Natural course of hypogonadism diagnosed during hospitalization in aged male patients

Abstract

Our aim was to assess short-term natural course of hypogonadism diagnosed during hospitalization for acute disease in aged male patients after discharge. A group of 43 hypogonadal males, aged 86.7 ± 5.7 year, was studied. Serum concentrations of testosterone (T) and gonadotropins (follicle-stimulating hormone, FSH, and luteinizing hormone, LH) were measured in every patient both at admission and one month after discharge. Mean serum T at entry was 115.4 ± 48.0 ng/dl. Hypogonadism was hyper-, hypo-, and normogonadotropic in 20 (46.5 %), 20 (46.5 %), and 3 (7.0 %) patients, respectively. One month after discharge serum T concentrations increased significantly (230.9 ± 135.6 ng/dl, p < 0.001). At this point, more than half of the patients (n = 27, 62.8 %) showed normal serum T concentrations. Both gonadotropins, FSH (p < 0.001), and LH (p = 0.04) also increased one month after discharge. Approximately, half of the patients (13, 48.1 %) who normalized serum T concentrations also showed normal serum gonadotropin concentrations. Patients who normalized their serum T concentrations one month after discharge showed significantly higher baseline values of T (134.7 ± 33.9 ng/dl) than those who persisted with hypogonadism (n = 16, 32.7 %; 82.8 ± 51.6 ng/dl, p < 0.001). Lastly, serum T was the only independent predictor for achieving eugonadal status (OR 1.030; CI 95 %, 1.010–1.050; p < 0.001). In conclusion, about 63 % of aged patients hospitalized for acute illness with hypogonadism discovered during hospitalization spontaneously normalize their serum T concentrations one month after discharge. Serum gonadotropin concentrations also increased after discharge. Serum T levels at admission was an independent predictor for the normalization of serum T concentrations.