Abstract
Obesity is associated with decreased circulating testosterone levels, the main male sex hormone. However, there are a number of different male sex hormones whose dynamics remain poorly understood regarding this pathology. In this regard, 17 hydroxyprogesterone (17-OH progesterone), as an important precursor of testosterone synthetized in testes and adrenal glands, could play an essential role in testosterone deficiency in male obesity. Moreover, similarly to testosterone, 17-OH progesterone could be closely associated with visceral fat distribution and metabolic dysfunction. Thus, the aim of this study was to assess serum 17-OH progesterone levels in non-diabetic obese young men and to evaluate their relationship with clinical, analytical, and anthropometric parameters. We conducted a cross-sectional study including 266 non-diabetic men with obesity (BMI ≥ 30 kg/m2) aged 18–49 years; 17-OH progesterone and total testosterone (TT) were determined by high-performance liquid chromatography mass spectrometry. 17-OH progesterone levels were significantly lower in tertile 3 of body fat percentage in comparison with tertile 1 (0.74 ng/mL vs. 0.94 ng/mL, p < 0.01; Bonferroni correction) and in comparison with tertile 2 (0.74 ng/mL vs. 0.89 ng/mL, p = 0.02; Bonferroni correction). 17-OH progesterone levels correlated negatively with weight, BMI, waist circumference, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and visceral fat, and positively with TT, free testosterone (FT), luteinizing hormone, and fat-free mass percentage. Multivariate linear-regression analysis showed that body fat percentage and HOMA-IR were inversely associated with 17-OH progesterone levels, while FT and ACTH were positively linked to circulating 17-OH progesterone levels. In conclusion, in a population of non-diabetic obese young men, 17-OH progesterone levels were inversely associated with adiposity. Body fat percentage and insulin resistance were negatively related to 17-OH progesterone levels, whereas FT and ACTH levels were positively associated with 17-OH progesterone levels.
Highlights
Overweight and obesity worldwide prevalence has increased in pandemic dimensions in the last few decades
Our results reveal that circulating 17-OH progesterone levels decrease in parallel with the increase of body fat percentage in non-diabetic young men with obesity
We found that 17-OH progesterone concentrations were independently related to visceral fat, insulin resistance, free testosterone (FT) and Adrenocorticotropic hormone (ACTH) levels
Summary
Overweight and obesity worldwide prevalence has increased in pandemic dimensions in the last few decades. Obesity is associated with a major number of comorbidities, such as type 2 diabetes, cardiovascular disease, cancer, or obstructive sleep apnea [2]. It is considered the most frequent cause of male hypogonadism [3]. Some conditions usually associated with obesity, such as type 2 diabetes or cardiovascular disease, are closely linked to testosterone decrease, even in young obese men without these comorbidities, the prevalence of hypogonadism remains high, affecting more than 25% of these subjects. The hypogonadism prevalence rises >75% in males with extreme obesity [5]
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