Metabolomics for the individualized therapy of androgen deficiency syndrome in male adults

Abstract

Testosterone is the major circulating androgen in men with a physiological age-related decline in the aging male. Late-onset hypogonadism or Androgen Deficiency Syndrome (ADS) is a syndromic diagnosis including both, persistent low testosterone concentrations together with clinical symptoms including erectile dysfunction, low libido, decreased muscle mass and strength, increased body fat, decreased vitality, and depressed mood. But due to its unspecific symptoms, treatment goals, and monitoring parameters, there are many uncertainties concerning the diagnosis, therapy, and monitoring of ADS to date. The present work intends to introduce the application of metabolomics as a novel and promising tool for the improved diagnosis, therapy, and monitoring of ADS. We will outline the current uncertainties and limitations in the diagnosis and therapy of ADS to subsequently explore the scientific opportunities of metabolomics to account for the specific metabolic requirements and characteristics of the individual patient, better understand the metabolic deviations in testosterone deficiency, and monitor the biochemical changes induced by testosterone replacement therapy. We also discuss the potential of metabolomics to optimize the effectiveness and safety of individualized testosterone replacement therapy, and to thereby significantly reduce the side effects and associated health care costs of ADS treatment.