Systematic literature review of the risk factors, comorbidities, and consequences of hypogonadism in men

Abstract

SUMMARYThe objective of this review was to summarize the literature on the risk factors, comorbidities, and consequences of male hypogonadism, which is defined as a syndrome complex that includes biochemical confirmation of low testosterone (T) and the consistent symptoms and signs associated with low T. A systematic literature search was performed in PubMed/MEDLINE, EMBASE, Cochrane Library for articles published in the last 10 years on risk factors, comorbidities, and consequences of male hypogonadism. Of the 53 relevant studies identified, nine examined potential risk factors, 14 examined potential comorbidities, and 30 examined potential consequences of male hypogonadism. Based on studies conducted in Asia, Australia, Europe, and North & South America, the important factors that predicted and correlated with hypogonadism were advanced age, obesity, a diagnosis of metabolic syndrome (MetS), and a poor general health status. Diabetes mellitus was correlated with hypogonadism in most studies, but was not established as a risk factor. Although diseases, such as coronary heart disease, hypertension, stroke, and peripheral arterial disease did not predict hypogonadism, they did correlate with incident low T. The data reviewed on potential consequences suggest that low T levels may be linked to earlier all-cause and cardiovascular related mortality among men. This literature review suggests that men with certain factors, such as advanced age, obesity, MetS, and poor general health, are more likely to have and develop hypogonadism. Low levels of T may have important long-term negative health consequences.

Prevalence of Late-Onset Hypogonadism in Men with Localized and Metastatic Renal Cell Carcinoma

“…Based on current EAU criteria, LOH was present in 13.7 and 15.2% of mRCC and loRCC patients, respectively. Although several epidemiologic studies have been published within the last years, prevalence rates of LOH vary significantly depending on the definitions used for the diagnosis 'hypogonadism' [17] . Despite the recognition that androgen deficiency in men should be defined according to biochemical and clinical criteria, most prevalence rates are based on low testosterone levels alone.…”

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

“…[241][242][243][244] In male individuals, low testosterone levels are also strongly associated with an increased risk of developing type 2 diabetes mellitus. 245 However, few studies have examined metabolic risk specifically in patients with CHH. Interestingly, even short-term hypogonadism (such as that resulting from discontinuation of sex steroids for 2 weeks) induces increased fasting insulin concentrations in young men with CHH, 246 which suggests that adherence to treatment is also important for promoting metabolic health.…”

Low Sex Hormone-Binding Globulin Levels Associate with Prediabetes in Chinese Men Independent of Total Testosterone

“…Multiple epidemiological studies showed that low testosterone was found in 30–50% of men with T2DM [6] and might predict the future development of T2DM. The causative relationship between low testosterone and T2DM, which was interrelated with advanced age, obesity, metabolic syndrome and other factors, might be bidirectional or multidirectional [10, 22, 23]. In previous studies, obesity was not only strongly associated with diabetes but also inversely related with the blood testosterone levels in men [24].…”