Title: Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: The European Male Aging Study
Authors: Wu, Frederick C W ×
Tajar, Abdelouahid
Pye, Stephen R
Silman, Alan J
Finn, Joseph D
O'Neill, Terence W
Bartfai, Gyorgy
Casanueva, Felipe
Forti, Gianni
Giwercman, Aleksander
Huhtaniemi, Ilpo T
Kula, Krzysztof
Punab, Margus
Boonen, Steven
Vanderschueren, Dirk #
Issue Date: Jul-2008
Publisher: Issued for the Endocrine Society by the Williams & Wilkins Co.
Series Title: Journal of Clinical Endocrinology and Metabolism vol:93 issue:7 pages:2737-2745
Abstract: CONTEXT The cause of declining testosterone (T) in aging men and their relationships with risk factors are unclear. OBJECTIVE To investigate the relationships between lifestyle and health with reproductive hormones in aging men. DESIGN Baseline cross-sectional survey on 3200 community - dwelling men aged 40 - 79 yr from a prospective cohort study in 8 European countries. RESULTS Four predictors were associated with distinct modes of altered function:- Age: lower free T (FT) (-3.12 pmol/L/ yr, p<0.001) with raised luteinizing hormone (LH) suggesting impaired testicular function. Obesity: lower total T (TT) (-2.32 nmol/L) and FT (-17.60 pmol/L) for BMI >/=25 - <30 kg/m(2) and lower TT (-5.09 nmol/L,) and FT (-53.72 pmol/L) for BMI >/=30 kg/m(2) (p <0.001 - 0.01, referent: BMI <25 kg/m(2)) with unchanged/decreased LH, indicating hypothalamus/pituitary dysfunction. Co-morbidity: lower TT (-0.80 nmol/L, p <0.01) with unchanged LH in younger men but higher LH in older men. Smoking: higher sex hormone binding globulin (SHBG) (5.96 nmol/L, p <0.001) and LH (0.77 U/L, p <0.01) with increased TT (1.31 nmol/L, p<0.001) but not FT, compatible with a resetting of T-LH negative feedback due to elevated SHBG. CONCLUSIONS Complex multiple alterations in the hypothalamic-pituitary-testicular axis function exist in ageing men against a background of progressive age-related testicular impairment. These changes are differentially linked to specific risk factors. Some risk factors operate independently of but others interact with age, in contributing to the T decline. These potentially modifiable risk factors suggest possible preventative measures to maintain T during in aging men.
ISSN: 0021-972X
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Clinical and Experimental Endocrinology
Gerontology and Geriatrics
× corresponding author
# (joint) last author

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