title: Is late-onset hypogonadotropic hypogonadism a specific age-dependent disease, or merely an epiphenomenon caused by accumulating disease-burden?
abstract: BACKGROUND
  The aim of this paper is to summarize the available evidence supporting the link between late onset hypogonadism (LOH) and associated common clinical illnesses, focusing on metabolic diseases. The possible benefits or risks related to testosterone replacement therapy (TRT) in these conditions will also be analyzed.
  
  
  METHODS
  An extensive Medline search was performed.
  
  
  RESULTS
  LOH is closely associated with a worse metabolic profile and a higher cardiovascular risk. The relationship between hypogonadism obesity and insulin resistance is complex and bidirectional. Emerging evidence suggests a positive role of TRT in improving body composition and metabolic outcomes in subjects with LOH.
  
  
  CONCLUSIONS
  Despite the aforementioned data, it is not completely known whether reduced testosterone levels in elderly males might play a direct pathogenetic role in these conditions or whether low T and associated morbidities are concomitant conditions, both associated with the aging process. Further and longer studies are advisable to confirm the preliminary results.
authors.affiliation: Endocrinology Unit, Azienda USL di Bologna, Medical Department, Maggiore-Bellaria Hospital, Bologna, Italy - m.maggi@dfc.unifi.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corona
authors.forename: Elisa
authors.initials: E
authors.lastname: Maseroli
authors.forename: Giulia
authors.initials: G
authors.lastname: Rastrelli
authors.forename: Davide
authors.initials: D
authors.lastname: Francomano
authors.forename: Antonio
authors.initials: A
authors.lastname: Aversa
authors.forename: Geoffrey I
authors.initials: GI
authors.lastname: Hackett
authors.forename: Simona
authors.initials: S
authors.lastname: Ferri
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sforza
authors.forename: Mario
authors.initials: M
authors.lastname: Maggi
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D017281:Cost of Illness; D006801:Humans; D007006:Hypogonadism / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male