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Endocrine Abstracts (2015) 37 GP08.01 | DOI: 10.1530/endoabs.37.GP.08.01

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1Andrology Research Unit, Centre for Endocrinology and Diabetes, Institute of Human Development, The University of Manchester, Old St Mary’s Building, Manchester, UK; 2Department of Surgery and Cancer, Institute of Reproductive and Developmental Biology, Imperial College London, Hammersmith Campus, London, UK; 3Arthritis Research UK Epidemiology Unit, The University of Manchester, Manchester, UK; 4Department of Obstetrics, Gynaecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; 5Department of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago (CHUS), CIBER de Fisiopatología Obesidad y Nutricion (CB06/03), Instituto Salud Carlos III, Santiago de Compostela, Spain; 6Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; 7Reproductive Medicine Centre, Malmö University Hospital, University of Lund, Lund, Sweden; 8Department of Endocrinology, Royal Free and University College Hospital Medical School, Royal Free Hospital, Hampstead, London, UK; 9Department of Andrology and Reproductive Endocrinology, Medical University of Łódź, Lodz, Poland; 10Department of Human Nutrition, University of Glasgow, Glasgow, UK; 11School of Community Based Medicine, Hope Hospital, The University of Manchester, Salford, UK; 12Andrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; 13Department of Andrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium.


Introduction: Primary hypogonadism (PHG, testosterone <10.5 nmol/l and LH >9.5 U/l) without a recognisable cause affects ~2% of community-dwelling middle-aged and older men. We sought to identify the clinical significance of, and risk factors for, this apparently age-related hypogonadal state.

Methods/design: The European Male Ageing Study (EMAS) is a prospective observational cohort survey of 3.369 community-dwelling men aged 40–79 in eight European countries who underwent follow up assessment an average of 4.3 years later. Men were classified as incident i) PHG (Eugonadal (EUG) at baseline, PHG at follow-up) or persistent (p) PHG (PHG at baseline and at follow-up), and were compared to those with pEUG (EUG at baseline and at follow-up). Differences in clinical and laboratory parameters between the groups and potential risk factors for iPHG were assessed using descriptive statistics and regression models.

Results: Of the 1.996 men comprising the analytical sample, 1.946 (97.5%) had pEUG, 23 (1.15%) had iPHG, 22 (1.10%) pPHG, and 5 (0.25%) reverted to EUG. The incidence of PHG was 0.27%/year. At baseline, iPHG (compared to pEUG) men were on average 9 years older (P<0.001), more likely to be smokers (OR 5.9 (1.8–18.6); P=0.003) and tended to have more illnesses (OR 2.8 (0.9–8.5); P=0.069). Their baseline total and free T levels were lower, and gonadotropin levels higher than in pEUG men. Upon transition from EUG to PHG, the characteristics which worsened significantly included erectile dysfunction, walking limitation, haemoglobin, self-rated physical function and frequency of >2 illnesses. Clinical parameters in iPHG and pPHG at follow-up were in the main similar.

Conclusion: PHG is a relatively rare condition in ageing men. The major risk factors for its development include older age, smoking and chronic illness. PHG in ageing men is characterised by clinical features compatible with both androgen deficiency and deteriorating functional health.

Disclosure: The European Male Ageing Study is funded by the Commission of the European Communities Fifth Framework Programme ‘Quality of Life and Management of Living Resources’ Grant QLK6-CT-2001-00258.

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