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Erschienen in: Journal of Endocrinological Investigation 2/2014

01.02.2014 | Original Article

Hypogonadism in aged hospitalized male patients: prevalence and clinical outcome

verfasst von: P. Iglesias, F. Prado, M. C. Macías, M. T. Guerrero, A. Muñoz, E. Ridruejo, P. Tajada, C. García-Arévalo, J. J. Díez

Erschienen in: Journal of Endocrinological Investigation | Ausgabe 2/2014

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Abstract

Objective

Male hypogonadism is common in the elderly and has been associated with increased risk of mortality. Our objective has been to assess the prevalence of primary and central hypogonadism in elderly male patients admitted to the hospital because of acute illness. We also evaluated the relationships between gonadal dysfunction and in-hospital mortality.

Patients and methods

150 patients, aged ≥65 years, admitted during 2010 and 2011 in our geriatric unit, were studied. Serum concentrations total, bioavailable and free testosterone, as well as of follicle-stimulating hormone and luteinizing hormone were quantified in every patient. Hypogonadism was defined by the presence of serum testosterone levels lower than 200 ng/dl.

Results

Hypogonadism was found in 80 patients (53.3 %). Serum gonadotropin concentrations were elevated in 43.7 % of these patients, whereas 41.3 % of hypogonadic patients showed normal and 15 % low gonadotropin concentrations. Respiratory tract infection and congestive heart failure were the main causes of hospitalization in hypogonadal men, whereas acute cerebrovascular disease was the main reason for admission in eugonadal patients. Of the 13 patients who died during hospitalization, 12 were hypogonadic. Patients who died showed significantly lower serum levels of total, free and bioavailable testosterone than those found in patients who survived.

Conclusion

Our results show that about half of patients admitted for acute illness have hypogonadism, mainly of non-hypergonadotropic type. Gonadal hypofunction is significantly related with in-hospital mortality. A low value of serum testosterone may be a predictor for mortality in elderly male patients.
Literatur
1.
Zurück zum Zitat Tostain JL, Blanc F (2008) Testosterone deficiency: a common, unrecognized syndrome. Nat Clin Pract Urol 5:388–396PubMedCrossRef Tostain JL, Blanc F (2008) Testosterone deficiency: a common, unrecognized syndrome. Nat Clin Pract Urol 5:388–396PubMedCrossRef
2.
Zurück zum Zitat Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR, Baltimore Longitudinal Study of Aging (2001) Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore longitudinal study of aging. J Clin Endocrinol Metab 86:724–731PubMedCrossRef Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR, Baltimore Longitudinal Study of Aging (2001) Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore longitudinal study of aging. J Clin Endocrinol Metab 86:724–731PubMedCrossRef
3.
Zurück zum Zitat Vermeulen A, Kaufman JM (2002) Diagnosis of hypogonadism in the aging male. Aging Male 5:170–176PubMedCrossRef Vermeulen A, Kaufman JM (2002) Diagnosis of hypogonadism in the aging male. Aging Male 5:170–176PubMedCrossRef
4.
Zurück zum Zitat Allan CA, McLachlan RI (2004) Age-related changes in testosterone and the role of replacement therapy in older men. Clin Endocrinol (Oxf) 60:653–670CrossRef Allan CA, McLachlan RI (2004) Age-related changes in testosterone and the role of replacement therapy in older men. Clin Endocrinol (Oxf) 60:653–670CrossRef
5.
Zurück zum Zitat Araujo AB, O’Donnell AB, Brambilla DJ et al (2004) Prevalence and incidence of androgen deficiency in middle-aged and older men: estimates from the Massachusetts male aging study. J Clin Endocrinol Metab 89:5920–5926PubMedCrossRef Araujo AB, O’Donnell AB, Brambilla DJ et al (2004) Prevalence and incidence of androgen deficiency in middle-aged and older men: estimates from the Massachusetts male aging study. J Clin Endocrinol Metab 89:5920–5926PubMedCrossRef
6.
Zurück zum Zitat Araujo AB, Esche GR, Kupelian V et al (2007) Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab 92:4241–4247PubMedCrossRef Araujo AB, Esche GR, Kupelian V et al (2007) Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab 92:4241–4247PubMedCrossRef
7.
Zurück zum Zitat Wang C, Nieschlag E, Swerdloff R et al (2008) Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations. Eur J Endocrinol 159:507–514PubMedCentralPubMedCrossRef Wang C, Nieschlag E, Swerdloff R et al (2008) Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations. Eur J Endocrinol 159:507–514PubMedCentralPubMedCrossRef
8.
Zurück zum Zitat Wu FC, Tajar A, Pye SR et al (2008) Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European male aging study. J Clin Endocrinol Metab 93:2737–2745PubMedCrossRef Wu FC, Tajar A, Pye SR et al (2008) Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European male aging study. J Clin Endocrinol Metab 93:2737–2745PubMedCrossRef
9.
Zurück zum Zitat Venkat K, Desai M, Arora MM, Singh P, Khatkhatay MI (2009) Age-related changes in sex steroid levels influence bone mineral density in healthy Indian men. Osteoporos Int 20:955–962PubMedCrossRef Venkat K, Desai M, Arora MM, Singh P, Khatkhatay MI (2009) Age-related changes in sex steroid levels influence bone mineral density in healthy Indian men. Osteoporos Int 20:955–962PubMedCrossRef
10.
Zurück zum Zitat Matsumoto AM (2002) Andropause: clinical implications of the decline in serum testosterone levels with aging in men. J Gerontol A Biol Sci Med Sci 57:M76–M99PubMedCrossRef Matsumoto AM (2002) Andropause: clinical implications of the decline in serum testosterone levels with aging in men. J Gerontol A Biol Sci Med Sci 57:M76–M99PubMedCrossRef
11.
Zurück zum Zitat Travison TG, Araujo AB, Kupelian V, O’Donnell AB, McKinlay JB (2007) The relative contributions of aging, health, and lifestyle factors to serum testosterone decline in men. J Clin Endocrinol Metab 92:549–555PubMedCrossRef Travison TG, Araujo AB, Kupelian V, O’Donnell AB, McKinlay JB (2007) The relative contributions of aging, health, and lifestyle factors to serum testosterone decline in men. J Clin Endocrinol Metab 92:549–555PubMedCrossRef
12.
Zurück zum Zitat Yeap BB (2010) Androgens and cardiovascular disease. Curr Opin Endocrinol Diabetes Obes 17:269–276PubMedCrossRef Yeap BB (2010) Androgens and cardiovascular disease. Curr Opin Endocrinol Diabetes Obes 17:269–276PubMedCrossRef
13.
Zurück zum Zitat Tirabassi G, Gioia A, Giovannini L et al (2013) Testosterone and cardiovascular risk. Intern Emerg Med 8(Suppl 1):S65–S69PubMedCrossRef Tirabassi G, Gioia A, Giovannini L et al (2013) Testosterone and cardiovascular risk. Intern Emerg Med 8(Suppl 1):S65–S69PubMedCrossRef
14.
Zurück zum Zitat Araujo AB, Kupelian V, Page ST, Handelsman DJ, Bremner WJ, McKinlay JB (2007) Sex steroids and all-cause and cause-specific mortality in men. Arch Intern Med 167:1252–1260PubMedCrossRef Araujo AB, Kupelian V, Page ST, Handelsman DJ, Bremner WJ, McKinlay JB (2007) Sex steroids and all-cause and cause-specific mortality in men. Arch Intern Med 167:1252–1260PubMedCrossRef
15.
Zurück zum Zitat Cummings-Vaughn LA, Malmstrom TK, Morley JE, Miller DK (2011) Testosterone is not associated with mortality in older African–American males. Aging Male 14:132–140PubMedCrossRef Cummings-Vaughn LA, Malmstrom TK, Morley JE, Miller DK (2011) Testosterone is not associated with mortality in older African–American males. Aging Male 14:132–140PubMedCrossRef
16.
Zurück zum Zitat Haring R, Teng Z, Xanthakis V et al (2013) Association of sex steroids, gonadotrophins, and their trajectories with clinical cardiovascular disease and all-cause mortality in elderly men from the Framingham heart study. Clin Endocrinol (Oxf) 78:629–634CrossRef Haring R, Teng Z, Xanthakis V et al (2013) Association of sex steroids, gonadotrophins, and their trajectories with clinical cardiovascular disease and all-cause mortality in elderly men from the Framingham heart study. Clin Endocrinol (Oxf) 78:629–634CrossRef
17.
Zurück zum Zitat Lehtonen A, Huupponen R, Tuomilehto J et al (2008) Serum testosterone but not leptin predicts mortality in elderly men. Age Ageing 37:461–464PubMedCrossRef Lehtonen A, Huupponen R, Tuomilehto J et al (2008) Serum testosterone but not leptin predicts mortality in elderly men. Age Ageing 37:461–464PubMedCrossRef
18.
Zurück zum Zitat Tivesten A, Vandenput L, Labrie F et al (2009) Low serum testosterone and estradiol predict mortality in elderly men. J Clin Endocrinol Metab 94:2482–2488PubMedCrossRef Tivesten A, Vandenput L, Labrie F et al (2009) Low serum testosterone and estradiol predict mortality in elderly men. J Clin Endocrinol Metab 94:2482–2488PubMedCrossRef
19.
Zurück zum Zitat Corona G, Rastrelli G, Monami M et al (2011) Hypogonadism as a risk factor for cardiovascular mortality in men: a meta-analytic study. Eur J Endocrinol 165:687–701PubMedCrossRef Corona G, Rastrelli G, Monami M et al (2011) Hypogonadism as a risk factor for cardiovascular mortality in men: a meta-analytic study. Eur J Endocrinol 165:687–701PubMedCrossRef
20.
Zurück zum Zitat Shah S, Vanclay F, Cooper B (1989) Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol 42:703–709PubMedCrossRef Shah S, Vanclay F, Cooper B (1989) Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol 42:703–709PubMedCrossRef
21.
Zurück zum Zitat Vermeulen A, Verdonck L, Kaufman JM (1999) A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab 84:3666–3672PubMedCrossRef Vermeulen A, Verdonck L, Kaufman JM (1999) A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab 84:3666–3672PubMedCrossRef
22.
Zurück zum Zitat Kalyani RR, Gavini S, Dobs AS (2007) Male hypogonadism in systemic disease. Endocrinol Metab Clin N Am 36:333–348CrossRef Kalyani RR, Gavini S, Dobs AS (2007) Male hypogonadism in systemic disease. Endocrinol Metab Clin N Am 36:333–348CrossRef
23.
Zurück zum Zitat Veldhuis JD, Keenan DM, Liu PY, Iranmanesh A, Takahashi PY, Nehra AX (2009) The aging male hypothalamic-pituitary-gonadal axis: pulsatility and feedback. Mol Cell Endocrinol 299:14–22PubMedCentralPubMedCrossRef Veldhuis JD, Keenan DM, Liu PY, Iranmanesh A, Takahashi PY, Nehra AX (2009) The aging male hypothalamic-pituitary-gonadal axis: pulsatility and feedback. Mol Cell Endocrinol 299:14–22PubMedCentralPubMedCrossRef
24.
Zurück zum Zitat Karadag F, Ozcan H, Karul AB, Yilmaz M, Cildag O (2009) Sex hormone alterations and systemic inflammation in chronic obstructive pulmonary disease. Int J Clin Pract 63:275–281PubMedCrossRef Karadag F, Ozcan H, Karul AB, Yilmaz M, Cildag O (2009) Sex hormone alterations and systemic inflammation in chronic obstructive pulmonary disease. Int J Clin Pract 63:275–281PubMedCrossRef
25.
Zurück zum Zitat Yeap BB, Hyde Z, Almeida OP et al (2009) Lower testosterone levels predict incident stroke and transient ischemic attack in older men. J Clin Endocrinol Metab 94:2353–2359PubMedCrossRef Yeap BB, Hyde Z, Almeida OP et al (2009) Lower testosterone levels predict incident stroke and transient ischemic attack in older men. J Clin Endocrinol Metab 94:2353–2359PubMedCrossRef
26.
Zurück zum Zitat Khaw KT, Dowsett M, Folkerd E et al (2007) Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men: European prospective investigation into cancer in Norfolk (EPIC-Norfolk) prospective population study. Circulation 116:2694–2701PubMedCrossRef Khaw KT, Dowsett M, Folkerd E et al (2007) Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men: European prospective investigation into cancer in Norfolk (EPIC-Norfolk) prospective population study. Circulation 116:2694–2701PubMedCrossRef
27.
Zurück zum Zitat Laughlin GA, Barrett-Connor E, Bergstrom J (2008) Low serum testosterone and mortality in older men. J Clin Endocrinol Metab 93:68–75PubMedCrossRef Laughlin GA, Barrett-Connor E, Bergstrom J (2008) Low serum testosterone and mortality in older men. J Clin Endocrinol Metab 93:68–75PubMedCrossRef
28.
Zurück zum Zitat Shores MM, Smith NL, Forsberg CW, Anawalt BD, Matsumoto AM (2012) Testosterone treatment and mortality in men with low testosterone levels. J Clin Endocrinol Metab 97:2050–2058PubMedCrossRef Shores MM, Smith NL, Forsberg CW, Anawalt BD, Matsumoto AM (2012) Testosterone treatment and mortality in men with low testosterone levels. J Clin Endocrinol Metab 97:2050–2058PubMedCrossRef
29.
Zurück zum Zitat Iglesias P, Muñoz A, Prado F et al (2009) Alterations in thyroid function tests in aged hospitalized patients: prevalence, aetiology and clinical outcome. Clin Endocrinol (Oxf) 70:961–967CrossRef Iglesias P, Muñoz A, Prado F et al (2009) Alterations in thyroid function tests in aged hospitalized patients: prevalence, aetiology and clinical outcome. Clin Endocrinol (Oxf) 70:961–967CrossRef
30.
Zurück zum Zitat Iglesias P, Polini A, Muñoz A et al (2011) Fasting hyperglycaemia and in-hospital mortality in elderly population. Int J Clin Pract 65:308–313PubMedCrossRef Iglesias P, Polini A, Muñoz A et al (2011) Fasting hyperglycaemia and in-hospital mortality in elderly population. Int J Clin Pract 65:308–313PubMedCrossRef
31.
Zurück zum Zitat Corona G, Rastrelli G, Monami M et al (2011) Body mass index regulates hypogonadism-associated CV risk: results from a cohort of subjects with erectile dysfunction. J Sex Med 8:2098–2105PubMedCrossRef Corona G, Rastrelli G, Monami M et al (2011) Body mass index regulates hypogonadism-associated CV risk: results from a cohort of subjects with erectile dysfunction. J Sex Med 8:2098–2105PubMedCrossRef
Metadaten
Titel
Hypogonadism in aged hospitalized male patients: prevalence and clinical outcome
verfasst von
P. Iglesias
F. Prado
M. C. Macías
M. T. Guerrero
A. Muñoz
E. Ridruejo
P. Tajada
C. García-Arévalo
J. J. Díez
Publikationsdatum
01.02.2014
Verlag
Springer International Publishing
Erschienen in
Journal of Endocrinological Investigation / Ausgabe 2/2014
Elektronische ISSN: 1720-8386
DOI
https://doi.org/10.1007/s40618-013-0009-x

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