PREDICTORS OF TESTOSTERONE DECLINE IN MIDDLE-AGED MEN

Overview

Age-related decline in testosterone levels in men is associated with multiple metabolic, functional and psychosocial consequences. Early identification of modifiable factors associated with decreased testosterone levels may contribute to improved prevention of androgen deficiency and related health conditions. This population-based observational cross-sectional study aims to investigate morphometric, functional and lifestyle factors associated with decreased total testosterone levels in middle-aged men. Approximately 650-800 men aged 35-55 years residing in the Andijan region of Uzbekistan will be recruited. Participants will undergo comprehensive assessment including anthropometric measurements, functional performance tests, standardized questionnaires evaluating lifestyle factors and laboratory determination of serum total testosterone levels. Morphometric variables will include body mass index, waist circumference, hip circumference and waist-to-hip ratio. Functional status will be assessed using hand-grip strength, chair-stand test, balance assessment and the six-minute walk test. Lifestyle factors including physical activity, sleep habits, dietary patterns and harmful habits will be evaluated using validated questionnaires. The study aims to identify predictors of decreased testosterone levels and develop a predictive model for early identification of androgen deficiency in middle-aged men.

Testosterone plays an important role in maintaining male reproductive health, body composition, muscle strength and metabolic homeostasis. Age-related decline in testosterone levels has been associated with increased risk of metabolic syndrome, obesity, type 2 diabetes, cardiovascular disease and reduced physical performance. Despite increasing recognition of androgen deficiency as an important public health issue, many cases remain undiagnosed due to nonspecific clinical manifestations. Previous studies have shown that several factors including obesity, physical inactivity, poor sleep and lifestyle habits may influence testosterone levels. However, the complex interactions between morphometric characteristics, functional status and lifestyle-related determinants remain insufficiently investigated, particularly in population-based studies. The present study is designed as a population-based analytical cross-sectional observational study aimed at identifying morphometric, functional and lifestyle predictors of decreased total testosterone levels in middle-aged men. Approximately 650-800 men aged 35-55 years living in the Andijan region of Uzbekistan will be recruited. Participants will undergo anthropometric measurements including height, body weight, body mass index, waist circumference, hip circumference and waist-to-hip ratio. Functional performance will be evaluated using hand-grip dynamometry, chair-stand test, balance test and six-minute walk test. Lifestyle characteristics will be assessed using standardized questionnaires including the International Physical Activity Questionnaire (IPAQ) and the World Health Organization Quality of Life questionnaire (WHOQOL). Additional information on sleep patterns, dietary habits, smoking status, alcohol consumption and psychoemotional stress will also be collected. Venous blood samples will be collected in the morning following overnight fasting to measure serum total testosterone levels using standardized laboratory methods. Statistical analysis will include correlation analysis, multivariable logistic regression and receiver operating characteristic (ROC) analysis to identify independent predictors of decreased testosterone levels. Based on the results, a predictive model for early identification of androgen deficiency in middle-aged men will be developed. The results of this study may contribute to improved understanding of modifiable determinants of testosterone decline and support development of preventive strategies aimed at improving men's health.