Hormonal determinants of the severity of andropausal and depressive symptoms in middle-aged and elderly men with prediabetes

Figures & data

Table 1 Baseline characteristics of men with prediabetes divided according to age

Clinical and laboratory variables	PD			P-value*
	40–80 years (n=196)	40–59 years (n=112)	60–80 years (n=84)
Age, years	58±4	52±3	69±4
TT, nmol/L	13.8±3.7	15.7±3.2	11.7±3.6	0.001
cFT, nmol/L	0.338±0.08	0.355±0.08	0.315±0.08	0.005
DHEAS, ng/mL	529 (198–897)	689 (234–907)	423 (167–745)	0.01
IGF-1, ng/mL	89.2±41.3	93.6±44.6	87.4±40.8
LH, IU/L	5.9±1.3	5.5±1.2	6.3±1.4
E2, pg/mL	29.4±9.8	28.4±11.7	32.6±9.7	0.05
SHBG, nmol/L	31.6±4.2	30.9±3.8	32.7±3.8
BMI, kg/m^2	29.4±4.5	28.6±4.7	30.8±4.3	0.05
WC, cm	102±7.5	101±7.6	104±6.8
HbA1c, %	6.0±0.3	5.9±0.2	6.1±0.3	0.02
FPG, mg/dL	117±5.6	115±5.2	121±6.2	0.001
Glucose in OGTT, mg/dL	141±6.1	137±12.6	147±12.6	0.05
SBP, mmHg	129±18	125±19	135±19
DBP, mmHg	94±11	92±10	96±11
Cholesterol, mg/dL	223±43	218±41	228±37	0.05
Triglycerides, mg/dL	169±12	167±14	172±14
HDL-cholesterol, mg/dL	36±4	39±6	34±4	0.05
LDL-cholesterol, mg/dL	147±22	142±22	156±24
Comorbidities
Obesity, % (n)	71 (140)	73 (82)	69 (58)
Current smoker, % (n)	32 (65)	36 (40)	30 (25)	0.05
Hypertension, % (n)	52 (102)	44 (49)	63 (53)	0.01
MetS, % (n)	83 (162)	81 (91)	86 (72)
CVD, % (n)	26 (52)	18 (20)	38 (32)	0.001
Andropausal symptoms
Psychological, points	11.3±4.2	9.9±4.7	11.6±4.9	0.05
Sexual, points	13.9±4.9	12.6±4.2	15.1±4.8	0.001
Somatovegetative, points	17.6±5.7	18.1±5.9	19.2±6.2
All symptoms, points	42.8±13.6	40.6±13.7	45.9±13.9	0.001
AS, % (n)	35 (69)	29 (33)	43 (36)	0.001
Depressive symptoms
SDS, points	38.2±7.2	36.7±7.7	42.5±7.2	0.002

Notes: Data are presented as a mean ± standard deviation of the mean, a median (with lower and upper quartiles) or number (percentage), where appropriate.

* Indicates differences between prediabetic men 60–80 years and 40–59 years old.

Abbreviations: AS, andropausal syndrome; BMI, body mass index; cFT, calculated free testosterone; CVD, cardiovascular disease; DBP, diastolic blood pressure; DHEAS, dehydroepiandrosterone sulfate; E2, estradiol; FPG, fasting plasma glucose; HbA_1c, glycated hemoglobin; HDL, high-density lipoprotein; IGF-1, insulin-like growth factor 1; LDL, low-density lipoprotein; LH, luteinizing hormone; MetS, metabolic syndrome; OGTT, oral glucose tolerance test; PD, prediabetes; SBP, systolic blood pressure; SDS, Self-rating Depression Scale; SHBG, sex hormone-binding globulin; TT, total testosterone; WC, waist circumference.

Figure 1 Prevalence (%) of andropausal syndrome in men with prediabetes (n=196) and healthy men (n=184).

Notes: Andropausal syndrome was diagnosed according to the AMS¹⁸ and was diagnosed if the total AMS score was 50 points or higher. The intergroup differences were tested using the χ² test.
Abbreviations: AMS, Aging Males’ Symptoms rating scale; PD, prediabetes.

Figure 2 Severity of andropausal symptoms (expressed as points).

Notes: Severity of andropausal symptoms (according to AMS scale) and depressive symptoms (according to SDS scale) in men with PD (A) aged 40–59 years (n=98), and (B) aged 60–80 years (n=86), compared with healthy men (n=184). The intergroup differences were tested using the t-test for unpaired samples.
Abbreviations: AMS, Aging Males’ Symptoms rating scale; NS, nonsignificant; PD, prediabetes; SDS, Self-rating Depression Scale.

Table 2 Correlations between andropausal (total) and depressive symptoms scores and clinical characteristics in 196 men with prediabetes

Variables	AMS (total) points		SDS points
	r	P-value	r	P-value
Age, years	−0.052	0.46	−0.081	0.31
BMI (kg/m^2)	0.021	0.29	−0.065	0.13
HbA1c	−0.3145	0.02	0.025	0.64

Note: Correlations were examined using Pearson’s correlation analyses.

Abbreviations: AMS, the Aging Males’ Symptoms rating scale score; BMI, body mass index; HbA_1c, glycated hemoglobin; SDS, the Self-rating Depression Scale score.

Table 3 Parameters associated with the severity of andropausal and depressive symptoms in men with prediabetes

Variables	Andropausal symptoms								Depressive symptoms
	Sexual		Psychological		Somatovegetative		All symptoms
	Univariable models	Multivariable model corrected R^2=25%a	Univariable models	Multivariable model corrected R^2=27%a	Univariable models	Multivariable model corrected R^2=30%a	Univariable models	Multivariable model corrected R^2=33%a	Univariable models	Multivariable model corrected R^2=30%a
Men with prediabetes aged 40–59 years
Age, years	0.19	–	0.11	–	0.09	–	0.11	–	0.09	–
TT, nmol/L	−0.26b	−0.24c	−0.22c	–	−0.19c	−0.21c	−0.09	–	−0.21c	−0.27c
cFT, nmol/L	−0.39c	−0.25c	−0.34b	−0.23c	−0.24c	−0.27c	−0.24c	−0.27c	−0.03	–
DHEAS, ng/mL (ln)	−0.24b	−0.21	−0.06a	−0.12	0.11b	–	−0.21b	–	−0.23c	−0.21c
IGF-1, ng/mL	0.01	–	−0.27b	−0.25c	−0.21c	−0.23c	0.02	–	0.03	–
E2, pg/mL	0.02	–	0.07	–	0.07	–	0.08	–	0.20a	–
BMI, kg/m^2	0.15	–	0.12	–	0.02	–	0.41c	–	0.05	–
HbA1c, %	0.21a	0.20c	0.03	–	−0.37b	0.32c	0.23	–	−0.02	–
Hypertension, yes vs no	0.06	–	0.07	–	0.03	–	0.03	–	0.06	–
MetS, yes vs no	0.12	–	0.19	–	0.27c	0.21c	0.09	–	0.09	–
CVD, yes vs no	0.27b	0.23c	0.21c	0.23c	0.07	–	0.13	–	0.31c	0.27c
COPD, yes vs no	0.07	–	0.15c	0.32c	0.11	–	0.19b	0.28c	0.09	–
Men with prediabetes aged 60–80 years
Age, years	0.11	–	0.34	–	0.11	–	0.11	–	0.11	–
TT, nmol/L	−0.21b	–0.22c	−0.28b	–	−0.31b	–	−0.21c	−0.20c	−0.17	–
cFT, nmol/L	−0.32a	–0.27c	−0.24c	−0.26c	−0.24c	−0.31c	−0.09	–	−0.52c	–0.41c
DHEAS, ng/mL (ln)	−0.25b	–	0.07	–	−0.29b	−0.21c	−0.28c	−0.31c	−0.43c	–0.38c
IGF-1, ng/mL	−0.12	–	−0.24b	−0.19c	−0.19b	–	0.41	–	0.27a	–
E2, pg/mL	0.12	–	0.19	–	0.34c	–	0.07	–	0.08	–
BMI, kg/m^2	0.10	–	0.02	–	0.02	–	0.13	–	0.11	–
HbA1c, %	0.41c	0.24c	0.24a	–	0.21	–	0.21c	–	0.02	–
Hypertension, yes vs no	0.08	–	0.08	–	0.08	–	0.08	–	0.03	–
MetS, yes vs no	0.21a	0.19c	0.19	–	0.25c	0.23c	0.03	–	0.21b	–
CVD, yes vs no	0.36c	0.22c	0.41c	0.18c	0.42a	0.27c	0.03	–	0.41c	0.34c
COPD, yes vs no	0.26b	0.21c	0.18a	0.22c	0.21c	0.32c	0.29a	0.23c	0.24c	0.29c

Notes:

a P<0.001;

b P<0.01;

c P<0.05; data are presented as standardized regression coefficient β (in both univariable and multivariable models). All variables shown to be significant determinants of the severity of andropausal symptoms in the univariable models (P<0.05) were included in the multivariable models. –Indicates no data available.

Abbreviations: BMI, body mass index; cFT, calculated free testosterone; COPD, chronic obstructive pulmonary disease; CVD, cardiovascular disease; DHEAS, dehydroepiandrosterone sulfate; E2, estradiol; HbA_1c, glycated hemoglobin; IGF-1, insulin-like growth factor 1; ln, natural logarithm; MetS, metabolic syndrome; TT, total testosterone; vs, versus.

Table 4 Risk factors associated with the higher prevalence of AS in men with prediabetes

Variables	Men with AS	Men without AS	Unit	Univariable model				Multivariable model
				OR	CI	χ^2	P-value	OR	CI	χ^2	P-value
	n=33	n=79	Men with prediabetes aged 40–59 years
Age, years	55±3	53±4	1 year	0.95	0.91–1.04	2.62	0.20	–	–	–	–
TT, nmol/L	15.1±3.1	16.1±3.4*	1 nmol/L	1.02	0.98–1.04	0.58	0.42	–	–	–	–
cFT, nmol/L	0.333±0.08	0.366±0.08*	1 nmol/L	0.88	0.68–1.06	6.72	0.04	0.66	0.42–0.79	4.59	0.03
DHEAS, ng/mL (ln)	676 (221–934)	702 (239–921)	1 ln ng/mL	0.68	0.34–1.02	1.02	0.32	–	–	–	–
IGF-1, ng/mL	91.6±38.4	96.6±32.6**	1 ng/mL	1.12	0.89–1.23	4.21	0.02	1.21	1.03–1.34	6.23	0.02
E2, pg/mL	29.7±12.7	28.1±10.5	1 pg/mL	0.94	0.84–1.06	0.78	0.43	–	–	–	–
BMI, kg/m^2	28.9±4.8	28.4±4.5	1 kg/m^2	0.89	0.78–0.96	2.34	0.10	–	–	–	–
HbA1c, %	5.9±0.3	6.1±0.3**	1%	2.21	1.37–3.52	7.34	0.046	1.16	0.52–1.49	0.001	0.28
Hypertension, yes	38 (19)	37 (30)	Yes vs no	1.09	0.97–1.24	0.01	0.95	–	–	–	–
MetS, yes	70 (23)	67 (53)	Yes vs no	2.54	1.45–5.62	0.16	0.78	–	–	–	–
CVD, yes	21 (7)	16 (13)	Yes vs no	1.24	0.41–3.68	0.17	0.62	–	–	–	–
	n=36	n=48	Men with prediabetes aged 60–80 years
Age, years	70±4	68±4	1 year	0.97	0.92–1.03	0.43	0.50	–	–	–	–
TT, nmol/L	10.2±3.7	12.8±3.8*	1 nmol/L	0.91	0.78–1.23	3.96	0.01	1.01	0.75–1.34	5.24	0.02
cFT, nmol/L	0.298±0.08	0.322±0.07	1 nmol/L	0.93	0.88–0.99	0.36	0.40	–	–	–	–
DHEAS, ng/mL (ln)	411 (147–7,476)	439 (171–753)	1 ln ng/mL	4.28	2.34–6.45	12.23	<0.001	1.98	1.43–4.12	3.90	0.03
IGF-1, ng/mL	88.74±41.8	84.3±40.5*	1 ng/mL	1.21	0.89–1.76	3.28	0.10	–	–	–	–
E2, pg/mL	33.7±8.9	31.2±9.8	1 pg/mL	0.87	0.77–1.76	0.16	0.55	–	–	–	–
BMI, kg/m^2	31.2±4.4	30.2±4.3	1 kg/m^2	0.85	0.78–0.95	2.12	0.22	–	–	–	–
HbA1c, %	5.8±0.3	6.4±0.3**	1%	1.98	1.68–2.56	0.64	0.44	–	–	–	–
Hypertension, yes	67 (24)	60 (29)	Yes vs no	0.88	0.48–1.98	0.16	0.94	–	–	–	–
MetS, yes	86 (31)	85 (41)	Yes vs no	2.21	1.45–5.61	0.36	0.58	–	–	–	–
CVD, yes	42 (15)	35 (17)	Yes vs no	1.45	0.97–4.21	0.02	1.45	–	–	–	–

Notes:

* P<0.05;

** P<0.01; data are presented as mean ± standard deviation of the mean, median (with lower and upper quartiles), or n (with %), where appropriate. All variables shown to be significant (P<0.05) risk factors for the presence of AS in the univariable models were included in the multivariable models. AS was diagnosed if the Aging Males’ Symptoms rating scale total score was ≥50 points. –Indicates no data available.

Abbreviations: AS, andropausal syndrome; BMI, body mass index; cFT, calculated free testosterone; CI, confidence interval; CVD, cardiovascular disease; DHEAS, dehydroepiandrosterone sulfate; E2, estradiol; HbA_1c, glycated hemoglobin; IGF-1, insulin-like growth factor 1; ln, natural logarithm; MetS, metabolic syndrome; OR, odds ratio; TT, total testosterone; vs, versus.

DaigIHeinemannLAKimSThe aging males’ symptoms (AMS) scale: review of its methodological characteristicsHealth Qual Life Outcomes20031778414675485

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