HYPOGONADISM IN METABOLIC SYNDROME PATIENTS

Abstract

Introduction. Previous studies have shown a high prevalence of low levels of the endogenous sexual hormones in patients with metabolic syndrome (MetS). The aim of this study was to analyze the prevalence of hypogonadism in MetS patients. Materials and Methods. We analyzed the relationship between testosterone levels and components of metabolic syndrome in 381 patients. These patients were divided into two groups: group A – patients with metabolic syndrome (MetS) and hypogonadism (MetS+T) and group B – patients with metabolic syndrome without hypogonadism (MetS-T). Overweight was defined as BMI 26-29.9kg/m2. Obesity was defined as BMI≥30 kg/m2. Male hypogonadism or androgen deficiency has been defined as a maximum level of total testosterone up to 3 ng/ml. Results. There were no significant age differences between groups (59.8±8.38 versus 58.31±7.47 years p=0.06). Prevalence of hypogonadism in metabolic syndrome patients was 33.5% (n=128). There were no significant differences between groups in terms of body weight, waist circumference, hip circumference, BMI and blood pressure between groups (all p>0.05). Patients with hypogonadism had significantly higher levels of triglycerides, FPI, HOMA-IR (all p<0.05) and smaller HDL-cholesterol and SHBG (all p<0.05). There was a significant decline in testosterone concentration with increase in age and BMI. 88.3% of the diabetic patients (n=113) had hypogonadism (p=0.0001). Hypogonadism was present in 25% patients (n=32) with 3 components of MetS, 43.8% (n=56) patients with 4 componets of MetS and in 31.2% (n=40) patients with 5 components of MetS (p=0.0001). Conclusions. Hypogonadism is a common occurrence in subjects with MetS. Males with MetS with or without diabetes have lower serum testosterone. Patients with MetS should be investigated for clinical and biochemical signs of hypogonadism and patients with hypogonadism should be investigated for signs of metabolic syndrome.