Characteristics of androgen deficiency in Late-onset hypogonadism: Results from the European Male Aging study (emas)

Abdelouahid Tajar, Ilpo T. Huhtaniemi, Terence W. O'Neill, Joseph D. Finn, Stephen R. Pye, David M. Lee, Gyorgy Bartfai, Steven Boonen, Felipe F F Casanueva, Gianni Forti, Aleksander Giwercman, Thang S. Han, Krzysztof Kula, Fernand Labrie, Michael E J Lean, Neil Pendleton, Margus Punab, Dirk Vanderschueren, Frederick C W Wu, C Pott (Collaborator)E Wouters (Collaborator), M Nilsson (Collaborator), M del Mar Fernandez (Collaborator), M Jedrzejowska (Collaborator), H-M Tabo (Collaborator), A Heredi (Collaborator), C Moseley (Collaborator), Luisa Petrone (Collaborator), Giovanni Corona (Collaborator), Herman Borghs (Collaborator), Jolanta Slowikowska-Hilczer (Collaborator), Renata Walczak-Jedrzejowska (Collaborator), Alan Silman (Collaborator), Philip Steer (Collaborator), Mary Lage (Collaborator), Ana I Castro (Collaborator), Imre Földesi (Collaborator), Imre Fejes (Collaborator), Paul Korrovitz (Collaborator), Min Jiang (Collaborator)

Research output: Contribution to journalArticlepeer-review


Context: Late-onset hypogonadism (LOH) has been defined as a syndrome in middle-aged and elderly men reporting symptoms in the presence of low testosterone (T). Objective: The objective of the study was to seek objective biochemical and end-organ evidence of androgen deficiency in men classified as having LOH according to our previously published criteria. Design, Setting, and Participants: The design of the study included cross-sectional data from the European Male Aging Study on 2966 community-dwelling men aged 40-79years in eight European countries. Main Outcome Measure(s): Waist circumference, body mass index, muscle mass, estimated heel bone mineral density (eBMD), hemoglobin, insulin sensitivity, physical activity, metabolic syndrome, insulin resistance index, and cardiovascular disease were measured. Results: Sixty-three men (2.1%) were classified as having LOH:36 moderate and 27 severe. They were older and more obese than eugonadal men and had, in proportion to the graded T deficiency, lower muscle mass, eBMD, and hemoglobin, with poorer general health. Both moderate and severe LOH was associated with lower hemoglobin, mid-upper arm circumference, eBMD, physical function (measured by the Short Form-36 questionnaire), slower gait speed and poorer general health. Only men with severe LOH showed significant associations with larger waist circumference (β= 1.93cm; 0.04-3.81), insulin resistance (β= 2.81; 1.39-4.23), and the metabolic syndrome (odds ratio 9.94; 2.73-36.22) after adjustments for confounders. Men with low testosterone only (irrespective of symptoms) showed lesser magnitudes of association with the same end points. Conclusions: LOH is associated with multiple end-organ deficits compatible with androgen deficiency. These data support the existence of a syndrome of LOH in only a minority of aging men, especially those with T below 8 nmol/liter. Copyright © 2012 by The Endocrine Society.
Original languageEnglish
Pages (from-to)1508-1516
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Issue number5
Publication statusPublished - May 2012


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