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Low Testosterone and Risk of Premature Death in Older Men: Analytical and Preanalytical Issues in Measuring Circulating Testosterone

Two recent papers in Circulation (1) and Journal of Clinical Endocrinology and Metabolism (2) reported that older men with lower serum testosterone concentrations had a greater risk of dying than did men with higher testosterone. This potentially clinically important finding was not observed in 2 other prospective cohort studies (3, 4), and another cohort study reported that low concentrations of a combination of hormones, but not of bioavailable testosterone alone, were associated with death (5 ). These studies raise important issues related to measuring testosterone for etiologic and clinical use.

MOTIVATION FOR DISCUSSING ISSUES IN MEASURING TESTOSTERONE

An important question in clinical ...

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