[The relationship between testosterone deficiency and metabolic syndrome in obese men].

UNLABELLED: In aging males testosterone decreases approximately 0,8-1% annually. This physiological process can be intensified in obesity and metabolic syndrome (MS). Progressive testosterone deficiency can exacerbate existing metabolic disorders, leading to a vicious circle. The aim of the study was to assess the frequency of testosterone deficiency syndrome (TDS) and concomitance of TDS and MS in obese male patients. Moreover assessment of correlation between TDS markers (total testosterone - TT, free testosterone - fT, sex-hormone binding globulin - SHBG) and obesity, blood pressure, fasting lipid levels, fasting blood glucose, high-sensitivity C-reactive protein (hsCRP), fibrynogen (Fb) was performed. The present study aimed to establish if patients with TDS and MS have more severe metabolic disorders, higher average systolic and diastolic pressure comparing to group with MS without TDS.

MATERIAL AND METHODS: 77 males aged 39 to 72 years, with MS were randomised into the study. 59 obese patients had MS confirmed (MS(+) group) and 18 obese were without MS (MS(-) group). The following were tested: fasting lipid levels, hsCRP, fibrinogen, total testosterone (TT), free testosterone (fT), sex hormone binding globulin (SHBG), and the following were measured: systolic blood pressure (BPs), diastolic bloodpressure (BPd), waist circumference, body weight, BMI. Patients fulfilled questionnaires: AMS (Aging Male Symptoms) and IIEF-5 (Intemational Index of Erectile Function-5).

RESULTS: Percentage of TDS in MS patients was 56%, in obese patients without MS 17% (n = 3). The BPs, BPd, triglycerides were significantly higher in MS(+) group compering to MS(-) patients. TT was significantly lower in MS(+) group, there were no significant differences between fT and SHBG in both groups. A negative correlation was observed between TTand body weight (r = -0.2792; p < 0.05) and between SHBG and waist circumference (r = -0.2840; p < 0.05), SHBG and body weight (r = -0.4783; p < 0.001) in MS(+) group. SHBG level was statistically significantly correlated with age (r = 0.2723; p < 0.05). There were no correlations between TT fT; SHBG and AMS, IIEF-5 questionnaires results, although patients with serious libido disorders according to IIEF-5 had the lowest TT concentrations. Patients MS(+)TDS(+) had significantly lower TT and SHBG concentrations, more serious libido disorders according to IIEF-5 and worse quality of life according to AMS scale comparing to MS(+) TDS(-) group.

CONCLUSION: Among obese males aged > or = 39 frequency of TDS is high (47%). Coincidence of MS and TDS was observed in 56% patients. The inverse correlation between body weight and SHBG and TT was noted and positive association between SHBG and age was established in MS(+) group. No statistically significant difference in fasting lipid levels, fasting blood glucose, CRP, Fb, BP was found between MS(+)TDS(+) patients and MS(+)TDS(-). No statistically significant correlation was found between TT fT, SHBG and IIEF-5, AMS score.