Hypogonadism and the metabolic syndrome in men: an association to be considered

Abstract

In recent years attention has focussed on the frequent association of male hypogonadism and the metabolic syndrome, and on its clinical implications. Indeed the term “Hypoandrogenic Metabolic Syndrome” was proposed [ [1] Gould D.C. Amoroso P. Kirby R.S. Hypoandrogen-Metabolic Sindrome: a significant issue for men's health. BJU. 2006; 98: 494 Crossref PubMed Scopus (13) Google Scholar ]. Recent epidemiological data suggested an androgen deficiency may play a role in the development of this syndrome since low serum testosterone and Sex Hormone Binding Globulin (SHBG) levels could both be risk factors for developing visceral obesity and type 2 diabetes later in life [ [2] Kupelian V. Page S.T. Araujo A.B. Travisan T.G. Bremner W.J. McKinlay J.B. Low sex hormone-binding globulin, total testosterone, and symptomatic androgen deficiency are associated with development of the metabolic syndrome in nonobese men. J Clin Endocrinol Metab. 2006; 91: 843 Crossref PubMed Scopus (473) Google Scholar ]. On the other hand, male subjects with the metabolic syndrome had a higher prevalence of hypogonadism than healthy men [ 3 Maggi M. Lauretani F. Ceda G.P. Bandineli S. Basarla S. Bele A. et al. Association between hormones and metabolic syndrome in older italian men. J Am Geriatr Soc. 2006; 54: 1832 Crossref PubMed Scopus (76) Google Scholar , 4 Seftel A.D. Sun P. Swindle R. The prevalence of hypertension, hyperlipidemia, diabetes mellitus and depression in men with erectile dysfunction. J Urol. 2004; 171: 2341 Abstract Full Text Full Text PDF PubMed Scopus (306) Google Scholar , 5 Lunefeld B. Testosterone deficiency and metabolic syndrome. Aging Male. 2007; 10: 53 Crossref PubMed Scopus (19) Google Scholar ]. Furthermore independently of diabetes or obesity, an inter-relationship also emerged between low serum testosterone levels and other abnormalities linked to the metabolic syndrome as they were, in fact, inversely correlated with triglycerides, fibrinogen, PAI-1 and blood pressure in addition to total and LDL-cholesterol [ [6] Yang X.C. Jing T.Y. Resnick L.M. Phillips G.B. Relation of hemostatic risk factors to other risk factors for coronary heart disease and to sex hormones in men. Arterioscler Thromb. 1991; 13: 307 Google Scholar ].