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Correlation between testosterone to estradiol ratio and score on the aging males’ symptom scale in late-onset hypogonadism

Suetomi, T1; Tsujimoto, I1; Kurobe, M2; Ikeda, A2; Ishitsuka, R2; Kimura, T2; Waku, N2; Kojima, T2; Johraku, A2; Kawai, K2; Nishiyama, H2

1: Ibaraki Seinan Medical Center hospital, Japan; 2: University of Tsukuba

Objectives: In the diagnosis of late-onset hypogonadism (LOH) syndrome, total testosterone (T) levels and symptom scores such as those of the Aging Males’ Symptom Scale (AMS) are considered essential. However, T levels are not generally correlated with symptom scores, making diagnosis difficult. Objective parameters correlated with subjective symptoms would be useful for more accurate diagnosis. The major source of estradiol (E2) in men is conversion from T via aromatase enzyme, and the ratio of T to E2 (T/E ratio) is thought to reflect aromatase activity. Although the T/E ratio has been investigated well in the field of male infertility, there have been few reports of its use in LOH syndrome. We investigated whether there was a correlation between the T/E ratio and the AMS.

Materials and Methods: A consecutive series of 155 patients attending our unit for LOH syndrome (LOH group) and 158 patients with urological problems unrelated to LOH or sexuality (control group) was studied. The relationship between T/E ratio and AMS (both total score and each subscale score) was examined in both groups.

Results: Even though the controls were significantly older, the LOH group had significantly lower values for all three items of TT, E2, and T/E ratio (each P < 0.001). The AMS total score and all subscale scores were significantly higher in the LOH group (each P < 0.001). There was no correlation between T level and the AMS total score in either group. However, in the LOH group alone, the T/E ratio and the total AMS score were significantly negatively correlated (P < 0.01, γ = –0.21). Among the subscales, only the somatic score was significantly (and negatively) correlated with the T/E ratio (P < 0.01, γ = –0.26).

Conclusion: T/E ratio and AMS are unrelated in general urological patients, whereas in LOH patients the T/E ratio may be a useful indicator of symptom severity.


Work supported by industry: no.

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