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.