Late-onset hypogonadism and mortality in aging men

S. R. Pye, I. T. Huhtaniemi, J. D. Finn, D. M. Lee, T. W. O'Neill, A. Tajar, G. Bártfai, S. Boonen, F. F. Casanueva, G. Forti, A. Giwercman, T. S. Han, K. Kula, M. E. Lean, N. Pendleton, M. Punab, M. K. Rutter, D. Vanderschueren, F. C W Wu

Research output: Contribution to journalArticle

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Abstract

Context: Late-onset hypogonadism (LOH) has recently been defined as a syndrome in middle-aged and elderly men reporting sexual symptoms in the presence of low T. The natural history of LOH, especially its relationship to mortality, is currently unknown. Objective: The aim of this study was to clarify the associations between LOH, low T, and sexual symptoms with mortality in men. Design, Setting, and Participants: Prospective data from the European Male Aging Study (EMAS) on 2599 community-dwelling men aged 40 -79 years in eight European countries was used for this study. Main Outcome Measure(s): All-cause, cardiovascular, and cancer-related mortality was measured. Results: One hundred forty-seven men died during a median follow-up of 4.3 years. Fifty-five men (2.1%) were identified as having LOH (31 moderate and 24 severe). After adjusting for age, center, body mass index (BMI), current smoking, and poor general health, compared with men without LOH, those with severe LOH had a 5-fold [hazard ratio (HR) 5.5; 95% confidence interval (CI) 2.7, 11.4] higher risk of all-cause mortality. Compared with eugonadal men, the multivariable-adjusted risk of mortality was 2-fold higher in those with T less than 8 nmol/L (irrespective of symptoms; HR 2.3; 95% CI 1.2, 4.2) and 3-fold higher in those with three sexual symptoms (irrespective of serum T; compared with asymptomatic men; HR 3.2; 95% CI 1.8, 5.8). Similar risks were observed for cardiovascular mortality. Conclusions: Severe LOH is associated with substantially higher risks of all-cause and cardiovascular mortality, to which both the level of T and the presence of sexual symptoms contribute independently. Detecting low T in men presenting with sexual symptoms offers an opportunity to identify a small subgroup of aging men at particularly high risk of dying.

Original languageEnglish
Pages (from-to)1357-1366
Number of pages10
JournalJournal of Clinical Endocrinology and Metabolism
Volume99
Issue number4
DOIs
Publication statusPublished - 2014

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Hypogonadism
Aging of materials
Mortality
Hazards
Confidence Intervals
Health
Independent Living
Natural History
Body Mass Index
Smoking
Outcome Assessment (Health Care)

ASJC Scopus subject areas

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

Cite this

Pye, S. R., Huhtaniemi, I. T., Finn, J. D., Lee, D. M., O'Neill, T. W., Tajar, A., ... Wu, F. C. W. (2014). Late-onset hypogonadism and mortality in aging men. Journal of Clinical Endocrinology and Metabolism, 99(4), 1357-1366. https://doi.org/10.1210/jc.2013-2052

Late-onset hypogonadism and mortality in aging men. / Pye, S. R.; Huhtaniemi, I. T.; Finn, J. D.; Lee, D. M.; O'Neill, T. W.; Tajar, A.; Bártfai, G.; Boonen, S.; Casanueva, F. F.; Forti, G.; Giwercman, A.; Han, T. S.; Kula, K.; Lean, M. E.; Pendleton, N.; Punab, M.; Rutter, M. K.; Vanderschueren, D.; Wu, F. C W.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 99, No. 4, 2014, p. 1357-1366.

Research output: Contribution to journalArticle

Pye, SR, Huhtaniemi, IT, Finn, JD, Lee, DM, O'Neill, TW, Tajar, A, Bártfai, G, Boonen, S, Casanueva, FF, Forti, G, Giwercman, A, Han, TS, Kula, K, Lean, ME, Pendleton, N, Punab, M, Rutter, MK, Vanderschueren, D & Wu, FCW 2014, 'Late-onset hypogonadism and mortality in aging men', Journal of Clinical Endocrinology and Metabolism, vol. 99, no. 4, pp. 1357-1366. https://doi.org/10.1210/jc.2013-2052
Pye SR, Huhtaniemi IT, Finn JD, Lee DM, O'Neill TW, Tajar A et al. Late-onset hypogonadism and mortality in aging men. Journal of Clinical Endocrinology and Metabolism. 2014;99(4):1357-1366. https://doi.org/10.1210/jc.2013-2052
Pye, S. R. ; Huhtaniemi, I. T. ; Finn, J. D. ; Lee, D. M. ; O'Neill, T. W. ; Tajar, A. ; Bártfai, G. ; Boonen, S. ; Casanueva, F. F. ; Forti, G. ; Giwercman, A. ; Han, T. S. ; Kula, K. ; Lean, M. E. ; Pendleton, N. ; Punab, M. ; Rutter, M. K. ; Vanderschueren, D. ; Wu, F. C W. / Late-onset hypogonadism and mortality in aging men. In: Journal of Clinical Endocrinology and Metabolism. 2014 ; Vol. 99, No. 4. pp. 1357-1366.
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abstract = "Context: Late-onset hypogonadism (LOH) has recently been defined as a syndrome in middle-aged and elderly men reporting sexual symptoms in the presence of low T. The natural history of LOH, especially its relationship to mortality, is currently unknown. Objective: The aim of this study was to clarify the associations between LOH, low T, and sexual symptoms with mortality in men. Design, Setting, and Participants: Prospective data from the European Male Aging Study (EMAS) on 2599 community-dwelling men aged 40 -79 years in eight European countries was used for this study. Main Outcome Measure(s): All-cause, cardiovascular, and cancer-related mortality was measured. Results: One hundred forty-seven men died during a median follow-up of 4.3 years. Fifty-five men (2.1{\%}) were identified as having LOH (31 moderate and 24 severe). After adjusting for age, center, body mass index (BMI), current smoking, and poor general health, compared with men without LOH, those with severe LOH had a 5-fold [hazard ratio (HR) 5.5; 95{\%} confidence interval (CI) 2.7, 11.4] higher risk of all-cause mortality. Compared with eugonadal men, the multivariable-adjusted risk of mortality was 2-fold higher in those with T less than 8 nmol/L (irrespective of symptoms; HR 2.3; 95{\%} CI 1.2, 4.2) and 3-fold higher in those with three sexual symptoms (irrespective of serum T; compared with asymptomatic men; HR 3.2; 95{\%} CI 1.8, 5.8). Similar risks were observed for cardiovascular mortality. Conclusions: Severe LOH is associated with substantially higher risks of all-cause and cardiovascular mortality, to which both the level of T and the presence of sexual symptoms contribute independently. Detecting low T in men presenting with sexual symptoms offers an opportunity to identify a small subgroup of aging men at particularly high risk of dying.",
author = "Pye, {S. R.} and Huhtaniemi, {I. T.} and Finn, {J. D.} and Lee, {D. M.} and O'Neill, {T. W.} and A. Tajar and G. B{\'a}rtfai and S. Boonen and Casanueva, {F. F.} and G. Forti and A. Giwercman and Han, {T. S.} and K. Kula and Lean, {M. E.} and N. Pendleton and M. Punab and Rutter, {M. K.} and D. Vanderschueren and Wu, {F. C W}",
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AU - Pye, S. R.

AU - Huhtaniemi, I. T.

AU - Finn, J. D.

AU - Lee, D. M.

AU - O'Neill, T. W.

AU - Tajar, A.

AU - Bártfai, G.

AU - Boonen, S.

AU - Casanueva, F. F.

AU - Forti, G.

AU - Giwercman, A.

AU - Han, T. S.

AU - Kula, K.

AU - Lean, M. E.

AU - Pendleton, N.

AU - Punab, M.

AU - Rutter, M. K.

AU - Vanderschueren, D.

AU - Wu, F. C W

PY - 2014

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N2 - Context: Late-onset hypogonadism (LOH) has recently been defined as a syndrome in middle-aged and elderly men reporting sexual symptoms in the presence of low T. The natural history of LOH, especially its relationship to mortality, is currently unknown. Objective: The aim of this study was to clarify the associations between LOH, low T, and sexual symptoms with mortality in men. Design, Setting, and Participants: Prospective data from the European Male Aging Study (EMAS) on 2599 community-dwelling men aged 40 -79 years in eight European countries was used for this study. Main Outcome Measure(s): All-cause, cardiovascular, and cancer-related mortality was measured. Results: One hundred forty-seven men died during a median follow-up of 4.3 years. Fifty-five men (2.1%) were identified as having LOH (31 moderate and 24 severe). After adjusting for age, center, body mass index (BMI), current smoking, and poor general health, compared with men without LOH, those with severe LOH had a 5-fold [hazard ratio (HR) 5.5; 95% confidence interval (CI) 2.7, 11.4] higher risk of all-cause mortality. Compared with eugonadal men, the multivariable-adjusted risk of mortality was 2-fold higher in those with T less than 8 nmol/L (irrespective of symptoms; HR 2.3; 95% CI 1.2, 4.2) and 3-fold higher in those with three sexual symptoms (irrespective of serum T; compared with asymptomatic men; HR 3.2; 95% CI 1.8, 5.8). Similar risks were observed for cardiovascular mortality. Conclusions: Severe LOH is associated with substantially higher risks of all-cause and cardiovascular mortality, to which both the level of T and the presence of sexual symptoms contribute independently. Detecting low T in men presenting with sexual symptoms offers an opportunity to identify a small subgroup of aging men at particularly high risk of dying.

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