The prevalence of and risk factors for androgen deficiency in aging Taiwanese men

Prevalence, incidence and risk factors of testosterone deficiency in a population-based cohort of men: results from the study of health in Pomerania

OBJECTIVE

Low total testosterone levels (TT) have been associated with increased morbidity and mortality. However, the prevalence and incidence of testosterone deficiency (TD) in association with its risk has not been assessed systematically to date.

METHODS

Data from the prospective population-based Study of Health in Pomerania were used. From the 2117 men aged 20-79 years at baseline, 1490 men with complete TT data were analysed. Crude and age-specific prevalence and incidence rates of TD were estimated by TT levels below the age-specific 10th percentile. Analysis of covariance and Poisson regression models were used to assess the association of socio-demographic characteristics, health-related lifestyle, as well as somatometric, medical and laboratory measures with risk of incident TD.

RESULTS

TD baseline prevalence was 10.4% (N = 155) and incidence 11.7 per 1000 person-years. TT levels showed a significant age-related decline with an unadjusted rate of 0.05 nmol/l per year. Obesity, metabolic syndrome, diabetes and dyslipidaemia were identified as risk factors of incident TD. Subpopulations of men without the revealed risk factors at both examinations maintained constant TT levels over time.

CONCLUSIONS

Besides aging alone, lifestyle and different comorbidities were associated with TT level decline, suggesting that the age-related TT decline may be at least partly prevented through the management of potentially modifiable risk factors and health related behaviour.

Treatment of 161 men with symptomatic late onset hypogonadism with long-acting parenteral testosterone undecanoate: effects on body composition, lipids, and psychosexual complaints

INTRODUCTION

Elderly men may suffer from late-onset hypogonadism (LOH). The long-term effects of long-acting testosterone undecanoate (TU) in a large number of LOH men have not yet been reported. Aims.  We analyzed the effects of normalization of plasma testosterone (T) in LOH men.

METHODS

The records of 161 men with LOH (baseline T<300 ng/dL) were reviewed and 100 men had used parenteral TU for >12 months. The mean duration of treatment was 90.6 weeks (54 to 150 weeks).

MAIN OUTCOME MEASURES

Body mass index (BMI), waist circumference, percentage body fat, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, prostate-specific antigen (PSA), and hematocrit were measured. Further the Aging Male Symptoms' scale (AMS) and the International Index of Erectile Function (IIEF-5 and 15) were scored.

RESULTS

T therapy was associated with a significant decline in waist circumference (P=0.028) and percentage body fat (P<0.001), but no change of BMI. Total cholesterol and LDL cholesterol declined significantly (P=0.005 and P=0.024, respectively), with no significant changes of HDL cholesterol and triglycerides. The scores of sub-scales of AMS (psychological, somotovegetative and sexual factors) decreased (P=0.044, P=0.200 and P=0.071, respectively). The mean IIEF-5 (P=0.011) and IIEF-15 scores (P=0.021) improved significantly. Erectile function domain, orgasmic function domain, sexual desire domain, intercourse satisfaction domain, and overall satisfaction domain improved. Median PSA rose from 0.95 (0.640; 1.558) ng/mL to 1.480 (1.015; 2.275) ng/mL (P<0.001), with 11 patients >4 ng/mL (4.01-13.21). On biopsy there was no evidence for malignancy. The mean hematocrit level increased significantly from 42.3±3.4% to 47.1±3.8%.

CONCLUSIONS

Normalizing serum T in men with LOH resulted in improvement of the metabolic syndrome, mood and sexual functions and appeared acceptably safe.

The impact of physical health and socioeconomic factors on sexual activity in middle-aged and elderly Taiwanese men

Sexual activity in older people has become a topic of growing interest. The aim of this study is to investigate the effect of physical health and socioeconomic factors on the sexual activity of middle-aged and elderly Taiwanese men. From August 2007 to April 2008, 744 men older than 40 years were enrolled from a free health screening in Kaohsiung, Taiwan. All participants received detailed physical examination and answered questionnaires that collected demographic and lifestyle information, and medical history as well as answered items from the International Prostate Symptoms Score and five-item version of the International Index of Erectile Function (IIEF-5). Overall, 100 (13.4%) participants reported to be sexually inactive in previous 6 months. Older age, lower education levels, loss of a partner, erectile dysfunction, and increased number of comorbidities were found to be independent predictors for sexual inactivity. In conclusion, most middle-aged and elderly Taiwanese men remain sexually active. In addition to erectile dysfunction and loss of a partner, lower education levels and increased number of comorbidities were found to be predictors for sexual inactivity. Further research would need to elucidate whether improvement of those factors could help to preserve sexual activity.