Results from the European Male Aging Study (EMAS)
The phenomenon of age-related decline in sexual function and testosterone continues to attract significant attention in men. A recent study conducted across several European countries aimed to seek objective biochemical and end-organ evidence of androgen deficiency in men classified as having late-onset hypogonadism (LOH).
Definitions of LOH have varied widely in the literature. The authors in this study define LOH as the presence of three sexual symptoms – decreased libido and morning erections, coupled with erectile dysfunction. In addition, the authors examined whether observed associations could be explained by other factors varying concurrently with (hypo)gonadal status.
A sample of 3369 men aged 40 to 79 were recruited from 8 European centers. A fasting blood sample was obtained from each subject to measure total testosterone (T) and estradiol, in addition to fasting lipids and glucose. One-hundred fifty subjects were excluded due to known endocrine disorders.
In this sample, 63 men (2.1%) were identified as meeting criteria for LOH (36 moderate and 27 severe). These men were of age above subject average, more obese, had lower lean muscle mass, and in overall poorer health. Men with severe LOH had larger abdominal waist circumference, insulin resistance, and metabolic syndrome (odds ratio = 9.94).
The results of this study conclude that LOH is associated with multiple end-organ adverse effects, supporting the notion of such a defined syndrome in a minority of elder men, especially those with serum T < 8 nmol/liter.
Reference: Tajar A, Huhtaniemi IT, O’Neill TW, et al. Characteristics of androgen deficiency in late-onset hypogonadism: results from the European Male Aging Study (EMAS). J Clin Endocrinol Metab 2012;97:1508-1516.