Volume 70, Issue 3 pp. 446-454

Prevalence of low male testosterone levels in primary care in Germany: cross-sectional results from the DETECT study

Harald Jörn Schneider

Harald Jörn Schneider

Medizinische Klinik, Ludwig-Maximilian-University, Innenstadt, Munich, Germany

Internal Medicine, Endocrinology and Clinical Chemistry, Max Planck Institute of Psychiatry, Munich, Germany

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Caroline Sievers

Caroline Sievers

Internal Medicine, Endocrinology and Clinical Chemistry, Max Planck Institute of Psychiatry, Munich, Germany

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Jens Klotsche

Jens Klotsche

Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany

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Steffen Böhler

Steffen Böhler

Institute of Clinical Pharmacology, Technical University of Dresden, Dresden , Germany

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David Pittrow

David Pittrow

Institute of Clinical Pharmacology, Technical University of Dresden, Dresden , Germany

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Hendrik Lehnert

Hendrik Lehnert

Warwick Medical School, University Hospital of Coventry, Coventry, UK

First Medical Department, University of Luebeck, Germany

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Hans-Ulrich Wittchen

Hans-Ulrich Wittchen

Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany

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Günter Karl Stalla

Günter Karl Stalla

Internal Medicine, Endocrinology and Clinical Chemistry, Max Planck Institute of Psychiatry, Munich, Germany

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First published: 11 February 2009
Citations: 37
Harald Jörn Schneider, Medizinische Klinik, Campus Innenstadt University of Munich, 80336 Munich, Germany. Tel.: +49 89 5160 2330; Fax: +49 89 5160 2194; E-mail: [email protected]

Summary

Objective Low testosterone levels in men occur with increasing age and are associated with increased morbidity, particularly metabolic syndrome, and mortality. As the prevalence of hypogonadal testosterone levels has not been assessed in the primary care setting in Europe, we aimed to investigate the prevalence of low testosterone levels in this setting, and the patient characteristics and comorbidities associated with this finding.

Design A cross-sectional, epidemiological study (the Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of Treatment (DETECT) study).

Patients A total of 2719 male primary care patients (age 58·7 ± 13·4 years) were included.

Measurements Testosterone was measured in all patients. Information on diseases, risk conditions and treatments was documented by the primary care physicians. A large set of laboratory parameters was measured in a central laboratory. We calculated univariate and multivariate logistic regression models to assess the associations of low testosterone levels with different health and life style factors.

Results A total of 19·3% of all men had hypogonadism as defined by testosterone levels < 3·0 ng/ml. Stepwise logistic regression analysis revealed that obesity, metabolic syndrome, cancer, intake of six or more drugs, acute inflammation and nonsmoking were associated with hypogonadal testosterone levels. Higher age, liver diseases, and cancer were associated with very low testosterone levels (< 1·0 ng/ml).

Conclusions Hypogonadal testosterone levels are common in primary care, particularly in patients with the above conditions.

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