Background: Life expectancy has increased dramatically worldwide, resulting in a sharp rise of age-associated diseases, including late-onset hypogonadism (LOH) in men. Aim: To assess the prevalence of LOH and to determine its relationships with cardiovascular risk factors in healthy middle-aged men. Material and Methods: A total of 200 men aged 44-55 (median 48.44, interquartile range 45.02-52.50) undergoing regular medical examinations were enrolled in a study. All participants were asked to complete the International Index of Erectile Dysfunction, Aging Male's Symptoms, and Beck Depression Inventory questionnaires. Sex and gonadotropin hormones were measured in all participants. Cardiovascular diseases (CVD) risk was assessed in all participants by using the Systematic Coronary Risk Evaluation scale, and additional risk factors were recommended in the 2019 European Society of Cardiology and European Atherosclerosis Society guidelines for the management of dyslipidemias: lipid modification to reduce cardiovascular risk. Results: Ninety-eight (49%) men suffered from LOH. Men with total testosterone (TT) of <12 nmol/L were considered testosterone-deficient. The mean TT level was 8.9 -2.4 nmol/L in the LOH group. Clinical signs and symptoms of LOH were associated with lower TT levels: 7.78 -2.49 and 10.15 -1.32 in the groups with and without LOH, respectively ( p = 0.004). The prevalence of obesity, metabolic syndrome, and depression was significantly higher among men with LOH, compared with men without it. High cardiovascular risk was found only in those participants present with LOH ( p = 0.003). After collecting other risk factors, we found that 94.9% of participants assigned to the LOH group had high cardiovascular risk. Conclusion:The prevalence of LOH is high among healthy middle-aged men. Moreover, it is associated with an increased cardiovascular risk. Early measurement of TT levels in this population group may predict the development of CVD and allow the introduction of timely primary prevention measures to reduce cardiovascular morbidity and mortality.

The prevalence of age-related diseases, including age-related hypogonadism in men, have increased with improved life expectancy of the population. This study is aimed at assessing the prevalence of age-related hypogonadism in healthy working middle-aged men and determining the relationships with cardiovascular risk factors. Material and methods. Men who underwent annual medical examinations were additionally questioned to identify symptoms of age-related hypogonadism. Level of sex and gonadotropic hormones were measured in the study sample. Cardiovascular risk factors and cardiac risk were estimated in all recruited subjects. Results. Age-related hypogonadism was diagnosed in 35 (32,1%) men. The prevalence of cardiovascular risk factors such as obesity, metabolic syndrome, and depression was significantly higher among men with age-related hypogonadism compared with men with normal testosterone levels. Conclusion. Early diagnosis and treatment of age-related hypogonadism in middle-aged men is relevant for improving their quality of life and managing cardiovascular risk factors, thereby increasing the effectiveness of primary prevention of cardiovascular morbidity and mortality. When agerelated hypogonadism is diagnosed, optimal management strategy should be selected. The identified cardiovascular risk factors should be modified using a more aggressive approach.

Aim. To study the relationship between age-related androgen deficiency and the level of cardiovascular risk in healthy middle-aged men.Materials and Methods. We enrolled 200 men of 44-55 (median 48.44, interquartile range 45.02- 52.50) years who underwent a routine medical examination, having additionally measured age-related androgen deficiency.Results. A decrease in total testosterone of < 12.1 nmol/L indicative of age-related hypogonadism was detected in 98 (49.0%) men. In 42 (42.8%) men, a decrease in total testosterone was accompanied by loss of libido and erectile dysfunction. Relatively high prevalence of lipid metabolism disorders and subclinical atherosclerosis was diagnosed in men without established cardiovascular disease. Analysis according to the SCORE scale showed a predominance of patients with moderately increased risk, with only a small number of high-risk patients. Notably, all high-risk cases were identified in the age-related hypogonadism group. The distribution of cardiovascular risk score significantly differed in groups with and without age-related androgen deficiency.Conclusion. We demonstrate a relatively high prevalence of age-related testosterone deficiency, which is also associated with increased cardiovascular risk, among healthy middle-aged men.

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