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

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159 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)1508-1516
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Issue number5
Publication statusPublished - May 2012

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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    Tajar, A., Huhtaniemi, I. T., O'Neill, T. W., Finn, J. D., Pye, S. R., Lee, D. M., Bartfai, G., Boonen, S., Casanueva, F. F. F., Forti, G., Giwercman, A., Han, T. S., Kula, K., Labrie, F., Lean, M. E. J., Pendleton, N., Punab, M., Vanderschueren, D., & Wu, F. C. W. (2012). Characteristics of androgen deficiency in Late-onset hypogonadism: Results from the European Male Aging study (emas). Journal of Clinical Endocrinology and Metabolism, 97(5), 1508-1516.