Visceral adiposity index and triglyceride/high-density lipoprotein cholesterol ratio in hypogonadism.

Cem Haymana,Erol Bolu,Mustafa Dinc,Yalcin Basaran,Aydogan Aydogdu,Alper Sonmez,Coskun Meric,Mahmut Ilker Yilmaz,Mahmut Yazici,Abdullah Taslipinar,Omer Azal,Kamil Baskoy,Cem Barcin,Serkan Tapan

doi:10.1590/2359-3997000000236

Abstract

Cardiometabolic risk is high in patients with hypogonadism. Visceral adiposity index (VAI) and triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio are the practical markers of atherosclerosis and insulin resistance and independent predictors of cardiaovascular risk. To date, no study has evaluated VAI levels and TG/HDL-C ratio in hypogonadism. A total of 112 patients with congenital hypogonadotrophic hypogonadism (CHH) (mean age, 21.7 ± 2.06 years) and 124 healthy subjects (mean age, 21.5 ± 1.27 years) were enrolled. The demographic parameters, VAI, TG/HDL-C ratio, asymmetric dimethylarginine (ADMA), high-sensitivity C-reactive protein (hs-CRP), and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured for all participants. The patients had higher total cholesterol (p = 0.04), waist circumference, triglycerides, insulin, and HOMA-IR levels (p = 0.001 for all) than the healthy subjects. VAI and ADMA and TG/HDL-C levels were also higher in patients than in healthy subjects (p < 0.001 for all). VAI was weakly correlated with ADMA (r = 0.27, p = 0.015), HOMA-IR (r = 0.22, p = 0.006), hs-CRP (r = 0.19, p = 0.04), and total testosterone (r = -0.21, p = 0.009) levels, whereas TG/HDL-C ratio was weakly correlated weakly with ADMA (r = 0.30, p = 0.003), HOMA-IR (r = 0.22, p = 0.006), and total testosterone (r = -0.16, p = 0.03) levels. Neither VAI nor TG/HDL-C ratio determined ADMA, HOMA-IR, and hs-CRP levels. The results of this study demonstrate that patients with hypogonadism have elevated VAI and TG/HDL-C ratio. These values are significantly correlated with the surrogate markers of endothelial dysfunction, inflammation, and insulin resistance. However, the predictive roles of VAI and TG/HDL-C ratio are not significant. Prospective follow-up studies are warranted to clarify the role of VAI and TG/HDL-C ratio in predicting cardiometabolic risk in patients with hypogonadism.

Highlights

Hypogonadism is a syndrome characterized by low testosterone levels and a clinical spectrum of poor libido, energy loss, muscle atrophy, and depression
Visceral adiposity index (VAI) were weakly correlated with asymmetric dimethylarginine (ADMA) (r = 0.27, p = 0.015), homeostatic model assessment of insulin resistance (HOMA-IR) (r = 0.22, p = 0.006), high-sensitivity C-reactive protein (hs-CRP) (r = 0.19, p = 0.04; Figure 1A), and total testosterone (r = −0.21, p = 0.009) levels, whereas TG/high-density lipoprotein cholesterol (HDL-C) ratio was weakly correlated with ADMA (r = 0.30, p = 0.003), HOMA-IR (r = 0.22, p = 0.006; Figure 1B), and total testosterone (r = −0.16, p = 0.03) levels
Total testosterone level was the only significant independent determinant of ADMA level, whereas waist circumference (WC) was an independent determinant of HOMA-IR level

Summary

Introduction

Hypogonadism is a syndrome characterized by low testosterone levels and a clinical spectrum of poor libido, energy loss, muscle atrophy, and depression. Inflammation, insulin resistance, and endothelial dysfunction are the major contributors to increased cardiometabolic risk in hypogonadism [4,5,6,7,8]. We observed that even young patients with hypogonadism exhibit endothelial dysfunction, inflammation, and insulin resistance [9,10,11].

Results

Conclusion