Late-onset hypogonadism: Clinical evidence, biological aspects and evolutionary considerations.


Journal

Ageing research reviews
ISSN: 1872-9649
Titre abrégé: Ageing Res Rev
Pays: England
ID NLM: 101128963

Informations de publication

Date de publication:
05 2021
Historique:
received: 09 10 2020
revised: 23 11 2020
accepted: 15 02 2021
pubmed: 22 2 2021
medline: 20 4 2021
entrez: 21 2 2021
Statut: ppublish

Résumé

The growing life expectancy in modern societies has raised scientific interest in identifying medical interventions to alleviate age-associated pathologies such as vascular calcification, cognitive decline, sarcopenia, osteoporosis and sexual dysfunction. Although no such single treatment has thus far been established in humans, some clinicians and patients have set their hopes on testosterone replacement therapy (TRT) as a potential "fountain of youth" for aging men. While TRT has proven effective in ameliorating distinct symptoms of late-onset hypogonadism (LOH), its safety remains to be demonstrated. Besides humans, multiple other species exhibit age-related reductions in circulating testosterone levels, raising the question whether such changes are an inherent, pathological feature of growing organismal age or rather reflect an adaptive response. In this manuscript, we apply key principles of evolutionary medicine to testosterone biology and LOH to provide a novel perspective on these two fields. Additionally, we discuss insightful data derived from the animal kingdom to illustrate the plasticity of individual testosterone trajectories across the lifespan, outline cost-benefit-considerations of TRT in LOH and highlight potential caveats of such therapies.

Identifiants

pubmed: 33610812
pii: S1568-1637(21)00048-9
doi: 10.1016/j.arr.2021.101301
pmc: PMC8043243
mid: NIHMS1675924
pii:
doi:

Substances chimiques

Testosterone 3XMK78S47O

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

101301

Subventions

Organisme : NIAID NIH HHS
ID : K08 AI128745
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

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Auteurs

Nikolai Jaschke (N)

Department of Medicine III & Center for Healthy Aging, Technische Universität Dresden, Dresden, Germany. Electronic address: nikolaipirmin.jaschke@uniklinikum-dresden.de.

Andrew Wang (A)

Department of Medicine (Rheumatology, Allergy & Immunology), Yale University School of Medicine, New Haven, CT, USA; Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA.

Lorenz C Hofbauer (LC)

Department of Medicine III & Center for Healthy Aging, Technische Universität Dresden, Dresden, Germany.

Martina Rauner (M)

Department of Medicine III & Center for Healthy Aging, Technische Universität Dresden, Dresden, Germany.

Tilman D Rachner (TD)

Department of Medicine III & Center for Healthy Aging, Technische Universität Dresden, Dresden, Germany.

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