scholarly journals The effect of changes in adiposity on testosterone levels in older men: longitudinal results from the Massachusetts Male Aging Study

2006 ◽  
Vol 155 (3) ◽  
pp. 443-452 ◽  
Author(s):  
Beth A Mohr ◽  
Shalender Bhasin ◽  
Carol L Link ◽  
Amy B O’Donnell ◽  
John B McKinlay
Keyword(s):  
Free Testosterone ◽  
Older Men ◽  
Population Based ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Age Related ◽  
Aging Study ◽  
Severely Obese ◽  
Overweight Group ◽  
Rate Of Decline

Objective: Changes in adiposity affecting total testosterone (TT) and free testosterone (FT) levels have not been examined in a population-based survey. We aimed to determine whether changes in adiposity predict follow-up levels and rates of change in TT, FT and sex hormone-binding globulin (SHBG) in men. Design: The Massachusetts Male Aging Study is a randomly sampled, population-based cohort interviewed at baseline (T1, 1987–1989; n = 1709; aged 40–70 years) and followed-up approximately 9 years later (T2, 1995–1997; n = 1156). Men were categorized as overweight (body mass index (BMI) ≥ 25 kg/m2) or having obesity (BMI ≥ 30 kg/m2), waist obesity (waist circumference ≥ 102 cm), or waist-to-hip ratio (WHR) obesity (WHR>0.95). For each adiposity group, we constructed four categories to represent changes between T1 and T2: overweight (or obese, etc.) at neither wave, T1 only, T2 only, or both waves. Results: After adjustment for confounding variables, men who were overweight at T2 only, or at both waves, had significantly lower mean T2 TT and SHBG levels than men in the neither group (P<0.05). Mean FT did not differ between any overweight group and the neither group. Men who were obese at both times, had the highest mean BMI, the highest fraction of severely obese men, and significantly greater rate of decline in FT than the neither group. Conclusions: In men who become overweight, the greater rate of decline in TT, but not FT, is related mostly to a lesser age-related increase in SHBG. Since weight gain is highly prevalent in older men, over-reliance on TT levels in the diagnosis of androgen deficiency could result in substantial misclassification.

scholarly journals In men older than 70 years, total testosterone remains stable while free testosterone declines with age. The Health in Men Study

2007 ◽  
Vol 156 (5) ◽  
pp. 585-594 ◽  
Author(s):  
Bu B Yeap ◽  
Osvaldo P Almeida ◽  
Zoë Hyde ◽  
Paul E Norman ◽  
S A Paul Chubb ◽  
...  
Keyword(s):  
Free Testosterone ◽  
Older Men ◽  
Early Morning ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Limited Data ◽  
Cross Sectional ◽  
Testosterone Concentration ◽  
Age Related ◽  
Clinical Consequences

Objective: An age-related decline in serum total and free testosterone concentration may contribute to ill health in men, but limited data are available for men > 70 years of age. We sought to determine the distribution and associations of reduced testosterone concentrations in older men. Design: The Health in Men Study is a community-representative prospective cohort investigation of 4263 men aged ≥ 70 years. Cross-sectional hormone data from 3645 men were analysed. Methods: Early morning sera were assayed for total testosterone, sex hormone binding globulin (SHBG) and LH. Free testosterone was calculated using the Vermeulen method. Results: Mean (± s.d.) serum total testosterone was 15.4 ± 5.6 nmol/l (444 ± 162 ng/dl), SHBG 42.4 ± 16.7 nmol/l and free testosterone 278 ± 96 pmol/l (8.01 ± 2.78 ng/dl). Total testosterone correlated with SHBG (Spearman’s r = 0.6, P < 0.0001). LH and SHBG increased with age (r = 0.2, P < 0.0001 for both). Instead of declining, total testosterone increased marginally (r = 0.04, P = 0.007) whilst free testosterone declined with age (r = −0.1, P < 0.0001). Free testosterone was inversely correlated with LH (r = −0.1, P < 0.0001). In multivariate analyses, increasing age, body mass index (BMI) and LH were associated with lower free testosterone. Conclusions: In men aged 70–89 years, modulation of androgen action may occur via an age-related increase in SHBG and reduction in free testosterone without a decline in total testosterone concentration. Increasing age, BMI and LH are independently associated with lower free testosterone. Further investigation would be required to assess the clinical consequences of low serum free testosterone, particularly in older men in whom total testosterone may be preserved.

scholarly journals Testosterone profile in older men with Alzheimer's disease

2008 ◽  
Vol 2 (4) ◽  
pp. 289-293
Author(s):  
Cristiana Roscito Arenella Dusi ◽  
Lílian Schafirovits Morillo ◽  
Regina Miksian Magaldi ◽  
Adriana Nunes Machado ◽  
Sami Liberman ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Free Testosterone ◽  
Older Men ◽  
Sex Hormone Binding Globulin ◽  
Control Group ◽  
Total Testosterone ◽  
Chi Square ◽  
Testosterone Levels ◽  
Significant Difference

Abstract Evidence suggests low testosterone levels in Alzheimer's disease. Objectives: To compare testosterone levels between older men with and without Alzheimer's disease. Methods: Fourteen men with Alzheimer's disease were compared with twenty eight men without dementia. Demographic variables and clinical profiles were analyzed. Within fifteen days before or after the described evaluation, measures of total testosterone and Sex Hormone Binding Globulin (SHBG) were performed. Free testosterone level was calculated based on total testosterone and SHBG. Quantitative variables were analyzed using Student's t test or Kruskal-Wallis test, while qualitative variables were analyzed using chi-square or Fisher test. Results: Mean age in the Control and Alzheimer's disease groups were 72.0 (SD±4.8) years and 79.3(SD±5.9) years, respectively (p=0.001). Mean schooling between these two groups were 8.78 and (±5.86) years, respectively (p=0.022). There were no statistically significant differences between the two groups for testosterone levels, although a trend was observed for the Alzheimer's disease group to present lower levels than the control group (p=0.066). There was no direct correlation between free testosterone and age, although a trend was evident (p=0.068). Conclusions: There was no significant difference in testosterone between men with AD and those without dementia.

scholarly journals The associations of age, lifestyle factors and chronic disease with testosterone in men: the Tromso Study

2003 ◽  
Vol 149 (2) ◽  
pp. 145-152 ◽  
Author(s):  
J Svartberg ◽  
M Midtby ◽  
KH Bonaa ◽  
J Sundsfjord ◽  
RM Joakimsen ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Linear Regression Analysis ◽  
Coffee Consumption ◽  
Free Testosterone ◽  
Lifestyle Factors ◽  
Analysis Of Covariance ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Cross Sectional ◽  
Age Related

OBJECTIVE: To study whether lifestyle factors and/or chronic disease are associated with the age-related decline of total and free testosterone in men, or if these factors might be associated with the variation of total and free testosterone but not with their age-related decline. DESIGN: A population-based, cross-sectional study was used. METHODS: Total testosterone and sex hormone binding globulin (SHBG) levels were analyzed and free testosterone levels were calculated in 1563 men participating in the Tromso study in 1994/1995. Anthropometric characteristics were also measured and two standardized questionnaires completed, including lifestyle factors and medical history. The data were analyzed with multiple linear regression analysis of covariance, and logistic regression. RESULTS: Total and free testosterone were inversely associated (P=0.001 and P<0.001), while SHBG was positively associated (P<0.001) with age. Body mass index (BMI) was inversely associated with total (P<0.001) and free (P=0.016) testosterone and SHBG (P<0.001). Both total and free testosterone were positively associated with tobacco consumption (P<0.001 and P=0.004) and total testosterone was positively associated with coffee consumption (P<0.001). SHBG was positively associated with smoking (P=0.004) and coffee consumption (P<0.001). Men who reported having had a stroke or having a cancer diagnosis had lower levels of total testosterone (P<0.001 and P<0.01) and free testosterone (P<0.01). CONCLUSIONS: BMI and smoking are independent contributors to the variation of total and free testosterone and SHBG levels, and coffee consumption to the variation of total testosterone and SHBG. Thus, lifestyle factors can have a direct effect on circulating levels of free endogenous sex hormones and to total levels due to the effect on SHBG levels.

scholarly journals Lung function changes over 8 years and testosterone markers in both sexes: UK Biobank

2020 ◽  
Vol 6 (3) ◽  
pp. 00070-2020
Author(s):  
Alexandra Lenoir ◽  
Elaine Fuertes ◽  
Francisco Gómez-Real ◽  
Benedicte Leynaert ◽  
Diana A. van der Plaat ◽  
...  
Keyword(s):  
Lung Function ◽  
Free Testosterone ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Uk Biobank ◽  
Lung Function Decline ◽  
Cross Sectional ◽  
Physically Active

Higher levels of testosterone have been associated with better lung function in cross-sectional population-based studies. The role of testosterone in lung function in women and in lung function decline in men or women is unclear.We studied 5114 men and 5467 women in the UK Biobank with high-quality spirometry at baseline (2006–2010) and 8.4 years later. We studied cross-sectional associations of total testosterone (TT), calculated free testosterone (cFT), free androgen index (FAI) and sex hormone-binding globulin (SHBG) with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC using linear regression and associations of baseline markers with lung function decline using linear mixed-effects regression.Men with higher levels of TT had higher FEV1 (27.56 mL per interquartile range increase TT, 95% CI 5.43–49.68) and FVC (48.06 mL, 95% CI 22.07–74.06) at baseline. Higher cFT levels were associated with higher FEV1 and FVC among physically active men only. In women, higher FAI and cFT levels were associated with lower lung function at baseline and higher levels of TT, cFT and FAI were associated with slightly attenuated FEV1 and FVC decline. Higher levels of SHBG were associated with better lung function in both sexes but slightly accelerated decline in men.In this population-based sample, higher levels of TT were associated with better lung function in men and higher levels of cFT with better lung function in physically active men. A small attenuation of lung function decline with higher levels of TT, cFT and FAI was seen in women only.

scholarly journals Lower sex hormone-binding globulin is more strongly associated with metabolic syndrome than lower total testosterone in older men: the Health in Men Study

2008 ◽  
Vol 158 (6) ◽  
pp. 785-792 ◽  
Author(s):  
S A Paul Chubb ◽  
Zoë Hyde ◽  
Osvaldo P Almeida ◽  
Leon Flicker ◽  
Paul E Norman ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Free Testosterone ◽  
Older Men ◽  
Community Dwelling ◽  
Sex Hormone ◽  
Mass Action ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Hormone Binding ◽  
Cross Sectional

BackgroundReduced circulating testosterone and sex hormone-binding globulin (SHBG) are implicated as risk factors for metabolic syndrome. As SHBG increases with age while testosterone declines, we examined the relative contributions of SHBG and testosterone to the risk of metabolic syndrome in older men.MethodsWe conducted a cross-sectional study of 2502 community-dwelling men aged ≥70 years without known diabetes. Metabolic syndrome was defined using the National Cholesterol Education Program-Third Adult Treatment Panel (NCEP-ATPIII) criteria. Early morning fasting sera were assayed for total testosterone, SHBG and LH. Free testosterone was calculated using mass action equations.ResultsThere were 602 men with metabolic syndrome (24.1%). The risk of metabolic syndrome increased for total testosterone <20 nmol/l, SHBG <50 nmol/l and free testosterone <300 pmol/l. In univariate analyses SHBG was associated with all five components of metabolic syndrome, total testosterone was associated with all except hypertension, and free testosterone was associated only with waist circumference and triglycerides. In multivariate analysis, both total testosterone and especially SHBG remained associated with metabolic syndrome, with odds ratios of 1.34 (95% confidence interval (CI): 1.18–1.52) and 1.77 (95% CI: 1.53–2.06) respectively. Men with hypogonadotrophic hypogonadism (total testosterone <8 nmol/l, LH ≤12 IU/l) had the highest prevalence of metabolic syndrome (53%,P<0.001).ConclusionsLower SHBG is more strongly associated with metabolic syndrome than lower total testosterone in community-dwelling older men. SHBG may be the primary driver of these relationships, possibly reflecting its relationship with insulin sensitivity. Further studies should examine whether measures that raise SHBG protect against the development of metabolic syndrome in older men.

scholarly journals Role of Metabolic Factors in the Association Between Osteocalcin and Testosterone in Chinese Men

2013 ◽  
Vol 98 (8) ◽  
pp. 3463-3469 ◽  
Author(s):  
Ming Liao ◽  
Xuefeng Guo ◽  
Xiaoxiang Yu ◽  
Guijian Pang ◽  
Shijun Zhang ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Central Obesity ◽  
Linear Regression Analysis ◽  
Density Lipoprotein ◽  
Positive Association ◽  
Free Testosterone ◽  
Population Based ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Metabolic Factors

Objective: Osteocalcin can regulate energy metabolism and increase testosterone production. Although previous studies have shown the positive association between osteocalcin and testosterone, the effect of metabolic factors in the association is unclear. Design and Setting: Osteocalcin, testosterone, and metabolic factors were accessed in 2400 men aged 20 to 69 years, who participated in the population-based Fangchenggang Area Male Health and Examination Survey in Guangxi province of China from September 2009 to December 2009. Main Outcome Measures: Metabolic syndrome was defined based on the updated report of National Cholesterol Education Program Adult Treatment Panel III criteria. Serum total osteocalcin, total testosterone (TT), and sex hormone binding globulin (SHBG) were measured, whereas free testosterone (FT) and bioavailable testosterone (BT) were calculated based on Vermeulen's formula. The multivariable linear regression analysis was used. Results: Osteocalcin was positively associated with TT, FT, and BT in the unadjusted model (all P &lt; .001). After adjusting for age, the positive association between osteocalcin and TT remained statistically significant (β = .17, 95% confidence interval = 0.14–0.20) and was not attenuated in each MetS subgroup including hypertriglyceridemia, hyperglycemia, elevated blood pressure, and low high-density lipoprotein cholesterol, while in the group of central obesity (waist circumstance ≥90 cm), the association appeared significantly stronger (β = 0.21, 95% confidence interval = 0.12–0.30). After further adjusting for SHBG, osteocalcin was positively associated with TT, FT, and BT in men with central obesity or men with any two MetS components (all P &lt; .05). Conclusions: Serum total osteocalcin is positively associated with testosterone, which is probably modified by SHBG and central obesity.

scholarly journals Prevalence and Incidence of Androgen Deficiency in Middle-Aged and Older Men: Estimates from the Massachusetts Male Aging Study

2004 ◽  
Vol 89 (12) ◽  
pp. 5920-5926 ◽  
Author(s):  
Andre B. Araujo ◽  
Amy B. O’Donnell ◽  
Donald J. Brambilla ◽  
William B. Simpson ◽  
Christopher Longcope ◽  
...  
Keyword(s):  
Free Testosterone ◽  
Older Men ◽  
Population Based ◽  
Incidence Rates ◽  
Androgen Deficiency ◽  
Middle Aged ◽  
Male Population ◽  
Incidence Data ◽  
Aging Study

Abstract Little is known about the descriptive epidemiology of androgen deficiency. In this study, we sought to address this issue by providing estimates of the crude and age-specific prevalence and incidence rates of androgen deficiency in a randomly sampled population-based cohort of middle-aged and older men. Data on androgen deficiency (defined using both signs/symptoms plus total and calculated free testosterone) were available for n = 1691 (baseline) and n = 1087 (follow-up) men from the Massachusetts Male Aging Study. Crude and age-specific prevalence and incidence rates were calculated. Based on these estimates, projections for the number of cases of androgen deficiency in the 40- to 69-yr-old U.S. male population were computed. Estimates of the crude prevalence of androgen deficiency at baseline and follow-up were 6.0 and 12.3%, respectively. Prevalence increased significantly with age. From baseline age-specific prevalence data, it is estimated that there are approximately 2.4 million 40- to 69-yr-old U.S. males with androgen deficiency. The crude incidence rate of androgen deficiency was 12.3 per 1,000 person-years, and the rate increased significantly (P &lt; 0.0001) with age. Based on these incidence data, we can expect approximately 481,000 new cases of androgen deficiency per year in U.S. men 40–69 yr old.

A clinical update on female androgen insufficiency—testosterone testing and treatment in women presenting with low sexual desire

Sexual Health ◽  
2006 ◽  
Vol 3 (2) ◽  
pp. 73 ◽  
Author(s):  
Henry G. Burger ◽  
Mary-Anne Papalia
Keyword(s):  
Sexual Desire ◽  
Well Being ◽  
Free Testosterone ◽  
Deficiency Syndrome ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Androgen Deficiency ◽  
Contributing Factors ◽  
Clear Cut ◽  
Age Related

The diagnosis of female androgen deficiency syndrome is suggested by complaints of a diminished sense of well being, persistent unexplained fatigue and decreased sexual desire, sexual receptivity and pleasure in a woman who is oestrogen-replete and in whom no other significant contributing factors can be identified. The diagnosis is supported by the finding of low circulating concentrations of free testosterone. Barriers to its recognition include the non-specificity of the symptoms and methodological problems due to insensitive testosterone assays. Barriers to its treatment include the unavailability of satisfactory forms of testosterone for administration to women and lack of data regarding long-term safety. Although several conditions lead to clear-cut androgen deficiency, such as hypopituitarism, adrenal and ovarian insufficiency, glucocorticoid therapy and use of oral contraceptives and oral oestrogens, it is important for clinicians to recognise that in normal women, androgen levels decline by 50% from the early 20s to the mid 40s, and hence age-related androgen insufficiency may occur in women in their late 30s and 40s, as well as postmenopausally. Satisfactory measurements of free testosterone requires a sensitive and reliable assay for total testosterone, and quantitation of sex hormone binding globulin, from which free testosterone is readily calculated. Adverse effects of testosterone treatment are few if replacement is monitored to achieve physiological circulating testosterone concentrations. Currently, available methods include testosterone implants and testosterone creams, and transdermal patches and sprays are in development.

scholarly journals Hypogonadism and liver fibrosis in HIV-infected patients

2021 ◽  
Author(s):  
E. Quiros-Roldan ◽  
T. Porcelli ◽  
L. C. Pezzaioli ◽  
M. Degli Antoni ◽  
S. Paghera ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Univariate Analysis ◽  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Cross Sectional ◽  
Pituitary Dysfunction ◽  
Consequent Reduction ◽  
Secondary Hypogonadism ◽  
The Relationship

Abstract Purpose Hypogonadism is frequent in HIV-infected men and might impact on metabolic and sexual health. Low testosterone results from either primary testicular damage, secondary hypothalamic-pituitary dysfunction, or from liver-derived sex-hormone-binding-globulin (SHBG) elevation, with consequent reduction of free testosterone. The relationship between liver fibrosis and hypogonadism in HIV-infected men is unknown. Aim of our study was to determine the prevalence and type of hypogonadism in a cohort of HIV-infected men and its relationship with liver fibrosis. Methods We performed a cross-sectional retrospective study including 107 HIV-infected men (median age 54 years) with hypogonadal symptoms. Based on total testosterone (TT), calculated free testosterone, and luteinizing hormone, five categories were identified: eugonadism, primary, secondary, normogonadotropic and compensated hypogonadism. Estimates of liver fibrosis were performed by aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and Fibrosis-4 (FIB-4) scores. Results Hypogonadism was found in 32/107 patients (30.8%), with normogonadotropic (10/107, 9.3%) and compensated (17/107, 15.8%) being the most frequent forms. Patients with secondary/normogonadotropic hypogonadism had higher body mass index (BMI) (p < 0001). Patients with compensated hypogonadism had longer HIV infection duration (p = 0.031), higher APRI (p = 0.035) and FIB-4 scores (p = 0.008), and higher HCV co-infection. Univariate analysis showed a direct significant correlation between APRI and TT (p = 0.006) and SHBG (p = 0.002), and between FIB-4 and SHBG (p = 0.045). Multivariate analysis showed that SHBG was independently associated with both liver fibrosis scores. Conclusion Overt and compensated hypogonadism are frequently observed among HIV-infected men. Whereas obesity is related to secondary hypogonadism, high SHBG levels, related to liver fibrosis degree and HCV co-infection, are responsible for compensated forms.

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