Partial Androgen Deficiency (PADAM) Among Aging Kashmiri Men: A Cross-Sectional Study

Abstract

Background: Partial Androgen Deficiency in Aging Men (PADAM), also known as late-onset hypogonadism, is characterized by age-related decline in testosterone levels, with implications for metabolic, cardiovascular, and quality-of-life outcomes. Despite global recognition, there is a paucity of region-specific data from India, particularly from the Kashmiri male population.

Objectives: To estimate the prevalence of PADAM and assess the hormonal profiles of apparently healthy Kashmiri men aged ≥35 years, with analysis of correlations with age, BMI, blood pressure, and lifestyle factors.

Methods: A cross-sectional study was conducted at Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, from February to September 2011. A total of 139 healthy Kashmiri men aged ≥35 years were recruited through community camps. Clinical assessments and anthropometric measurements were followed by biochemical evaluation including serum total testosterone (TT), sex hormone-binding globulin (SHBG), and calculated free testosterone (FT) and bioavailable testosterone (BT).

Results: Median TT was 502 ng/dL; 8% of men had TT <250 ng/dL. FT and BT medians were 8.1 ng/dL and 192 ng/dL respectively, with 31% and 10% of participants below clinically relevant thresholds. TT, FT, and BT declined significantly with age (p<0.001), and were negatively correlated with hypertension but positively with BMI. SHBG increased with age and was higher among smokers. PADAM prevalence, defined as FT <5 ng/dL, was 13%. Age was the strongest independent predictor of androgen deficiency.

Conclusions: PADAM is prevalent among aging Kashmiri men, with significant age-associated hormonal decline. These findings highlight the need for region-specific screening strategies and holistic approaches to male aging and endocrine health in South Asian populations.