title: Association of specific symptoms and metabolic risks with serum testosterone in older men.
abstract: BACKGROUND
  Although attention and concern about health disorders in aging men have been growing, the structure of psychological and somatic complaints of actual patients, not population-based cohorts, has not been elucidated in relation to sex hormone patterns and metabolism.
  
  
  OBJECTIVE
  The objective of the study was investigation of factors influencing complaint structures in aging male patients.
  
  
  METHODS
  This was a cross-sectional cohort study.
  
  
  METHODS
  The study was conducted in an andrological outpatient department.
  
  
  METHODS
  Subjects included 434 consecutive male patients aged 50-86 yr.
  
  
  METHODS
  The following hypotheses were measured: 1) psychosomatic complaints and metabolic factors in aging male patients are related to sex hormone levels in a symptom-specific manner, and 2) patients form subcohorts.
  
  
  RESULTS
  A clear-cut threshold for late-onset hypogonadism was not found; rather, prevalence of psychosomatic symptoms and metabolic risk factors accumulated with decreasing androgen levels. For example, androgen-induced prevalence of loss of libido or vigor increased below testosterone concentrations of 15 nmol/liter (P < 0.001), whereas depression and diabetes mellitus type 2 (also in nonobese men) were significantly more present in men with testosterone concentrations below 10 nmol/liter (P < 0.001). Erectile dysfunction was identified as a composite pathology of metabolic risk factors, smoking, and depressivity, whereas only testosterone concentrations below 8 nmol/liter contributed to that symptom (P = 0.003). Cluster analysis revealed aging men to present within three independent groups characterized by psychosomatic complaints, metabolic disorders, and sexual health problems. These subgroups of patients exhibit distinct features in terms of androgen levels, age, and body mass index.
  
  
  CONCLUSIONS
  There is no evidence that a uniform structure of testosterone concentrations and complaints exists within the cohort of elderly male patients. Rather, in aging male patients, psychosomatic complaints and metabolic risk relate to testosterone in a symptom-specific manner.
authors.affiliation: Institute of Reproductive Medicine of the University, Domagkstr. 11, D-48129 Münster, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Zitzmann
authors.forename: Stephanie
authors.initials: S
authors.lastname: Faber
authors.forename: Eberhard
authors.initials: E
authors.lastname: Nieschlag
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood* / Q000378:metabolism*; D047649:Andropause; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000453:epidemiology / Q000378:metabolism; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D011602:Psychophysiologic Disorders / Q000097:blood / Q000453:epidemiology; D012307:Risk Factors; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology; D013739:Testosterone / Q000097:blood*
chemical_list: D013739:Testosterone