Abstract
Introduction
Little is known about temporal trends in the
incidence of male hypogonadism and its correlation with socioeconomic
status, which we examined in the present study.
Methods
Data were extracted from the Maccabi Health Services
computerized database between 2001–2017. The study population included 4,261
men aged 21 to 80 years with biochemically proven hypogonadism defined and
classified according to the European Male Aging Study criteria. Patients on
testosterone or testosterone-modifying drugs were excluded. The
socioeconomic status was assessed based on verified financial data pertinent
to the area of residence.
Results
The incidence of male hypogonadism increased with age
in all the socioeconomic strata. Among the hypogonadal men, 75% had
hypogonadotropic hypogonadism. The overall incidence of hypogonadism
increased 1.4-fold between the 2001–2009 and 2010–2017 periods [from 41.7
(39.7–43.8) to 58.5 (56.4–60.8) per 100,000 person-years) (95% CI)], mainly
due to an increase in hypogonadotropic hypogonadism. The temporal increase
in hypogonadotropic hypogonadism occurred in all age groups and all
socioeconomic strata but was notably more prominent in >51-year age
groups of the more affluent socioeconomic strata. The mean body mass index
remained unchanged throughout the study period.
Conclusions
A temporal increase was observed in male
hypogonadism, mainly hypogonadotropic hypogonadism, corresponding with
previously observed temporal decreases in testosterone levels in men. This
trend could be possibly partly attributed to an underappreciated increase in
mental distress due to decreasing global happiness indices, increasing
stress, and occupational burnout in specific occupations associated with
more affluent populations (i.e., high-tech, finance, medical). This
preliminary proposition deserves further investigation.
Keywords
Insufficiencies - Hypopituitarism - Hormones - Luteinizing hormone - Follicle-stimulating
hormone - Cardiovascular incidences - Cardiovascular risk management - Gonadotrophins