NON-DRUG TREATMENT FOR AGE-RELATED HYPOGONADISM IN OVERWEIGHT MEN. LITERATURE REVIEW.
Introduction: Age-related decrease in testosterone essentially triggers the development of hypogonadism, and it is naturally found in middle-aged and older men. Currently, the number of such patients is about 43%. In studies on male aging in Massachusetts (ММАS-MassachusettsMaleAgingStudy), blood testosterone levels in men aged 40 to 70 years were determined by random sampling, where a total of 1491 men were examined. There was a decrease in the level of total testosterone starting from 30–35 years by 0.8%, and the level of free testosterone by 2% per year. Based on baseline prevalence data by age, it is estimated that approximately 2,4 million men aged 40 to 69 in the United States suffer from androgen deficiency. By these morbidity data approximately 481,000 new cases of androgen deficiency are expected per year in men aged 40–69 in the USA. And these data can undoubtedly be extrapolated to men in other countries and continents. Aim: to analyze the literature on methods of non-pharmacological correction of age-related hypogonadism in overweight men in Kazakhstan, neighboring countries and the world. Searchstrategy: literature search was carried out in the electronic databases PubMed, CochraneLibrary, ResearchGate, Webofscience, GoogleScholar, Paragraphmedicine, ScienceDirect and e-library by keywords (age-related hypogonadism, overweight, methods of correction of hypogonadism). 74 relevant works reflecting the characteristics of the problem were selected for description in the review. Results: The basis of non-drug therapy for age-related decrease in testosterone is an integrated approach. The most promising are adequate physical activity against a background of a balanced diet and minimization of stressful situations. In addition to these basic methods there are other ways of treatment to be suggested: spa therapy and general balneotherapy, correction of concomitant diseases of the organs of the reproductive system (varicocele, hydrocele, exacerbation of chronic prostatitis). With pronounced overweight bariatric surgery is gaining popularity. Conclusion: With the existing set of methods and techniques used for non-drug correction of age-related hypogonadism, there is no single standard for the management and observation of this category of patients. Such an abundance of applied methods, with all its certain positivity, indicates that there are no methods that could be reliably classified as highly effective in case of androgen deficiency. Therefore, this direction requires further structuring and adaptation to modern requirements by age categories.
Merkhat N. Akkaliev1, https://orcid.org/0000-0003-3122-7411 Nurlan Ye. Aukenov2, Meruyert R. Massabayeva1, https://orcid.org/0000-0001-8240-361Х Bakytbek А. Apsalikov1, https://orcid.org/0000-0001-6983-9224 Nariman M. Sadykov3, Muratkhan T. Kuderbaev1, https://orcid.org/0000-0002-7431-6273 1 NCJSC “Semey Medical University”, Semey, Republic of Kazakhstan; 2 Department of Science and New Technologies of the Department of Science and Human Resources, the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Republic of Kazakhstan; 3 Pavlodar Branch of NCJSC “Semey Medical University”, Pavlodar, Republic of Kazakhstan.
1. Гамидов С.И., Шатылко Т.В., Гасанов Н.Г. Мужское здоровье и ожирение - диагностика и терапевтические подходы // Ожирение и метаболизм. 2019, Т 16. № 3. С. 29-36. 2. Ефремов Е.А., Шеховцов С.Ю., Бутов А.О. Современный взгляд на физиологические эффекты тестостерона у мужчин // Экспериментальная и клиническая урология. 2017, № 3. С. 64-69. 3. Комиссаренко И.А. Метаболический синдром как проблема полиморбидности // Consilium Medicum. 2012, Т. 14. № 1. С. 12-20. 4. Клинический протокол диагностики и лечения ожирения у взрослых. Утверждено Совместной комиссией по качеству медицинских услуг Министерства здравоохранения и социального развития Республики Казахстан 18.08.2017г. 26-Paragraph https://online.zakon.kz/Document/?doc_id=38429341> [доступ 17 декабря 2018 г.]. 5. Пашкова Е.Ю., Рождественская О.А. Возрастной андрогенный дефицит у мужчин: этиология, клиника, диагностика, лечение // Андрология и генитальная хирургия. 2015, № 1. С. 95-101. 6. Савзиханов Р.Т. Популяционное изучение симптомов андрогенной недостаточности // Журнал урологии. 2016, № 1. С. 38-51. 7. Тюзиков И.А., Калинченко С.Ю. Андрогенная недостаточность в общей врачебной практике: эндокринология, рациональная диагностика и клинические «маски» (Лекция), часть 2. Рациональная клинико-лабораторная диагностика андрогенной недостаточности у мужчин // Медицинский алфавит. 2012, Том 2. № 12. С. 42-50. 8. Тюзиков И.А., Калиниченко С.Ю., Ворслов Л.О. Место андрогенной недостаточности в клиническом портрете современного урологического пациента // Андрология и генитальная хирургия. 2013. № 3. С. 48-57. 9. Хамзин А.А., Фролов Р.А., Абдиев Г.С. Обоснованность данных эпидемиологического исследования сексуальной дисфункции у мужчин в рамках критериев шкалы PRINS // Вестник КазНМУ. 2016, № 3. С. 42-45. 10. Финагина Е.А., Теодорович О.В. и др. Андрогенная недостаточность. Современное состояние проблемы // Урология. 2017, № 5. С. 111-114. 11. Чернобровкина С.В. Гендерные особенности переживания и преодоления кризиса среднего возраста // Вестник Омского университета из серии «Психология». 2014, № 2. С. 30-42. 12. Чернышев А.И., Сорочинская И.Н. Оптимизация санаторно-курортного лечения больных с метаболическим синдромом // Вопросы курортологии, физиотерапии и лечебной физической культуры. 2012. № 6. С. 12-16. 13. Шелаев А.Ю., Процак В.В., Ашанина Е.Н. и др. Современные представления о возрастной андрогенной недостаточности // Экспериментальная и клиническая урология. 2016, № 4. С. 80-84. 14. Шеплев П.А. Клинические практические рекомендации по урологии-андрологии. Медфорум-Альфа. 2016. 120 с. 15. Almehmadi Y., Dany-Jan Y., Aksam A. Erectile dysfunction is a prognostic indicator of concomitant diseases in men with late onset hypogonadism // The aging male.2015, Vol. 18.№ 3.рр. 186-194 16. Alonso Viana, Ana Carolina Daflon, Arnaldo Couto, Denise Neves, Maria Helena de Araujo-Melo. Nocturnal hypoxemia is associated with low testosterone levels in overweight men and older men with normal weight // Journal of clinical sleep medicine.2017, Vol. 13.№ 12.рр. 1395-1401 17. Ashley G. Winter, Fujun Zh., Richard K.Li. Androgen deficiency and metabolic syndrome in men // Translational andrology and urology. 2014, T 3. (1): рр. 50-58. 18. Basaria S. Reproductive aging in men// Endocrinology and metabolic clinics of North America. 2013. Vol. 42. No. 2. pp. 255-270 19. Bercea R.M., Traian M., Cristian C., Bjorn B. Fatigue and serum testosterone in obstructive sleep apnea patients // The Clinical Respiratory Journal. 2015. Т. 9. № 3.рр. 342–349 https://doi.org/10.1111/crj.12150. (Accessed January 5, 2020). 20. Bhasin S., Brito J.P., Cunningham G.R., Hayes F.J., Hodis H.N., Matsumoto A.M., Snyder P.J., Swerdloff R.S., Wu F.C., Yialamas M.A.Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline // J Clin Endocrinol Metab. 2018. T1. №5 рр. 1715-1744. 21. Burschtin Omar, Jing Wang. Testosterone Deficiency and Sleep Apnea // Urologic Clinics of North America. 2016. Т.43. №2. рр. 233–237 https://doi.org/10.1016/j.ucl.2016.01.012. (Accessed June 5, 2019). 22. Cabral R.D., Busin L., Rosito T.E., Koff W.J. Performance of Massachusetts Male Aging Study (MMAS) and androgen deficiency in the aging male (ADAM) questionnaires in the prediction of free testosterone in patients aged 40 years or older treated in outpatient regimen // Journal The Aging Mal., 2014. T 17(3).рр 147-154. 23. Camacho E.M., Huhtaniemi I.T., O’Neill T.W., Finn J.D., Pye S.R., Lee D.M., et al. Age-associated changes in hypothalamic–pituitary–testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing Study // European Journal of Endocrinology. 2013. Т 168. № 3.рр. 445–455. https://doi.org/10.1530/EJE-12-0890. (Accessed January 5, 2020). 24. Canguven Onder, Banu Salepci, Selami Albayrak, Ahmet Selimoglu, Muhsin Balaban, и Mustafa Bulbul. Is there a correlation between testosterone levels and the severity of the disease in male patients with obstructive sleep apnea? // Archivioitaliano di urologia, andrologia : organoufficiale [di] Societaitaliana di ecografiaurologica e nefrologica. 2010. Т 82. №4. рр. 143–147 http://www.ncbi.nlm.nih.gov/pubmed/21341549. (Accessed September 19, 2019). 25. Carré J.M., Geniole S.N., Ortiz T.L., Bird B.M., Videto A., Bonin P.L. Exogenous Testosterone Rapidly Increases Aggressive Behavior in Dominant and Impulsive Men // Biological Psychiatry. 2016. T 82. № 4.рр. 249-256. 26. Chrysohoou C., Panagiotakos D., Pitsavos C., Siasos G. Low total testosterone levels are associated with the metabolic syndrome in elderly men: the role of body weight, lipids, insulin resistance, and inflammation; the Ikaria study // The Review of Diabetic Studies.2013. T10. № 1. рр. 27-38 DOI10.1900/RDS.2013.10.27 (Accessed June 17, 2019). 27. Corona G., Lee D.M., Forti G. et. al. Age-related changes in general and sexual health in middle-aged and older men: results from the European Male Ageing Study (EMAS) // The Journal of Sexual medicine. 2010. Vol. 7. №4. рр. 1362-1380. 28. Cunningham Glenn R. Testosterone and metabolic syndrome // Asian journal of andrology. 2015. Т.17. № 2. рр. 192–196. 29. Cunningham G.R., Ellenberg S.S., Bhasin S., Matsumoto A.M., et al. Prostate-Specific Antigen Levels During Testosterone Treatment of Hypogonadal Older Men: Data from a Controlled Trial // Clin Endocrinol Metab. 2019. T 104 (12) : 6238. 30. Cutillas-Tolín A., L. Mínguez-Alarcón J. Mendiola, J.J. López-Espín, N. Jørgensen, E.M. Navarrete-Muñoz, et.al., Mediterranean and western dietary patterns are related to markers of testicular function among healthy men // Human Reproduction. 2015. Т30. № 12. рр. 2945–2955.https://doi.org/10.1093/humrep/dev236. (Accessed June 12, 2018). 31. Dandona P.,Rosenberg M.T. A practical guide to male hypogonadism in the primary care setting // International Journal of Clinical Practice. 2010. Т 64. № 6.рр. 682–696. 32. Dixon John B., Linda M. Schachter, Paul E. O’Brien, Kay Jones, Mariee Grima, Gavin Lambert, et al. Surgical vs Conventional Therapy for Weight Loss Treatment of Obstructive Sleep Apnea // JAMA. 2012. Т 308. № 11.рр. 1142- 1149. https://doi.org/10.1001/2012.jama.11580. (Accessed May 16, 2018). 33. Farid Saad, Antonio Aversa, Andrea M Isidori, Louis J Gooren. Testosterone as potential effective therapy in treatment of men with testosterone deficiency: a review // Current Diabetes Reviews. 2012. T 8 (2) рр.131–143. 34. Fahed Akl C., Joanna M. Gholmieh, Sami T. Azar. Connecting the Lines between Hypogonadism and Atherosclerosis // International Journal of Endocrinology. 2012. № 2. рр.1–12. 35. Fernández Balsells, M. Mercè, Mohammad Hassan Murad, Melanie Lane, Juliana F. Lampropulos, Felipe Albuquerque, Rebecca J. Mullan, et al. Adverse Effects of Testosterone Therapy in Adult Men: A Systematic Review and Meta-Analysis // The Journal of Clinical Endocrinology & Metabolism. 2010. Т 95. № 6. рр. 2560–2575 36. Fillo Juraj, Michaela Levcikova, Martina Ondrusova, Jan Breza, и Peter Labas. Importance of Different Grades of Abdominal Obesity on Testosterone Level, Erectile Dysfunction, and Clinical Coincidence // American journal of men’s health. 2017. Т. 11. № 2. рр. 240–245 37. Handelsman David J. Global trends in testosterone prescribing, 2000–2011: expanding the spectrum of prescription drug misuse // The Medical Journal of Australia. 2013. Т 199. № 8. рр. 548–551 38. Hauer E. Mathew. Population projections for U.S. counties by age, sex, and race controlled to shared socioeconomic pathway // Scientific Data Published: 05 February 2019. 39. Hayes Lawrence D., Peter Herbert, Nicholas F Sculthorpe, Fergal M Grace. Exercise training improves free testosterone in lifelong sedentary aging men // Endocrine connections. 2017. № 6. № 5.рр. 306–310 https://doi.org/10.1530/EC-17-0082. (Accessed 05.18 2019). 40. Himpens Jacques, Guy-Bernard Cadière, Michel Bazi at al. Long-term Outcomes of Laparoscopic Adjustable Gastric Banding // Archives of Surgery, 2011. Т 146. № 7. рр.802-807. https://doi.org/10.1001/archsurg.2011.45. (Accessed May 15, 2020). 41. Huhtaniemi Ilpo. Late-onset hypogonadism: current concepts and controversies of pathogenesis, diagnosis and treatment // Asian journal of andrology. 2014. Т 16. № 2.рр. 192–202 42. Khoo J, C Piantadosi, S Worthley, and G A Wittert. Effects of a low-energy diet on sexual function and lower urinary tract symptoms in obese men // International Journal of Obesity. 2010. Т 34. № 9. рр. 1396–1403 https://doi.org/10.1038/ijo.2010.76. (Accessed 05.01. 2018). 43. Kim Sung Dong, and Kyu Sup Cho. Obstructive Sleep Apnea and Testosterone Deficiency // The world journal of men’s health. 2019. Т 37. № 1. рр. 12–18 https://doi.org/10.5534/wjmh.180017. (Accessed January 12, 2019). 44. Kumagai Hiroshi, Asako Zempo-Miyaki, Toru Yoshikawa, Takehiko Tsujimoto, Kiyoji Tanaka, Seiji Maeda. Lifestyle modification increases serum testosterone level and decrease central blood pressure in overweight and obese men // Endocrine Journal. 2015. Т 62. № 5. рр. 423–430. 45. Kumar Peeyush, Nitish Kumar, Devendra Singh Thakur, Ajay Patidar. Male hypogonadism: Symptoms and treatment // Journal of advanced pharmaceutical technology & research. 2010. Т. 1. № 5. рр. 297–301. 46.Lunenfeld Bruno. The relationship between sex hormones and the metabolic syndrome // ACTA BIOMED 2010; 81; Suppl 1: P 79-84 47. Lunenfeld Bruno, Mskhalaya George, Zitzmann Michael, Arver Stefan. Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men // The Aging Male. 2015. T18. № 1. рр. 5-15. 48. Leibar Tamayo, Asier, Ander Astobieta Odriozola, Eduardo García-Cruz, Alberto Cordero Fort, Javier Romero Otero. Testosterone and coronary artery disease // Archivosespanoles de urologia. 2013. Т. 66. № 7. рр. 689–695 49. Leproult Rachel, Eve Van Cauter. Effect of 1 Week of Sleep Restriction on Testosterone Levels in Young Healthy Men // JAMA. 2011. Т. 305. № 21. рр. 2173-2174 https://doi.org/10.1001/jama.2011.710. (Accessed January 5, 2020). 50. Li Fuping, Huanxun Yue, Kohei Yamaguchi, Keisuke Okada, Kei Matsushita, Makoto Ando, et al. Effect of surgical repair on testosterone production in infertile men with varicocele: A meta-analysis // International Journal of Urology. 2012. Т. 19. № 2. рр. 149–154 51. Li Zhijun, Tingyu Tang, Wenjuan Wu, Liang Gu, Jianzong Du, Tian Zhao, et.al. Efficacy of nasal continuous positive airway pressure on patients with OSA with erectile dysfunction and low sex hormone levels // Respiratory Medicine. 2016. Т. 119. рр. 130–134 52. Lo Eric M., Katherine M. Rodriguez, Alexander W. Pastuszak, and Mohit Khera. Alternatives to Testosterone Therapy: A Review // Sexual Medicine Reviews. 2018. Т. 6. № 1. рр. 106–113. 53. McBride J. Abram, Culley C. Carson, Robert M. Coward Testosterone deficiency in the aging male // Therapeutic advances in urology. 2016. Т.8. №1. рр.47–60. 54. McKenzie Sarah K., Sunny Collings, Gabrielle Jenkin, и Jo River Masculinity, Social Connectedness, and Mental Health: Men’s Diverse Patterns of Practice // American Journal of Men’s Health. 2018. Т. 12. № 5. рр. 1247–61 https://doi.org/10.1177/1557988318772732. (Accessed January 5, 2020). 55. Meysam Jangkhan, Faramarz Farrahi, Mohammad Muzakkir Ali, Sadighi Gilani. Effects of Varicocelectomy on Serum Testosterone Levels among Infertile Men with Varicocele // International Journal Fertility & Sterility. 2018. T 12. № 2. рр.169-172 56. Mingrone Geltrude, Simona Panunzi, Andrea De Gaetano, Caterina Guidone, Amerigo Iaconelli, Laura Leccesi, et.al. Bariatric Surgery versus Conventional Medical Therapy for Type 2 Diabetes // New England Journal of Medicine. 2012. Т. 366. №17. рр. 1577–1585. 57. Park Chong Yoon, Joon Hyeong Hong, Jae Heon Lee, Kyu Eun Lee, Hyun Sang Cho, Su Jin Lim, et.al. Clinical effect of surgical correction for nasal pathology on the treatment of obstructive sleep apnea syndrome // PloS one. 2014. Т 9. № 6. рр. e98765. 58. Pasquali Renato. The hypothalamic-pituitary-adrenal axis and sex hormones in chronic stress and obesity: pathophysiological and clinical aspects // Annals of the New York Academy of Sciences. 2012. Т. 1264. № 1. рр. 20–35 https://doi.org/10.1111/j.1749-6632.2012.06569.x. (Accessed December 15, 2019) 59. Pellitero Silvia, Izaskun Olaizola, Antoni Alastrue, Eva Martínez, María Luisa Granada, Jose María Balibrea, et.al. Hypogonadotropic Hypogonadism in Morbidly Obese Males Is Reversed After Bariatric Surgery // Obesity Surgery. 2012. Т. 22. №12. рр. 1835–1842 60. Piccolo R.S., Araujo A.B., Pearce N. Cohort Profile: The Boston Area Community Health (BACH) survey // International Journal of Epidemiology. 2014. Т. 43. № 1. рр. 42–51. 61. Pivonello Rosario, Menafra Davide. Metabolic Disorders and Male Hypogonadotropic Hypogonadism // Frontiers in Endocrinology. 2019. Т 10: 345. Published online 2019 Jul 25. 62. Sathya Srini Vasan, Srinivas Belur Veerachari. Does varicocelectomy improve gonadal function in men with hypogonadism and infertility? Analysis of a prospective study // International journal of endocrinology. 2011 (1). рр. 1-6 https://doi.org/10.1155/2011/916380. (Accessed December 5, 2019). 63. Sola Galarza, Ignacio, Borja López López, Carlos Llorente Abarca. Patient with testosterone deficit syndrome and dyslipemia // Archivosespanoles de urologia. 2013. Т. 66. № 7.рр. 752–759 64. Staerman F., Léon P. Andropause (androgen deficiency of the aging male): diagnosis and management // Minerva medica. 2012 Oct. T 103(5). рр. 333-342. 65. Steven R. Wainwright, Stephanie E. Lieblich, Liisa A.M. Galea. Hypogonadism predisposes males to the development of behavioural and neuroplastic depressive phenotypes // Psychoneuroendocrinology. 2011. Т.36. №9. рр. 1327–1341 66. Steven R. Wainwright, Joanna L Workman, Amir Tehrani, Dwayne K. Hamson, Carmen Chow, Stephanie E. Lieblich, et al. Testosterone has antidepressant-like efficacy and facilitates imipramine-induced neuroplasticity in male rats exposed to chronic unpredictable stress // Hormones and Behavior. 2016. Т. 79. рр. 58–69. 67. Tchernof A., Despres J.P. Pathophysiology of human visceral obesity: an update // Physiological Reviews. 2013. Vol. 93. №1.рр. 359-404. 68. Tajar Abdelouahid, Ilpo T. Huhtaniemi, Terence W. O’Neill, Joseph D. Finn et.al. Characteristics of Androgen Deficiency in Late-Onset Hypogonadism: Results from the European Male Aging Study (EMAS) // The Journal of Clinical Endocrinology & Metabolism. 2012. Т. 97. № 5. рр. 1508–1516 https://doi.org/10.1210/jc.2011-2513. (Accessed December 5, 2019) 69. Tanabe Makito, Yuko Akehi, Takashi Nomiyama, Junji Murakami, Toshihiko Yanase. Total testosterone is the most valuable indicator of metabolic syndrome among various testosterone values in middle-aged Japanese men // Endocrine Journal. 2015. Т. 62. № 2. рр. 123–132 https://doi.org/10.1507/endocrj.EJ14-0313. (Accessed December 10, 2019). 70.Traish AM, Haider A, Doros G, et al. Longterm testosterone therapy in hypogonadal men ameliorates elements of the metabolic syndrome: an observational, long-term registry study // International Journal of Clinical Practice. 2014. Т 68. № 3. рр. 314–329. 71. Vlková B., Mucska, J. Hodosy, P. Celec. Short-term effects of continuous positive airway pressure on sex hormones in men and women with sleep apnoea syndrome // Andrologia. 2014. Т. 46. № 4.рр. 386–390 https://doi.org/10.1111/and.12092. (Accessed December 10, 2019). 72. Woodard G., Ahmed S., Podelski V., T. Hernandez-Boussard, J. Presti, J. M. Morton. Effect of Roux-en-Y gastric bypass on testosterone and prostate-specific antigen // British Journal of Surgery. 2012. Т. 99. № 5. рр. 693–698 https://doi.org/10.1002/bjs.8693. (Accessed December 25, 2020). 73. Zhang Xiao-Bin, Xing-Tang Jiang, Yan-Ping Du, Ya-Ting Yuan, и Bo Chen. Efficacy of Continuous Positive Airway Pressure on Testosterone in Men with Obstructive Sleep Apnea: A Meta-Analysis // PLoS ONE. 2014. Т. 9. № 12. рр. 1-13 https://doi.org/10.1371/journal.pone.0115033. (Accessed December 15, 2019) References: 1. Gamidov S.I., Shatylko T.V., Gasanov N.G. Muzhskoe zdorov'e i ozhirenie - diagnostika i terapevticheskie podhody [Men’s health and obesity-diagnostics and therapeutic approaches]. Ozhirenie i metabolism [Obesity and metabolism]. 2019, T 16. № 3. pp. 29-36. [in Russian] 2. Efremov E.A., Shehovcov S.Ju., Butov A.O. Sovremennyi vzglyad na fiziologicheskie effekty testosterona u muzhchin [Modern view on the physiological effects of testosterone in men]. Eksperimental'naya i klinicheskaya urologiya [Experimental and clinical urology]. 2017, № 3. pp. 64-69. [in Russian] 3. Komissarenko I.A. Metabolicheskii sindrom kak problema polimorbidnosti [Metabolic syndrome as a problem of polymorbidity]. Consilium Medicum. 2012, T. 14.№ 1. pp. 12-20. [in Russian] 4. Klinicheskii protokol diagnostiki i lecheniya ozhireniya u vzroslykh. Utverzhdeno Sovmestnoi komissiei po kachestvu meditsinskikh uslug Ministerstva zdravookhraneniya i sotsial'nogo razvitiya Respubliki Kazakhstan 18.08.2017g. 26-Paragraph [“Adult Obesit” clinical Protocol for diagnosis and treatment.Approved by the joint Commission on quality of medical services of the Ministry of health and social development of the Republic of Kazakhstan on 18.08.2017 Protocol №26] https://online.zakon.kz/Document/?doc_id=38429341> [dostup 17 dekabrja 2018 g.]. [in Russian] 5. Pashkova E.Ju., Rozhdestvenskaya O.A. Vozrastnoi androgennyi defitsit u muzhchin: etiologiya, klinika, diagnostika, lechenie [Age-related androgen deficiency in men: etiology, clinic, diagnosis, treatment]. Andrologiya i genital'naya khirurgiya [Andrology and genital surgery]. 2015, № 1. pp. 95-101. [in Russian] 6. Savzihanov R.T. Populyatsionnoe izuchenie simptomov androgennoi nedostatochnosti [Population study of androgen deficiency symptoms]. Zhurnal urologii [The journal of urology].2016, № 1.pp. 38-51. [in Russian] 7. Tyuzikov I.A., Kalinchenko S.Ju. Androgennaya nedostatochnost' v obshhei vrachebnoi praktike: endokrinologiya, ratsional'naya diagnostika i klinicheskie «maski» (Lektsiya), chast' 2. Ratsional'naya kliniko-laboratornaya diagnostika androgennoi nedostatochnosti u muzhchin [Androgen deficiency in General medical practice: endocrinology, rational diagnostics and clinical "masks" (Lecture) part 2. Rational clinical and laboratory diagnostics of androgen deficiency in men]. Meditsinskii alfavit [Medical alphabet].2012, Volume 2.№ 12. pp. 42-50. [in Russian] 8. Tyuzikov I.A., Kalinichenko S.Ju., Vorslov L.O. Mesto androgennoi nedostatochnosti v klinicheskom portrete sovremennogo urologicheskogo patsienta [The Place of androgen deficiency in the clinical portrait of a modern urological patient]. Andrologiya i genital'naya khirurgiya [Andrology and genital surgery]. 2013. № 3. pp. 48-57. [in Russian] 9. Khamzin A.A., Frolov R.A., Abdiev G.S. Obosnovannost' dannykh epidemiologicheskogo issledovaniya seksual'noi disfunktsii u muzhchin v ramkakh kriteriev shkaly PRINS [Validity of data of epidemiological study of sexual dysfunction in men within the criteria of the PRINS scale]. Vestnik KazNMU [Bulletin of KazNMU]. 2016, № 3.pp. 42-45. [inRussian] 10. Finagina E.A., Teodorovich O.V. i dr. Androgennaya nedostatochnost'. Sovremennoe sostoyanie problem [Androgen deficiency. Current state of the problem]. Urologiya [Urology]. 2017, № 5.pp. 111-114. [in Russian] 11. Chernobrovkina S.V. Gendernye osobennosti perezhivaniya i preodoleniya krizisa srednego vozrasta [Gender features of experiencing and overcoming the mid-life crisis]. Vestnik Omskogo universiteta iz serii «Psihologiya» [Bulletin of Omsk University series “Psychology”]. 2014, № 2.pp. 30-42. [in Russian] 12. Chernyshev A.I., Sorochinskaja I.N. Optimizatsiya sanatorno-kurortnogo lecheniya bol'nykh s metabolicheskim sindromom [Optimization of Spa treatment of patients with metabolic syndrome]. Voprosy kurortologii, fizioterapii ilechebnoi fizicheskoi kul'tury [Questions of balneology, physiotherapy and therapeutic physical culture]. 2012. № 6. pp. 12-16. [in Russian] 13. Shelaev A.Ju., Procak V.V., Ashanina E.N. i dr. Sovremennye predstavleniya o vozrastnoi androgennoi nedostatochnosti [Modern understanding of age-related androgen deficiency]. Eksperimental'naya i klinicheskaya urologiya [Experimental and clinical urology]. 2016, № 4. pp. 80-84. [in Russian] 14. Sheplev P.A. Klinicheskie prakticheskie rekomendatsii po urologii-andrologii [Clinical practice guidelines for urology andrology]. Medforum-Al'fa. 2016. 120 p.[in Russian] 15. Almehmadi Y., Dany-Jan Y., Aksam A. Erectile dysfunction is a prognostic indicator of concomitant diseases in men with late onset hypogonadism. The aging male. 2015, Vol. 18. № 3.рр. 186-194 16. Alonso Viana, Ana Carolina Daflon, Arnaldo Couto, Denise Neves, Maria Helena de Araujo-Melo, Nocturnal hypoxemia is associated with low testosterone levels in overweight men and older men with normal weight. Journal of clinical sleep medicine. 2017, Vol. 13.№ 12. рр. 1395-1401 17. Ashley G. Winter, Fujun Zh., Richard K.Li. Androgen deficiency and metabolic syndrome in men. Translational andrology and urology. 2014, T 3. (1): рр. 50-58. 18. Basaria S. Reproductive aging in men. Endocrinology and metabolic clinics of North America. 2013. Vol. 42. No. 2. pp. 255-270 19. Bercea R. M., Traian M., Cristian C., Bjorn B. Fatigue and serum testosterone in obstructive sleep apnea patients. The Clinical Respiratory Journal. 2015. Т. 9. №3. рр. 342–349 https://doi.org/10.1111/crj.12150. (Accessed January 5, 2020). 20. Bhasin S., Brito J.P., Cunningham G.R., Hayes F.J., Hodis H.N., Matsumoto A.M., Snyder P.J., Swerdloff R.S., Wu F.C., Yialamas M.A.Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline.J Clin Endocrinol Metab. 2018. T 1. № 5 рр.1715-1744. 21. Burschtin Omar, Jing Wang. Testosterone Deficiency and Sleep Apnea.Urologic Clinics of North America. 2016. Т. 43. № 2. рр. 233–237 https://doi.org/10.1016/j.ucl.2016.01.012. (Accessed June 5, 2019). 22. Cabral R.D.,Busin L., Rosito T.E., Koff W.J. Performance of Massachusetts Male Aging Study (MMAS) and androgen deficiency in the aging male (ADAM) questionnaires in the prediction of free testosterone in patients aged 40 years or older treated in outpatient regimen. Journal The Aging Mal., 2014. T 17(3). рр 147-154. 23. Camacho E.M., HuhtaniemiI T., O’Neill T.W., Finn J.D., Pye S.R., Lee D.M. et al. Age-associated changes in hypothalamic–pituitary–testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing Study. European Journal of Endocrinology. 2013. Т 168. №3. рр. 445–455. https://doi.org/10.1530/EJE-12-0890. (Accessed January 5, 2020). 24. Canguven Onder, Banu Salepci, Selami Albayrak, Ahmet Selimoglu, Muhsin Balaban, Mustafa Bulbul. Is there a correlation between testosterone levels and the severity of the disease in male patients with obstructive sleep apnea? Archivio italiano di urologia, andrologia : organoufficiale. Societaitaliana di ecografia, urologica e nefrologica. 2010. Т 82. № 4. рр. 143–147 http://www.ncbi.nlm.nih.gov/pubmed/21341549. (Accessed September 19, 2019). 25. Carré J.M., Geniole S.N., Ortiz T.L., Bird B.M., Videto A., Bonin P.L. Exogenous Testosterone Rapidly Increases Aggressive Behavior in Dominant and Impulsive Men. Biological Psychiatry. 2016. T 82. № 4. рр. 249-256. 26. Chrysohoou C., Panagiotakos D., Pitsavos C., Siasos G. Low total testosterone levels are associated with the metabolic syndrome in elderly men: the role of body weight, lipids, insulin resistance, and inflammation; the Ikaria study. The Review of Diabetic Studies. 2013. T10. №1. рр. 27-38 DOI10.1900/RDS.2013.10.27 (Accessed June 17, 2019). 27. Corona G., Lee D.M., Forti G. et. al. Age-related changes in general and sexual health in middle-aged and older men: results from the European Male Ageing Study (EMAS). The Journal of Sexual medicine. 2010. Vol. 7. № 4. рр. 1362-1380. 28. Cunningham Glenn R. Testosterone and metabolic syndrome. Asian journal of andrology. 2015. Т. 17. № 2. рр. 192–196. 29. Cunningham G.R., Ellenberg S.S., Bhasin S., Matsumoto A.M., et al. Prostate-Specific Antigen Levels During Testosterone Treatment of Hypogonadal Older Men: Data from a Controlled Trial // Clin Endocrinol Metab. 2019. T 104 (12) : 6238. 30. Cutillas-Tolín A., L. Mínguez-Alarcón J. Mendiola, J.J. López-Espín, N. Jørgensen, E.M. Navarrete-Muñoz, et.al., Mediterranean and western dietary patterns are related to markers of testicular function among healthy men. Human Reproduction.2015. Т 30. № 12. рр. 2945–2955. https://doi.org/10.1093/humrep/dev236. (Accessed June 12, 2018). 31. Dandona P., Rosenberg M.T. A practical guide to male hypogonadism in the primary care setting. International Journal of Clinical Practice. 2010. Т64. № 6. рр. 682–696. 32. Dixon John B., Linda M. Schachter, Paul E. O’Brien, Kay Jones, Mariee Grima, Gavin Lambert, and other Surgical vs Conventional Therapy for Weight Loss Treatment of Obstructive Sleep Apnea. JAMA. 2012. Т 308. № 11. рр. 1142-1149. https://doi.org/10.1001/2012.jama.11580. (Accessed May 16, 2018). 33. Farid Saad, Antonio Aversa,Andrea M. Isidori,Louis J Gooren. Testosterone as potential effective therapy in treatment of men with testosterone deficiency: a review. Current Diabetes Reviews. 2012. T 8 (2) рр.131–143. 34. Fahed Akl C., Joanna M. Gholmieh, Sami T. Azar. Connecting the Lines between Hypogonadism and Atherosclerosis. International Journal of Endocrinology. 2012. № 2. рр.1–12 35. Fernández-Balsells, M. Mercè, Mohammad Hassan Murad, Melanie Lane, Juliana F. Lampropulos, Felipe Albuquerque, Rebecca J. Mullan, and other. Adverse Effects of Testosterone Therapy in Adult Men: A Systematic Review and Meta-Analysis. The Journal of Clinical Endocrinology & Metabolism. 2010. Т 95. № 6. рр. 2560–2575 36. Fillo Juraj, Michaela Levcikova, Martina Ondrusova, Jan Breza, и Peter Labas. Importance of Different Grades of Abdominal Obesity on Testosterone Level, Erectile Dysfunction, and Clinical Coincidence. American journal of men’s health. 2017. Т. 11. № 2. рр. 240–245 37. Handelsman David J. Global trends in testosterone prescribing, 2000–2011: expanding the spectrum of prescription drug misuse. The Medical Journal of Australia. 2013. Т 199. № 8. рр. 548–551 38. Hauer E. Mathew. Population projections for U.S. counties by age, sex, and race controlled to shared socioeconomic pathway. Scientific Data. Published: 05 February 2019. 39. Hayes Lawrence D., Peter Herbert, Nicholas F. Sculthorpe, Fergal M. Grace. Exercise training improves free testosterone in lifelong sedentary aging men. Endocrine connections. 2017. № 6. № 5. рр. 306–310 https://doi.org/10.1530/EC-17-0082. (Accessed 05.18 2019). 40. Himpens Jacques, Guy-Bernard Cadière, Michel Bazi et al. Long-term Outcomes of Laparoscopic Adjustable Gastric Banding. Archives of Surgery, 2011.Т 146. № 7. рр. 802-807. https://doi.org/10.1001/archsurg.2011.45. (Accessed May 15, 2020). 41. Huhtaniemi Ilpo. Late-onset hypogonadism: current concepts and controversies of pathogenesis, diagnosis and treatment. Asian journal of andrology. 2014. Т16. №2. рр.192–202 42. Khoo J., Piantadosi C., Worthley S., Wittert G.A. Effects of a low-energy diet on sexual function and lower urinary tract symptoms in obese men. International Journal of Obesity. 2010. Т 34. № 9. рр. 1396–1403 https://doi.org/10.1038/ijo.2010.76. (Accessed January 5, 2018). 43. Kim Sung Dong, Kyu Sup Cho. Obstructive Sleep Apnea and Testosterone Deficiency. The world journal of men’s health. 2019. Т 37. № 1. рр. 12–18 https://doi.org/10.5534/wjmh.180017. (Accessed January 12, 2019). 44. Kumagai Hiroshi, Asako Zempo-Miyaki, Toru Yoshikawa, Takehiko Tsujimoto, Kiyoji Tanaka, и Seiji Maeda. Lifestyle modification increases serum testosterone level and decrease central blood pressure in overweight and obese men. Endocrine Journal. 2015. Т 62. № 5. рр. 423–430. 45. Kumar, Peeyush, Nitish Kumar, Devendra Singh Thakur, и Ajay Patidar. Male hypogonadism: Symptoms and treatment. Journal of advanced pharmaceutical technology & research. 2010. Т. 1. № 5. рр. 297–301. 46. Lunenfeld Bruno. The relationship between sex hormones and the metabolic syndrome. ACTA BIOMED 2010; 81; Suppl 1: P 79-84 47. Lunenfeld Bruno, Mskhalaya George, Zitzmann Michael, Arver Stefan. Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. The Aging Male.2015. T 18. № 1. рр. 5-15. 48. Leibar Tamayo, Asier, Ander AstobietaOdriozola, Eduardo García-Cruz, Alberto Cordero Fort, Javier Romero Otero. Testosterone and coronary artery disease. Archivos espanoles de urologia. 2013. Т.66. №7. рр. 689–695 49. Leproult Rachel, Eve Van Cauter. Effect of 1 Week of Sleep Restriction on Testosterone Levels in Young Healthy Men. JAMA. 2011. Т. 305. № 21. рр. 2173-2174 https://doi.org/10.1001/jama.2011.710. (Accessed January 5, 2020). 50. Li Fuping, Huanxun Yue, Kohei Yamaguchi, Keisuke Okada, Kei Matsushita, Makoto Ando, et al. Effect of surgical repair on testosterone production in infertile men with varicocele: A meta-analysis. International Journal of Urology. 2012. Т. 19. № 2. рр. 149–154 51. Li Zhijun, Tingyu Tang, Wenjuan Wu, Liang Gu, Jianzong Du, Tian Zhao, et.al. Efficacy of nasal continuous positive airway pressure on patients with OSA with erectile dysfunction and low sex hormone levels. Respiratory Medicine. 2016. Т. 119. рр. 130–134 52. Lo Eric M., Katherine M. Rodriguez, Alexander W. Pastuszak, MohitKhera. Alternatives to Testosterone Therapy: A Review. Sexual Medicine Reviews. 2018. Т. 6. № 1. рр. 106–113. 53. McBride J. Abram, Culley C. Carson, Robert M. Coward Testosterone deficiency in the aging male. Therapeutic advances in urology. 2016. Т.8. №1. рр.47–60. 54. McKenzie Sarah K., Sunny Collings, Gabrielle Jenkin, и Jo River. Masculinity, Social Connectedness, and Mental Health: Men’s Diverse Patterns of Practice. American Journal of Men’s Health. 2018. Т.12. №5. рр.1247–61 https://doi.org/10.1177/1557988318772732. (Accessed January 5, 2020). 55. Meysam Jangkhan, Faramarz Farrahi, Mohammad Muzakkir Ali, Sadighi Gilani. Effects of Varicocelectomy on Serum Testosterone Levels among Infertile Men with Varicocele. International Journal Fertility & Sterility. 2018. T 12. № 2. рр.169-172 56. Mingrone Geltrude, Simona Panunzi, Andrea De Gaetano, CaterinaGuidone, AmerigoIaconelli, Laura Leccesi, et.al. Bariatric Surgery versus Conventional Medical Therapy for Type 2 Diabetes. New England Journal of Medicine. 2012. Т. 366. № 17. рр. 1577–1585. 57. Park Chong Yoon, Joon Hyeong Hong, Jae Heon Lee, Kyu Eun Lee, Hyun Sang Cho, Su Jin Lim, et.al. Clinical effect of surgical correction for nasal pathology on the treatment of obstructive sleep apnea syndrome. PloS one. 2014. Т 9. № 6. рр. e98765. 58. Pasquali Renato. The hypothalamic-pituitary-adrenal axis and sex hormones in chronic stress and obesity: pathophysiological and clinical aspects. Annals of the New York Academy of Sciences. 2012. Т. 1264. № 1. рр. 20–35 https://doi.org/10.1111/j.1749-6632.2012.06569.x. (Accessed December 15, 2019) 59. Pellitero Silvia, Izaskun Olaizola, Antoni Alastrue, Eva Martínez, María Luisa Granada, Jose María Balibrea, et.al. Hypogonadotropic Hypogonadism in Morbidly Obese Males Is Reversed After Bariatric Surgery. Obesity Surgery. 2012. Т. 22. № 12. рр. 1835–1842 60. Piccolo R.S., Araujo A.B., Pearce N. Cohort Profile: The Boston Area Community Health (BACH) survey. International Journal of Epidemiology. 2014. Т. 43. № 1. рр. 42–51 61. Pivonello Rosario, MenafraDavide. Metabolic Disorders and Male Hypogonadotropic Hypogonadism. Frontiers in Endocrinology. 2019. Т 10: 345. Published online 2019 Jul 25. 62. Sathya Srini Vasan, Srinivas Belur Veerachari. Does varicocelectomy improve gonadal function in men with hypogonadism and infertility? Analysis of a prospective study. International journal of endocrinology.2011 (1). рр. 1-6 https://doi.org/10.1155/2011/916380. (Accessed December 5, 2019). 63. Sola Galarza, Ignacio, Borja López López, Carlos Llorente Abarca. Patient with testosterone deficit syndrome and dyslipemia. Archivosespanoles de urologia. 2013. Т. 66. № 7. рр. 752–759 64. Staerman F., Léon P. Andropause (androgen deficiency of the aging male): diagnosis and management. Minerva medica. 2012 Oct. T 103(5). рр. 333-342. 65. Steven R. Wainwright, Stephanie E. Lieblich, Liisa A.M. Galea. Hypogonadism predisposes males to the development of behavioural and neuroplastic depressive phenotypes. Psychoneuroendocrinology. 2011. Т. 36. №9. рр. 1327–1341 66. Steven R. Wainwright, Joanna L Workman, Amir Tehrani, Dwayne K. Hamson, Carmen Chow, Stephanie E. Lieblich, and other Testosterone has antidepressant-like efficacy and facilitates imipramine-induced neuroplasticity in male rats exposed to chronic unpredictable stress. Hormones and Behavior. 2016. Т. 79. рр. 58–69. 67. Tchernof A., Despres J.P. Pathophysiology of human visceral obesity: an update. Physiological Reviews. 2013. Vol. 93. №1. рр. 359-404. 68.Tajar Abdelouahid, Ilpo T. Huhtaniemi, Terence W. O’Neill, Joseph D. Finn et.al. Characteristics of Androgen Deficiency in Late-Onset Hypogonadism: Results from the European Male Aging Study (EMAS). The Journal of Clinical Endocrinology & Metabolism. 2012. Т. 97. № 5. рр. 1508–1516 https://doi.org/10.1210/jc.2011-2513. (Accessed December 5, 2019) 69. Tanabe Makito, Yuko Akehi, Takashi Nomiyama, Junji Murakami, Toshihiko Yanase. Total testosterone is the most valuable indicator of metabolic syndrome among various testosterone values in middle-aged Japanese men. Endocrine Journal. 2015. Т. 62. № 2. рр. 123–132 https://doi.org/10.1507/endocrj.EJ14-0313. (Accessed December 10, 2019). 70. Traish A.M., Haider A., Doros G., et al. Longterm testosterone therapy in hypogonadal men ameliorates elements of the metabolic syndrome: an observational, long-term registry study. International Journal of Clinical Practice. 2014. Т 68. № 3. рр. 314–329. 71. Vlková B., Mucska, J. Hodosy, P. Celec. Short-term effects of continuous positive airway pressure on sex hormones in men and women with sleep apnoea syndrome. Andrologia. 2014. Т.46. №4. рр.386–390 https://doi.org/10.1111/and.12092. (Accessed 10.12.2019). 72. Woodard G., Ahmed S., Podelski V., Hernandez-Boussard T., Presti J., Morton J.M. Effect of Roux-en-Y gastric bypass on testosterone and prostate-specific antigen. British Journal of Surgery. 2012. Т. 99. № 5. рр. 693–698 https://doi.org/10.1002/bjs.8693. (Accessed December 25, 2020). 73. Zhang Xiao-Bin, Xing-Tang Jiang, Yan-Ping Du. Efficacy of Continuous Positive Airway Pressure on Testosterone in Men with Obstructive Sleep Apnea: A Meta-Analysis. PLoS ONE. 2014. Т. 9. № 12. рр. 1-13 https://doi.org/10.1371/journal.pone.0115033. (Accessed 15.12.2019)
: 106

:

Akkaliev M.N., Aukenov N.Ye., Massabayeva M.R., Apsalikov B.А., Sadykov N.M., Kuderbaev M.T. Non-drug treatment for age-related hypogonadism in overweight men. Literature review // Nauka i Zdravookhranenie [Science & Healthcare]. 2020, (Vol.22) 5, pp. 18-30. doi:10.34689/SH.2020.22.5.002