The CATCH checklist to investigate adult‐onset hypogonadism

Abstract

Adult-onset hypogonadism is a syndrome often underdiagnosed, undertreated, or incompletely explored. There are various reasons for this: firstly, undefined age range of men in whom testosterone levels should be investigated and then no definitive serum cutoff point for the diagnosis of hypogonadism; and finally, variable and non-specific signs and symptoms; men and physicians do not pay adequate attention to sexual health. All these factors make the diagnostic criteria for hypogonadism controversial. The evaluation of the clinical features and causes of this syndrome, its link with age, the role of testosterone and other hormone levels, and the presence of any comorbidities are all useful factors in the investigation of this population. The purpose of this manuscript, after an accurate analysis of current literature, is to facilitate the diagnosis of hypogonadism in men through the use of the CATCH acronym and a checklist to offer a practical diagnostic tool for daily clinical practice. A narrative review of the relevant literature regarding the diagnosis of late-onset hypogonadism or adult-onset hypogonadism was performed. PubMed database was used to retrieve articles published on this topic. A useful new acronym CATCH (Clinical features [symptoms] and Causes, Age, Testosterone level, Comorbidities, and Hormones) and a practical checklist to facilitate the evaluation of hypogonadism in aging men were used. The evaluation of the clinical features and causes of hypogonadism, the link with age, the role of Testosterone and other hormones, and the evaluation of comorbidities are important in investigating adult-onset hypogonadism. The CATCH checklist could be helpful for clinicians for an early diagnosis of both hypogonadism and associated comorbidities. We suggest the use of this acronym to advocate the investigation of declining testosterone in aging men.

Low serum testosterone levels and the incidence of chronic kidney disease among male adults: A prospective population‐based study

“…15,16 A recent study suggested that the early diagnosis of both hypogonadism and related comorbidities may be helpful for the patients in terms of changing lifestyle and appropriate treatment. 17 Despite existing strong evidence demonstrating the role of testosterone as a protective hormone on the kidney function in men, there are controversies on the influence of decreased levels of endogenous testosterone on developing CKD in men. 4,7,18 This long term follow-up study aimed to investigate the incidence and hazard ratio of CKD among male adults with low concentrations of testosterone compared to controls with normal concentrations.…”

Association of high circulating testosterone with increased glycaemic variability in type 2 diabetes: A cross‐sectional study in China

“…Given the hypogonadism is widely defined as TT < 12 nmol/L . We therefore compared the difference in SDBG between the low‐and high‐ TT groups divided by TT = 12 nmol/L (low TT group 1.81 ± 0.07, and high TT group 2.13 ± 0.09, P < 0.01).…”

“…First, the sample size of older patients was small (a total of 72 patients aged >60 years), which may have led to unobserved statistical differences in hypoglyc a emia between the groups with different levels of TT. Moreover, considering the sample size was moderate, so we included patients without age criteria, though the testosterone is more affected after 40 years . Second, this cross‐sectional study could not clearly indicate the causality between testosterone levels and glyc a emic variability.…”

“…Naifar et al suggested that low testosterone level played a central role in the development of metabolic syndrome in hypogonadal men . Testosterones (free and total) were modestly reduced in T2D with and without metabolic syndrome and poor blood glucose control could reduce testosterones . Souteiro et al also found that obese men with T2D and prediabetes had lower testosterone level than those with normal glucose tolerance.…”

Borderline‐low testosterone levels are associated with lower left ventricular wall thickness in firefighters: An exploratory analysis

“…To our knowledge, the prevalence of low TT among firefighters has not been investigated, despite several population studies that have demonstrated an association between low testosterone and dysmetabolic conditions, 20 and a high prevalence of obesity, diabetes, and metabolic syndrome in the fire service, which in turn are associated with increased risk of cardiovascular events 1,21‐23 . Thus, we initially sought to determine the prevalence of low testosterone among firefighters, considering their high rates of obesity.…”