Comparing calculated free testosterone with total testosterone for screening and diagnosing late-onset hypogonadism in aged males: A cross-sectional study

Liu, Zhangshun; Liu, Jie; Shi, Xiuquan; Wang, Lihong; Yang, Yan; Tao, Minfang; Fu, Qiang

doi:10.1002/jcla.22073

Cited by 18 publications

(11 citation statements)

References 40 publications

(77 reference statements)

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“…These findings, although initially counterintuitive, are logically supported physiologically and with recent findings [25‐29]. In general, prostate cancer is well known for its sensitivity to obesity, diabetes, and metabolic syndrome [29], an effect also documented for BCR in men after RP [27,28]. This morbidity profile has also been linked to both prostate cancer aggressiveness and low serum testosterone [13,25,26].…”

Section: Discussionmentioning

confidence: 63%

Testosterone replacement therapy reduces biochemical recurrence after radical prostatectomy

et al. 2020

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Objective To evaluate risk of prostate cancer biochemical recurrence (BCR) after radical prostatectomy (RP) in men receiving vs not receiving testosterone replacement therapy (TRT). Patients and Methods A total of 850 patients underwent RP by a single surgeon. All patients had preoperative testosterone and sex hormone‐binding globulin levels determined; free testosterone was calculated prospectively. In all, 152 (18%) patients with low preoperative calculated free testosterone (cFT) levels and delayed postoperative sexual function recovery were placed on TRT and proportionately matched to 419 control patients by pathological Gleason Grade Group (GGG) and stage. Rates and time to BCR [two consecutive prostate‐specific antigen (PSA) levels of ≥0.2 ng/mL] were compared in univariate and multivariate regression; Cox regression was used to generate a survival function at the mean of covariates. Results The median follow‐up was 3.5 years. There were no statistically significant differences in demographics or general health complications between groups. BCR occurred in 11/152 (7.2%) and 53/419 (12.6%) patients in the TRT and control groups, respectively. In adjusted time‐to‐event analysis, TRT was an independent predictor of recurrence‐free survival. After accounting for GGG, pathological stage, preoperative PSA level, and cFT, patients on TRT were ~54% less likely to recur (hazard ratio 0.54, 95% confidence interval 0.292–0.997). In men destined to recur, TRT delayed time to recurrence by an average of 1.5 years. Conclusion In our experience, TRT after RP significantly reduced BCR and delayed time to BCR. There was no identifiable general health complications associated with TRT. These findings are hypothesis‐generating and require confirmation with multi‐centred, prospective randomised controlled trials.

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Section: Discussionmentioning

confidence: 63%

Testosterone replacement therapy reduces biochemical recurrence after radical prostatectomy

et al. 2020

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“…These studies illustrate several important points: 1) low T is associated most specifically with an increase in sexual symptoms, and with physical and psychological symptoms and 2) sexual, physical and psychological symptoms are non-specific, may have a high background prevalence and do not, in isolation, identify the population with low T. Indeed, questionnaires that have been developed to assess symptoms of hypogonadism and aging have proven to have low specificity in the identification of LOH 169 170. As a result, ES has recommended that symptoms alone are insufficient to make the diagnosis of hypogonadism, and laboratory assessment is also required.…”

Section: Late-onset Hypogonadismmentioning

confidence: 95%

Male Hypogonadism: A Review

Marcelli

Mediwala

2020

Journal of Investigative Medicine

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“…[ 9 , 10 ] Patients with preoperative AMS scores higher than 37 and serum-free testosterone levels lower than 8.5 pg/mL were classified as Group A, whereas those whose preoperative AMS scores were 37 or lower, or whose serum-free testosterone level were 8.5 pg/mL or higher, were classified as Group B, in accordance with the criteria previously described. [ 11 , 12 ] AMS scores were measured at 1, 3, 6, 9, and 12 months after surgery. Patients were measured for serum free and serum total testosterone and were assessed preoperatively.…”

Section: Methodsmentioning

confidence: 99%

Change of preoperative symptoms of the late-onset hypogonadism syndrome after robot-assisted radical prostatectomy

et al. 2021

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Background: As prostate cancer (PCa) is a common cancer among older men, patients with PCa often show aging male symptoms (AMSs). This study aimed to investigate the preoperative AMSs of the late-onset hypogonadism (LOH) syndrome and the effects on them after robot-assisted radical prostatectomy (RARP). Materials and methods: One hundred eighty-eight patients who underwent RARP without androgen deprivation therapy were measured for serum free and serum total testosterone, and were preoperatively assessed for symptoms of the LOH syndrome using a questionnaire containing an AMS score. Patients with a preoperative AMS score higher than 37 and a serum free testosterone level lower than 8.5 pg/mL were classified as Group A, with the remaining classified as Group B. AMS scores were measured at 1, 3, 6, 9, and 12 months after surgery. Results: Of the 188 patients, 49 and 139 patients were classified as Groups A and B, respectively. Preoperative AMS scores were 44.5 ± 8.2 in Group A and 28.6 ± 5.3 in Group B ( p < 0.0001). AMS scores in Group A significantly improved 1 month after RARP (30.6 ± 8.4, p < 0.0001) compared with their preoperative scores and remained at the same level from 3 to 12 months postoperatively, whereas those in Group B became significantly worse (32.0 ± 7.8, p < 0.0001) than their preoperative ones. There were no differences between AMS scores in Groups A and B at every postoperative period ( p = 0.3259, 0.2730, 0.2429, 0.4629, 0.1771 at 1, 3, 6, 9, and 12 months after surgery, respectively). Conclusions: Our results indicate that AMSs in PCa patients with the LOH syndrome can expect the same level of improvement as patients without it.

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Comparing calculated free testosterone with total testosterone for screening and diagnosing late-onset hypogonadism in aged males: A cross-sectional study

Abstract: Calculated free testosterone levels are more reliable than T levels for diagnosing LOH in middle-aged and elderly males.

Cited by 18 publications

References 40 publications

Testosterone replacement therapy reduces biochemical recurrence after radical prostatectomy

Testosterone replacement therapy reduces biochemical recurrence after radical prostatectomy

Male Hypogonadism: A Review

Change of preoperative symptoms of the late-onset hypogonadism syndrome after robot-assisted radical prostatectomy

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