Introduction: One of the changes observed in the ageing process is the progressive reduction in androgen levels, which may be associated with the development of the clinical syndrome of androgen deficiency. The androgen receptor gene polymorphism may also contribute to the development of the above syndrome of clinical manifestations. To assess the relationship between CAG androgen receptor gene polymorphism and the development of manifestations of androgen deficiency syndrome in men aged 45 to 65.
Material and methods: A total of 268 men aged 45-65, randomly selected from the population of Wroclaw, Poland, were included in the study. The subjects completed the Heinemann questionnaire, followed by blood sampling for determination of the CAG androgen receptor gene polymorphism by polymerase chain reaction (PCR). The PCR reaction products for all the subjects were separated by capillary electrophoresis (ABI PRISM 310) and the number of CAG repeats was determined using the previously constructed standard curve: (CAG) n = 0.5*M[bp]-101.
Results: The minimum number of CAG repeats was 52 with the mean of 24. Based on the total score in the Heinemann questionnaire in all of the study subjects we found no or slight manifestations of androgen deficiency syndrome in 68 (25%) subjects, mild manifestations consistent with the andropause syndrome in 93 (35%) subjects, moderate manifestations in 88 (33%) subjects and severe manifestations in 19 (7%) subjects. The numbers of subjects with specific severities of androgen deficiency manifestations across the specific subscales were as follows: a) Psychological manifestations subscale: 111 subjects with no or very mild manifestations, 117 with mild manifestations, 33 with moderate manifestations and 7 with severe manifestations; b) Somatic manifestations subscale: 17 subjects with no or very mild manifestations, 72 with mild manifestations, 120 with moderate manifestations and as many as 59 with severe manifestations; c) Sexual dysfunction subscale: 26 subjects with no or very mild manifestations, 45 with mild manifestations, 80 with moderate manifestations and 117 with severe manifestations. In all the study men (n = 268) we found 76 with a low (< 21) and 119 with a high (> 23) number of CAG repeats.
Conclusions:
1. In the entire study group (n = 268) we found a positive correlation between the number of CAG repeats and the severity of psychological manifestations. We also found that in men with a higher number of CAG repeats (> 23 repeats) the somatic and psychological manifestations associated with signs of androgen deficiency are more common during the ageing period and that these patients score higher on the overall Heinemann scale.
2. We found no correlation between the number of CAG repeats in men divided into 4 subgroups with respect to their scores (hence the severity) on the overall Heinemann scale and its three subscales (psychological, somatic and sexual dysfunction subscales) and their scores.