Doctoral thesis on the association between late-onset hypogonadism and various chronic diseases

On 15 January 2018 at 15:00 in an open meeting of Rīga Stradiņš University (RSU) Medical Promotion Council to be held in the Hippocrates Lecture Theatre (16 Dzirciema Street, Riga) Anatolijs Požarskis will defend his doctoral thesis “Peculiarities of the development and diagnosis of late-onset hypogonadism in men in case of chronic diseases – arterial hypertension, dyslipidaemia, adiposity, metabolic syndrome, type 2 diabetes mellitus, chronic obstructive pulmonary disease and combinations thereof”.

Late-onset hypogonadism is a clinical and biochemical syndrome associated with the age and with a number of typical symptoms and reduced testosterone levels. Testosterone deficiency in men aged 30 and above ranges from 7 to 30 %. The objective of the thesis was to examine the prevalence of late-onset hypogonadism in patients aged above 40 with comorbidity and/or simultaneously occurring pathology – arterial hypertension (high blood pressure), chronic obstructive pulmonary disease (COPD), metabolic syndrome ( a combination of adiposity, increased sugar and cholesterol levels and high blood pressure), type 2 diabetes mellitus, adiposity (obesity), dyslipidaemia (high cholesterol) who have referred to a general practitioner or a sexologist’s practice, and to develop clinical and laboratory criteria regarding the impairment of gonadal function.

According to the study, a more rapid reduction in the serum testosterone levels has been identified in patients with arterial hypertension, dyslipidaemia, type 2 diabetes mellitus, adiposity, metabolic syndrome, chronic obstructive lung disease or a combination thereof as compared to the control group, whereby the most significant decrease was observed for dyslipidaemia, COPD and metabolic syndrome patients. Each coexistant disease has signs of late-onset hypogonadism, whereas symptoms of erectile dysfunction are the joint feature of all surveyed diseases in combination with late-onset hypogonadism.

The results of the study have served as basis for the development of late-onset hypogonadism early diagnostic criteria depending on comorbidity and for drafting of recommendations to general practitioners for timely diagnosis of late-onset hypogonadism.