The relationship between the level of serum-free testosterone and depression in obese adolescent men in Sharkia Governorate

Abstract

BackgroundObesity among children and adolescents is considered as one of the most serious public health concerns; low levels of testosterone have been associated with higher levels of morbidity and may have been associated with depression.ObjectiveTo assess the relationship between the level of serum-free testosterone and depression in obese adolescent men in Sharkia Governorate.Patients and methodsThe present study was conducted on 240 age-matched healthy Egyptian adolescent men, collected from the obesity clinic, Internal Medicine Department, Zagazig University Hospital and five high schools in Sharkia Governorate; all the included participants were subjected to: (a) history taking; (b) physical examination (weight, height, BMI, waist circumference, waist to hip ratio, and Tanner stage using Prader orchidometer); (c) hormonal investigations (free testosterone, estradiol, follicular-stimulating hormone, and luteinizing hormone); (d) psychological assessment for depression using: Mini International Neuropsychiatric Interview for Children and Adolescents and children’s depression inventory.ResultsThere was a significant inverse correlation between free testosterone levels and waist circumference among both control and obese cases (r= –0.31, P=0.031 and r= –0.30, P=0.01, respectively). The free testosterone level was significantly lower in obese cases with depression (2.81±2.32 pg/ml) in comparison with obese cases without depression (3.63±2.65 pg/ml) (P=0.04) and testosterone levels was significantly lower in obese cases having some depressive symptoms (feeling depressed, feeling restless, feeling guilty, eating disorders, sleeping disorders, feeling restless, and suicidality). There were significant inverse correlations (P<0.05) between mean free testosterone level and both mild and moderate depression (r= –0.45, P=0.02 and r= –0.58, P=0.012, respectively), and with the following depressive symptoms; feeling depressed, feeling restless, feeling guilty, eating disorder, sleeping disorders, poor concentration, and suicidality.ConclusionObese adolescent men in Sharkia Governorate are significantly associated with lower free testosterone levels. Most of the depression symptoms and their degree are inversely correlated with the levels of free testosterone, otherwise the levels of luteinizing hormone, follicular-stimulating hormone, and estradiol showed no correlation with the depression symptoms or their degree. We recommend further larger studies to prove the relationship between the level of serum-free testosterone and depression in obese adolescent men and try to put a management protocol.