT between LOH-positive and LOH-negative patients, as shown by the ADAM. In summary, TT levels were not related to aging, even though SHBG did increase while fT and Bio-T decreased with aging. Clinically, the diagnosis of LOH cannot be based on serum TT level. Keywords: ADAM; AMS; late-onset of hypogonadism; male aging; old and middle-aged males; survey INTRODUCTIONTestosterone deficiency in elderly males has become a rather interesting and controversial topic. Late-onset hypogonadism (LOH) is a common condition for old and middle-aged males around the world, and it is an acquired state of reduced function in gonads during later life stages. 1-3 The condition is affected by many factors. It can severely impact the life quality of old and middle-aged males, while it also has a negative effect on the functions of many organs and systems. 4 The general consensus is that the partial deficiency in levels of testosterone from gonads leads to the onset of LOH, but the exact pathogenesis and mechanism remain unclear. The diagnosis of LOH is primarily performed through the combination of symptom evaluation and the measurement of serum testosterone. Currently, the aging male symptoms (AMS) scale and the androgen deficiency in aging males (ADAM) questionnaire, because of the high sensitivity, ease of operation and time-saving characteristics, have become well recognized and widely used. The Chinese versions of the two charts have been in use for several years, but there are still no research data on the LOH-positive rates for both charts. Furthermore, epidemiological data on LOH from large community populations are even rarer. In order to understand the prevalence of LOH in old and middle-aged males in Shanghai communities, we initiated a large-sample survey on a community population aged 40-70 years in Shanghai between

Testosterone preserves endothelial function through regulation of S1P1/Akt/FOXO3a signalling pathway in the rat corpus cavernosum

“…Late‐onset hypogonadism (LOH) is a clinical and biochemical state characterised by a low level of serum testosterone (Wu et al, ), and its main symptoms include poor morning erection, libido reduction, ED, depression and fatigue. Testosterone supplementation treatment is an important intervention for LOH (Sun et al, ). Although the role of testosterone in improving libido is well known (Wang et al, ), its exact mechanism of preserving erectile function is still not clear.…”

Late-onset hypogonadism: Current concepts and controversies of pathogenesis, diagnosis and treatment

“…Most of the studies on LOH have been carried out in Europe, USA and Australia, but there are also studies on the diagnosis, prevalence and treatment of LOH form numerous Asian countries (see e.g 891011…”

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

“…However, the prevalence of symptomatic androgen deficiency in Taiwanese men was 12.0% using the criterion of TT <300 ng dl −1 and FT <5 ng dl −1 37. In our previously published work, the incidence of LOH according to the AMS questionnaires (without reference to hormone criteria) was 59.88% 7. Using the new criteria provided in our current study, the prevalence of LOH in 40–79 years old Shanghai men was much lower than previously reported (9.1%).…”