Endocrinological and symptomatic characteristics of patients with late‐onset hypogonadism classified by functional categories based on testosterone and luteinizing hormone levels

Abstract

Objectives To define the characteristics of patients with late‐onset hypogonadism based on endocrinological findings. Methods We assessed age, body mass index, laboratory/endocrinological profiles and symptom‐specific questionnaire scores of 967 men with late‐onset hypogonadism symptoms. The patients comprised four groups by testosterone and luteinizing hormone concentrations: normal group, compensated hypogonadism group, primary hypogonadism group and secondary hypogonadism group. We compared characteristics between the normal group and compensated hypogonadism group in men with normal testosterone concentration, and the primary hypogonadism group and secondary hypogonadism group in hypogonadal men after age adjustment. Results The normal group, compensated hypogonadism group, primary hypogonadism group and secondary hypogonadism group accounted for 83.6%, 3.4%, 0.8% and 12.2% of patients, respectively. Despite age adjustment, serum dehydroepiandrosterone sulfate and insulin‐like growth factor 1 concentrations were significantly lower in the compensated hypogonadism group than the normal group. Only the Aging Males' Symptoms scale mental subscore was significantly different. Serum testosterone and dehydroepiandrosterone sulfate concentrations were significantly lower in the primary hypogonadism group than the secondary hypogonadism group. Only the Aging Males' Symptoms scale sexual subscore was significantly different. Conclusions Most patients with late‐onset hypogonadism symptoms are in the normal group, with secondary hypogonadism being much more frequent than primary hypogonadism. Current symptomatic differences among these groups are minor. Classifying patients by testosterone and luteinizing hormone levels might provide useful information for follow up.

The Role of Testosterone in the Elderly: What Do We Know?

“…As previously reported, the diagnosis of LOH is based on signs and symptoms of hypogonadism associated with biochemical evidence of low testosterone serum values [ 25 , 26 ]. Notably, although signs and symptoms are mostly related to sexual function, they could also include mild and specific symptoms, such as increased fatigue, irritability, anemia and sleep disturbances [ 27 , 28 ]. As result, to improve the clinical evaluation in the detection of LOH, different questionnaires, embracing other domains in addition to the sexual activity, have been developed, although their low specificity represents a limitation for clinical applicability [ 29 ].…”

Low testosterone at age 31 associates with maternal obesity and higher body mass index from childhood until age 46: A birth cohort study

“…The results did not change after excluding opioid users (data not shown). LH (cutoff value 9.4 U/L) and T were used to classify functional hypogonadism according to the literature 29–31 . Men with primary and compensated hypogonadism were excluded from the main analyses due to their small number and different etiology.…”

“…LH (cutoff value 9.4 U/L) and T were used to classify functional hypogonadism according to the literature. [29][30][31] Men with primary and compensated hypogonadism were excluded from the main analyses due to their small number and different etiology. This exclusion did not change the results (data not shown).…”

Editorial Comment to Endocrinological and symptomatic characteristics of patients with late‐onset hypogonadism classified by functional categories based on testosterone and luteinizing hormone levels

“…They also tried to identify specific characteristics of each group by evaluating other endocrinological hormones and by assessing symptom scores. 5 The groundbreaking aspects of this study were that most patients with LOH-related symptoms were categorized into the normal group, and that serum concentrations of dehydroepiandrosterone sulfate and insulin-like growth factor-1 were low in the compensated hypogonadism group. Although some limitations exist, this article suggests that classifying symptomatic LOH patients by functional categories based on T and LH levels might provide more precise physiological information for refining the LOH diagnosis and choosing an appropriate management strategy.…”