Development of and Recovery from Secondary Hypogonadism in Ageing XXXX : Prospective Results from the EMAS.

@entity1 @entity323 @entity353 @entity1017 @entity6126
CONTEXT: @entity6126 is common in ageing @entity1 ; its natural history and predisposing factors are unclear. OBJECTIVES: 1) To identify factors which predispose eugonadal @entity1 (T >= 10.5nmol/L) to develop biochemical @entity6126 (T<10.5nmol/L, LH <=9.4U/L) and secondary hypogonadal @entity1 to recover to eugonadism. 2) To characterize clinical features associated with these transitions. DESIGN: Prospective observational general population cohort survey. SETTING: Clinical research centres. @entity1 : 3369 community-dwelling @entity1 aged 40-79 yr in eight European centres. INTERVENTION: Observational follow-up of 4.3 years. MAIN OUTCOME MEASURE: Subjects were categorised according to change/no change in biochemical gonadal status during follow-up into persistent eugonadal (n=1909), incident secondary hypogonadal (n=140), persistent secondary hypogonadal (n=123) and recovered from @entity6126 to eugonadism (n=96). Baseline predictors and changes in clinical features associated with incident @entity6126 and recovery from @entity6126 were analysed by regression models. RESULTS: The incidence of @entity6126 was 155.9/10,000/year, while 42.9% of @entity1 with @entity6126 recovered to eugonadism. Incident @entity6126 was predicted by obesity [BMI>= 30kg/m(2): odds ratio (OR)=2.86 (95% confidence interval 1.67;4.90); p<0.0001], @entity1017 [OR=1.79 (1.15;2.80);p=0.011] and increased waist circumference [OR=1.73 (1.07;2.81); p=0.026 and 2.64 (1.66;4.21);p<0.0001, for waist circumference 94-102 and >= 102 cm, respectively]. Incident secondary hypogonadal @entity1 experienced new/worsening sexual symptoms [low libido, @entity323 and infrequent spontaneous erections]. Recovery from @entity6126 was predicted by non-obesity [OR=2.28 (1.21;4.31); p=0.011], @entity353 [OR=2.24 (1.04;4.85); p=0.042], normal waist circumference [OR=1.93 (1.01;3.70); p=0.048], younger age [<60yr OR=2.32 (1.12;4.82); p=0.024] and higher education [OR=2.11 (1.05;4.26); p=0.037], but symptoms did not show significant concurrent improvement. CONCLUSION: Obesity-related metabolic and lifestyle factors predispose older @entity1 to the development of @entity6126 , which is frequently reversible with @entity353 .
