The relationship between health-related quality of life, obesity and testosterone levels in older men.

BACKGROUND: quality of life evaluated by Short-Form 36 (SF-36) is decreased in obesity and hypogonadism, but the importance of regional fat mass is unknown. In the present study, we evaluated associations between SF-36, regional fat deposits and bioavailable testosterone (BioT) in ageing men. METHODS: a population-based cross-sectional study in older men. Data included SF-36 questionnaires with the dimensions such as physical function, role limitations physical, bodily pain, general health, vitality, social function, role limitations emotional and mental health. Furthermore, waist, lean body mass (measured by dual X-ray absorptiometry), visceral adipose tissue and subcutaneous adipose tissue (SAT) (measured by magnetic resonance imaging) and BioT were established. RESULTS: five hundred and ninety-eight men aged 60-74 years were included. The SF-36 dimensions such as physical function, general health, vitality and role limitations functional were inversely associated with waist and SAT and positively associated with BioT. In multiple regression analysis, waist was the body composition measure with the strongest association with SF-36 dimension scores. CONCLUSION: SF-36 dimension scores were more closely associated with central obesity than with BioT. CLINICAL TRIAL REGISTRATION NUMBER: www.clinicaltrials.gov, NCT00155961.

Osteoporosis and vertebral fractures in men aged 60-74 years.

BACKGROUND: limited information on the prevalence of osteoporosis and VFxs in men in high-risk populations is available. The choice of reference values for dual X-ray absorptiometry (DXA) is debated. We evaluated the prevalence of osteoporosis and vertebral deformities in a population-based sample of men. METHODS: bone mineral density (BMD) was measured and vertebral deformities assessed using DXA and VFx assessment (VFA), respectively, in a random sample of 600 Danish men aged 60-74 years. Osteoporosis was defined as a T-score of -2.5 or less. RESULTS: the study population was comparable with the background population with regard to age, body mass index and co-morbidity. Osteoporosis was diagnosed in less than 1% of the participants at inclusion. Using Danish and NHANES III reference data, 10.2 and 11.5% of the study population had osteoporosis, respectively. In all, 6.3% participants had at least one VFx. BMD was significantly lower in participants with vertebral deformities, but only 24% of these cases had osteoporosis. CONCLUSIONS: osteoporosis and VFxs are prevalent in men aged 60-74 years. Although the majority of deformities were present in individuals without osteoporosis, BMD was lower in patients with VFxs at all sites investigated. Male osteoporosis was markedly underdiagnosed.

Chronic diseases in elderly men: underreporting and underdiagnosis.

OBJECTIVE: prevalence estimates for chronic diseases and associated risk factors are needed for priority setting and disease prevention strategies. The aim of this cross-sectional study was to estimate the self-reported and clinical prevalence of common chronic disorders in elderly men. STUDY DESIGN AND SETTING: a questionnaire was sent to a random sample of 4,975 men aged 60-74 years. An age-stratified randomised sample (n = 1,845) of those with complete questionnaires was invited to participate in a telephone interview (n = 864), followed by physical examination (n = 600). Self-reported data on risk factors and disease prevalence were compared with data from hospital medical records. RESULTS: physical inactivity, smoking and excessive alcohol intake were reported by 27, 22 and 17% of the study population, respectively. Except for diabetes, all the chronic diseases investigated, including hypertension, musculoskeletal and respiratory diseases were underreported by study participants. Erectile dysfunction and hypogonadism were substantially underreported in the study population even though these diseases were found to affect 48 and 21% of the participants, respectively. CONCLUSIONS: the study showed a high prevalence of detrimental life style factors including smoking, excessive alcohol consumption and physical inactivity in elderly Danish men. Except for diabetes and respiratory disease, chronic diseases were underreported and in particular erectile dysfunction and osteoporosis were underdiagnosed in the study population, underlining the importance of awareness of chronic diseases among both the general population and physicians.

The impact of the CAG repeat polymorphism of the androgen receptor gene on muscle and adipose tissues in 20-29-year-old Danish men: Odense Androgen Study.

BACKGROUND: The number of CAG repeats (CAG(n)) within the CAG repeat polymorphism of the androgen receptor gene correlates inversely with the transactivation of the receptor. OBJECTIVE: To examine the impact of CAG(n) on muscle, fat distribution, and circulating androgen levels. Design, settings and participants Population-based, cross-sectional study of 783 Danish men aged 20-29 years. METHODS: Genotyping was performed in 767 men. Areas of thigh and lower trunk muscle (muscle(thigh) and muscle(lower trunk)), subcutaneous adipose tissues (SAT(thigh) and SAT(lower trunk)), and deep adipose tissues (i.m. and visceral) were measured in 393 men by magnetic resonance imaging (MRI). Lean body mass (LBM) and fat mass (FM) were measured in all men by whole body dual-energy X-ray absorptiometry (DEXA). The absolute areas acquired by MRI were the main outcomes. The absolute DEXA measurements and relative assessments of both modalities were considered as the secondary outcomes. Results CAG(n) (range: 10-32) correlated inversely with absolute muscle(thigh) (r=-0.108), absolute muscle(lower trunk) (r=-0.132), relative muscle(thigh) (r=-0.128), relative muscle(lower trunk) (r=-0.126), relative LBM(lower extremity) (r=-0.108), and relative LBM(total) (r=-0.082), and positively with relative SAT(thigh) (r=0.137), relative SAT(lower trunk) (r=0.188), relative FM(lower extremity) (r=0.107), and relative FM(total) (r=0.082). These relationships remained significant, controlling for physical activity, smoking, chronic disease, and age. CAG(n) did not correlate with any circulating androgen. CONCLUSIONS: The CAG repeat polymorphism affects body composition in young men: absolute muscle(thigh) and absolute muscle(lower trunk) increase as CAG(n) decreases. Expressed relatively, muscle areas and LBM increase, while SAT and FM decrease as CAG(n) decreases. The polymorphism does not affect deep adipose tissues or circulating androgen levels in young men.

Visceral and subcutaneous adipose tissue assessed by magnetic resonance imaging in relation to circulating androgens, sex hormone-binding globulin, and luteinizing hormone in young men.

CONTEXT: No large studies of young men have examined circulating sex hormones in relation to visceral and sc adipose tissues. OBJECTIVE: The aim of this study was to investigate the role of visceral adipose tissue and sc adipose tissue on circulating sex hormones and the impact of obesity on sex hormone reference intervals. DESIGN, SETTING, AND PARTICIPANTS: Population-based study of 783 Danish 20- to 29-yr-old men was performed using dual-energy x-ray absorptiometry in all men and magnetic resonance imaging in 406 men. MAIN OUTCOME MEASURES: Total, bioavailable, and free testosterone, dihydrotestosterone (DHT), total and bioavailable estradiol, SHBG, and LH were measured. RESULTS: In multiple regressions, visceral adipose tissue was an independent, inverse correlate of bioavailable and free testosterone. Subcutaneous adipose tissue correlated negatively with SHBG and positively with bioavailable estradiol adjusted for total testosterone. Both visceral adipose tissue and sc adipose tissue correlated inversely with total testosterone and DHT. Adjusting for SHBG, only visceral adipose tissue remained significantly correlated. Low total testosterone in viscerally obese men was not accompanied by increased LH. The androgen reference intervals were significantly displaced toward lower limits in obese vs. nonobese men (total testosterone: 8.5-29.3 vs. 12.5-37.6 nmol/liter; bioavailable testosterone: 6.1-16.9 vs. 7.6-20.7 nmol/liter; free testosterone: 0.23-0.67 vs. 0.29-0.78 nmol/liter; and DHT: 0.63-2.5 vs. 0.85-3.2 nmol/liter), whereas total estradiol (36.5-166 pmol/liter) and bioavailable estradiol (23.4-120 pmol/liter) reference intervals were not. In obese men, 22.9% had total testosterone less than 12.5 nmol/liter. CONCLUSIONS: Visceral adipose tissues correlate independently with bioavailable and free testosterone in young men. The inverse relationship between total testosterone and sc adipose tissue seems to be accounted for by variations in SHBG. The reference intervals for total testosterone, bioavailable testosterone, free testosterone, and DHT are displaced toward lower limits in obese men.