مقالات پذیرفته شده در نهمین کنگره بین المللی زیست پزشکی
Hypoandrogenism in the elderly with metabolic syndrome: prevalence, complications, and treatment
Hypoandrogenism in the elderly with metabolic syndrome: prevalence, complications, and treatment
Maedeh sirati,1Akbar Abbasi,2Nastaran Rafiei,3,*
1. MSc Student in Geriatric Nursing, Department of Nursing, Shahed University, Tehran, Iran. 2. MSc in Anesthesia Education, Department of Nursing, Naghadeh Faculty of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran. 3. M.Sc in Medical Surgical Nursing, Clinical Research Development Unit, Ramsar Imam Sajjad (AS) Hospital, Mazandaran University of Medical Sciences, Ramsar, Iran.
Introduction: Hypoandrogenism, common yet often underdiagnosed in elderly men, is characterized by reduced androgen levels and frequently coexists with metabolic syndrome—a cluster of cardiometabolic risk factors. Their bidirectional interaction exacerbates health risks: low androgens contribute to insulin resistance, visceral adiposity, and impaired glucose metabolism, while metabolic syndrome disrupts the hypothalamic-pituitary-gonadal axis, leading to secondary hypogonadism. This complex interplay underlines the importance of investigating prevalence, complications, and treatment strategies for hypoandrogenism within the metabolic syndrome context. Comprehensive understanding of the underlying pathophysiology and clinical impact is vital to optimize diagnosis and management, ultimately aiming to reduce morbidity and improve quality of life in this vulnerable population. This study systematically reviews existing literature on these aspects.
Methods: This systematic review was conducted in accordance with PRISMA guidelines. A comprehensive search of PubMed, Scopus, and Web of Science databases was performed for articles published from 2015 to 2025, using keywords such as “hypoandrogenism,” “elderly,” “metabolic syndrome,” “prevalence,” “complications,” and “treatment.” Studies were included if they addressed hypoandrogenism in individuals aged 60 and above with metabolic syndrome. Data extraction focused on prevalence rates, associated complications, and therapeutic interventions, and findings were summarized qualitatively.
Results: The review revealed that the prevalence of hypoandrogenism is significantly elevated in elderly men with metabolic syndrome, with estimates ranging from 30% to 50%. Common complications include increased cardiovascular risk, insulin resistance, diminished muscle mass and strength, decreased libido, mood disturbances, and impaired cognitive function. Treatment options, primarily involving testosterone replacement therapy (TRT), demonstrate improvements in metabolic parameters, body composition, and quality of life, but are associated with potential adverse effects, including cardiovascular and prostate health concerns. The optimal selection of patients and careful monitoring are critical when initiating TRT in this population.
Conclusion: Hypoandrogenism is prevalent among elderly individuals with metabolic syndrome and contributes to substantial morbidity. Early recognition and tailored interventions, including consideration of TRT when appropriate, are vital to mitigate complications and improve patient outcomes.