Eendebak Robert JAH, et al. - In this present study, the researchers described the natural history, risk factors and clinical parameters correlated with the development of high luteinising hormone (LH)(HLH, LH>9.4 U/L) in ageing men with normal T (T≥10.5 nmol/L). Multiple factors predicted elevation of LH with normal T. This elevation reverted frequently and was not correlated with unequivocal evidence of androgen deficiency. Among aged men who tended to develop primary hypogonadism, high LH was a biomarker for deteriorating health.

Methods

• A 4.3-year prospective observational study of 3,369 community-dwelling European men aged 40-79 years was conducted.
• The researchers classified participants as:
  • Incident (i) HLH (n=101, 5.2%);
  • Persistent (p) HLH (n=128, 6.6%);
  • Reverted (r) HLH (n=46, 2.4%);
  • Persistent normal LH (pNLH, n=1667, 85.8%).
• They analysed potential predictors and changes in clinical features associated with iHLH and rHLH using regression models.

Results

• Factors predictive of HLH development were age >70 years (OR=4.12[2.07–8.20]), diabetes (OR=2.86[1.42–5.77]), chronic pain (OR=2.53[1.34-4.77]), pre-degree education (OR=1.79[1.01–3.20]) and low physical activity (PASE≤78, OR=2.37[1.24–4.50]).
• Younger age (40-49 years, OR=8.14[1.35-49.13]) and non-smoking (OR=5.39[1.48-19.65]) were the predictive factors of HLH recovery.
• Compared to pNLH men, men with iHLH developed erectile dysfunction, poor health, cardiovascular disease (CVD) and cancer more frequently.
• Co-morbidities, including CVD, developed more frequently, and cognitive and physical function deteriorated more in pHLH men than in pNLH men.
• Compared to NLH men, men with HLH developed primary hypogonadism more frequently (OR=15.97[5.85-43.60]).
• A small rise in BMI was observed in men with rHLH.