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Severe late-onset hypogonadism increased risk for all-cause, CV mortality
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Severe late-onset hypogonadism was associated with a higher risk for all-cause and cardiovascular mortality, according to researchers. In addition, both the level of testosterone and the presence of sexual symptoms contributed independently.
Observations of low testosterone in men with sexual symptoms could offer a chance to identify the small subgroup of aging men who have an increased risk for dying, according to Stephen R. Pye, MPhil, of the andrology research unit at the University of Manchester and arthritis research UK epidemiology unit at the Manchester Academic Health Science Centre, and colleagues.
They gathered prospective data from the European Male Aging Study (EMAS) on 2,599 community-dwelling men aged 40 to 79 years, spanning eight countries. The primary outcome was all-cause, CV and cancer-related mortality, according to data.
At the median follow-up of 4.3 years, 147 men died. Of those, 56 (38.1%) were due to CVD and 60 (40.8%) to cancer; 22 (15%) were due to other causes. Of the 55 men (2.1%) identified as having late-onset hypogonadism, 31 were classified as moderate and 24 as severe, researchers wrote.
Those with severe late-onset hypogonadism demonstrated a fivefold (HR=5.5; 95% CI, 2.7-11.4) higher risk for all-cause mortality vs. men without late-onset hypogonadism.
The multivariable-adjusted risk for mortality was twofold among those with testosterone less than 8 nmol/L (HR=2.3; 95% CI, 1.2-4.2) and threefold higher among those with three sexual symptoms (decreased frequency of morning erections and sexual thoughts and erectile dysfunction; HR=3.2; 95% CI, 1.8-5.8) compared with asymptomatic men, according to data.
Similarly, researchers reported those with moderate late-onset hypogonadism had a threefold (HR=2.9; 95% CI, 1.2-7.1) higher risk for CVD mortality and those with severe late-onset hypogonadism had an eightfold (HR=8.5; 95% CI, 3-23.8) higher risk for CVD mortality.
Disclosure: Some of the researchers report various financial ties to Acrux, Ardana Biosciences, Bayer-Schering, Ferring Pharmaceuticals, GlaxoSmithKline, Jenapharm, Lilly-ICOS, New England Research Institute in Watertown, Mass., Organon, Pierre Fabre Medicaments, Proctor & Gamble and TAP.
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