Introduction

Studies have demonstrated that metabolic syndrome (MetS) is associated with low testosterone (T) levels. However the incremental effect of every MetS component in predicting testosterone deficiency (TD) has not been well explored in the literature. The primary goal of this study was to investigate the association of MetS and low T levels in men from 40 to 80 years of age, while investigating the cumulative effect of the syndrome components

Methods

We reviewed records of all men who presented to our men’s health clinic from January 2014 to August 2016. We evaluated age, presence of hypertension, waist circumference (WC), blood glucose level and the serum lipid profile (HDL and triglycerides - TGL), and MetS was considered present when 3 or more factors were present. TD was defined as serum total T <300 ng/dL. Univariable analyses were performed to assess the association variables and T levels. ROC curves analyses were performed to evaluate diagnostic accuracy of each MetS component in predicting TD.

Results

_x000D_ The study comprised 902 men with a mean age of 57.2 ± 9.85 years. The overall prevalence of low T levels was 23.4% and it was similar across all age subgroups: age 40-49 years (y) 22.7%, 50-59y 23.1%, 60-69y 23.8%, and 70-79y 24.4%, p=0.25. The diagnosis of MetS was established in 27.9% of subjects and was associated with TD (OR=3.1, 95%CI 1.2-4.0, p<0.001). The prevalence of each MetS components was: hypertension = 43.6%, increased WC (>102) = 34.5%%, elevated glucose levels (>100 ng/dl) =33,8%, low HDL (< 40 mg/dL) = 25%, and high TGL (> 150 mg/dL) = 53.2%. Median T levels for patients with 5 MetS components was 293 ± 147 ng/dL, 4 = 306 ± 173 ng/dL, 3 = 356 ± 154 ng/dL, 2 = 387 ± 184 ng/dL, 1 = 421 ± 215 ng/dL, 0 = 460 ± 222 ng/dL. Accordingly, TD prevalence for subjects with none MetS components was 9.6%, 1 = 15.4%, 2 = 24%, 3 = 29%, 4= 48%, and 5= 52%. Increased WC was the most accurate predictor of TD in our population. The overall accuracy estimates by area under ROC curve was 0.716(0.686-0.745)95%CI. Diagnostic accuracy measurements of cumulative MetS components are demonstrated in Table 1.

Conclusions

There is an increased prevalence of TD with increasing number of MetS components. WC was the best predictor of TD in our population and age was not associated with lower T levels

Funding

None