nach oben

International Urology and Nephrology

Erschienen in:

02.07.2020 | Urology - Original Paper

Looking beyond hypogonadism: association between low testosterone and metabolic syndrome in men 20–59 years

verfasst von: Stephanie Gleicher, Michael Daugherty, Elizabeth Ferry, Timothy Byler

Erschienen in: International Urology and Nephrology | Ausgabe 12/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Rates of low testosterone and metabolic syndrome are increasing among adult men in the United States. Both are associated with increased cardiovascular mortality. This study aims to assess the association between low testosterone and metabolic syndrome with a population-based contemporary cohort of men aged 20–59 years.

Methods

National Health and Nutrition Examination Survey (NHANES) was used between the years of 2013 and 2016. Men aged 20–59 years with testosterone levels were included. Metabolic syndrome was defined by National Cholesterol Education Program (NCEP) Adult Treatment Protocol (ATP) III.

Results

24.4% of the cohort had low testosterone and 26.4% had metabolic syndrome. Univariate analysis revealed that men with low testosterone had a significantly higher prevalence of metabolic syndrome and metabolic syndrome criteria. Multivariable logistic regression revealed a significant association between low testosterone and a large waistline (Odds ratio (OR) 4.32), as well as low levels of high-density lipoprotein (HDL) (OR 1.67) among all men. Age-stratification revealed that men 20–39 years with a large waistline had an OR 6.43 for low testosterone.

Conclusion

Nearly one quarter of men aged 20–59 years have low testosterone and metabolic syndrome. A large waistline increases the risk of low testosterone six-fold among young men.

Mulligan T, Frick MF, Zuraw QC, Stemhagen A, McWhirter C (2006) Prevalence of hypogonadism in males aged at least 45 years: the HIM study. Int J Clin Pract 60(7):762–769. https://doi.org/10.1111/j.1742-1241.2006.00992.xCrossRefPubMed

John P. Mulhall MLWT, MD; Robert E. Brannigan, MD; Emily G. Kurtz, MD; J. Bruce Redmon, MD; Kelly A. Chiles, MD, MSc; Deborah J. Lightner, MD; Martin M. Miner, MD; M. Hassan Murad, MD, MPH; Christian J. Nelson, PhD; Elizabeth A. Platz, ScD, MPH; Lakshmi V. Ramanathan, PhD; Ronald W. Lewis, MD. (2018) American Urological Association Guidelines: Evaluation and Management of Testosterone Deficiency. American Urological Association. https://www.auanet.org/guidelines/testosterone-deficiency-guideline#x7697. Accessed 6 June 2019

Wu FC, Tajar A, Beynon JM, Pye SR, Silman AJ, Finn JD et al (2010) Identification of late-onset hypogonadism in middle-aged and elderly men. NEngl J Med 363(2):123–135. https://doi.org/10.1056/NEJMoa0911101CrossRef

Travison TG, Araujo AB, Kupelian V, O'Donnell AB, McKinlay JB (2007) The relative contributions of aging, health, and lifestyle factors to serum testosterone decline in men. J Clin Endocrinol Metab 92(2):549–555. https://doi.org/10.1210/jc.2006-1859CrossRefPubMed

Feldman HA, Longcope C, Derby CA, Johannes CB, Araujo AB, Coviello AD et al (2002) Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging study. J Clin Endocrinol Metab 87(2):589–598. https://doi.org/10.1210/jcem.87.2.8201CrossRefPubMed

Corona G, Vignozzi L, Sforza A, Mannucci E, Maggi M (2015) Obesity and late-onset hypogonadism. Mol Cell Endocrinol 418(Pt 2):120–133. https://doi.org/10.1016/j.mce.2015.06.031CrossRefPubMed

Selvin E, Feinleib M, Zhang L, Rohrmann S, Rifai N, Nelson WG et al (2007) Androgens and diabetes in men: results from the Third National Health and Nutrition Examination Survey (NHANES III). Diabetes Care 30(2):234–238. https://doi.org/10.2337/dc06-1579CrossRefPubMed

Laaksonen DE, Niskanen L, Punnonen K, Nyyssonen K, Tuomainen TP, Valkonen VP et al (2004) Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-aged men. Diabetes Care 27(5):1036–1041. https://doi.org/10.2337/diacare.27.5.1036CrossRefPubMed

Rao PM, Kelly DM, Jones TH (2013) Testosterone and insulin resistance in the metabolic syndrome and T2DM in men. Nat Rev Endocrinol 9(8):479–493. https://doi.org/10.1038/nrendo.2013.122CrossRefPubMed

10.

Fernandez CJ, Chacko EC, Pappachan JM (2019) Male obesity-related secondary hypogonadism—pathophysiology. Clin Implic Manag Eur Endocrinol 15(2):83–90. https://doi.org/10.17925/ee.2019.15.2.83CrossRef

11.

Corona G, Rastrelli G, Monami M, Guay A, Buvat J, Sforza A et al (2011) Hypogonadism as a risk factor for cardiovascular mortality in men: a meta-analytic study. Eur J Endocrinol 165(5):687–701. https://doi.org/10.1530/eje-11-0447CrossRefPubMed

12.

Khaw KT, Dowsett M, Folkerd E, Bingham S, Wareham N, Luben R et al (2007) Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men: European prospective investigation into cancer in Norfolk (EPIC-Norfolk) prospective population study. Circulation 116(23):2694–2701. https://doi.org/10.1161/circulationaha.107.719005CrossRefPubMed

13.

Moskovic DJ, Araujo AB, Lipshultz LI, Khera M (2013) The 20-year public health impact and direct cost of testosterone deficiency in US men. J Sex Med 10(2):562–569. https://doi.org/10.1111/j.1743-6109.2012.02944.xCrossRefPubMed

14.

Lokeshwar SD, Patel P, Fantus RJ, Halpern J, Chang C, Kargi AY et al (2020) Decline in serum testosterone levels among adolescent and young adult men in the USA. Eur Urol Focus. https://doi.org/10.1016/j.euf.2020.02.006CrossRefPubMed

15.

Peterson MD, Belakovskiy A, McGrath R, Yarrow JF (2018) Testosterone deficiency, weakness, and multimorbidity in Men. Sci Rep 8(1):5897. https://doi.org/10.1038/s41598-018-24347-6CrossRefPubMedCentralPubMed

16.

Boonchaya-Anant P, Laichuthai N, Suwannasrisuk P, Houngngam N, Udomsawaengsup S, Snabboon T (2016) Changes in testosterone levels and sex hormone-binding globulin levels in extremely obese men after bariatric surgery. Int J Endocrinol 2016:1416503. https://doi.org/10.1155/2016/1416503CrossRefPubMedCentralPubMed

17.

Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA et al (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 112(17):2735–2752. https://doi.org/10.1161/circulationaha.105.169404CrossRefPubMed

18.

Corona G, Monami M, Rastrelli G, Aversa A, Tishova Y, Saad F et al (2011) Testosterone and metabolic syndrome: a meta-analysis study. J Sex Med 8(1):272–283. https://doi.org/10.1111/j.1743-6109.2010.01991.xCrossRefPubMed

19.

Tajar A, Forti G, O'Neill TW, Lee DM, Silman AJ, Finn JD et al (2010) Characteristics of secondary, primary, and compensated hypogonadism in aging men: evidence from the European male ageing study. J Clin Endocrinol Metab 95(4):1810–1818. https://doi.org/10.1210/jc.2009-1796CrossRefPubMed

20.

Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J et al (2002) The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 288(21):2709–2716. https://doi.org/10.1001/jama.288.21.2709CrossRefPubMed

21.

Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM et al (2016) American association of clinical endocrinologists and American college of endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract off j Am Coll Endocrinol Am Assoc Clin Endocrinol 22(Suppl 3):1–203. https://doi.org/10.4158/ep161365.GlCrossRef

22.

Prevention CfDCa. Overweight and Obesity- Adult Obesity Facts. 2020. https://www.cdc.gov/obesity/data/adult.html. Accessed 4 Jan 2020

23.

Prevention CfDCa. National Health and Nutrition Examination Survey Data. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Hyattsville, MD. 2019. https://wwwn.cdc.gov/nchs/nhanes/default.aspx. Accessed 6 June 2019

24.

Prevention CfDCa. National Health and Nutrition Examination Survey: 2015–2016 Data Documentation, Codebook, Frequencies- Sex Steroid Hormones. 2019. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/TST_I.htm. Accessed 6 June 2019

25.

Prevention CfDCa. National Health and Nutrition Examination Survey: 2013–2014 Data Documentation, Codebook, Frequencies- Glycohemoglobin. 2019. https://wwwn.cdc.gov/Nchs/Nhanes/2013-2014/GHB_H.htm. Accessed 6 Jan 2019

26.

Prevention CfDCa. National Health and Nutrition Examination Survey: 2015–2016 Data Documentation, Codebook, and Frequencies- Glycohemoglobin. 2019. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/GHB_H.htm. Accessed 6 Jan 2019

27.

Classification and Diagnosis of Diabetes (2020) Standards of medical care in diabetes-2020. Diabetes Care 43(Suppl 1):S14–s31. https://doi.org/10.2337/dc20-S002CrossRef

28.

Corona G, Rastrelli G, Morelli A, Vignozzi L, Mannucci E, Maggi M (2011) Hypogonadism and metabolic syndrome. J Endocrinol Invest 34(7):557–567. https://doi.org/10.3275/7806CrossRefPubMed

29.

Gyawali P, Martin SA, Heilbronn LK, Vincent AD, Jenkins AJ, Januszewski AS et al (2019) Higher serum sex hormone-binding globulin levels are associated with incident cardiovascular disease in men. J Clin Endocrinol Metab 104(12):6301–6315. https://doi.org/10.1210/jc.2019-01317CrossRefPubMed

30.

Prevention CfDCa. National Health and Nutrition Examination Survey 2015–2016 Data Documentation, Codebook, and Frequencies- Cholesterol HDL. 2019. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/HDL_H.htm. Accessed 6 Jan 2019

31.

Prevention CfDCa. National Health and Nutrition Examination Survey: 2013–2014 Data Documentation, Codebook, Frequencies- Cholesterol LDL and Triglycerides. 2019. https://wwwn.cdc.gov/Nchs/Nhanes/2013-2014/GLU_H.htm#Laboratory_Method_Files. Accessed 15 June 2020

32.

Prevention CfDCa. National Health and Nutrition Examination Survey: 2013–2014 Data Documentation, Codebook, Frequencies- Plasma Fasting Glucose. 2019. https://wwwn.cdc.gov/Nchs/Nhanes/2013-2014/GLU_H.htm#Laboratory_Method_Files. Accessed 6 Jan 2019

33.

Camacho EM, Huhtaniemi IT, O'Neill TW, Finn JD, Pye SR, Lee DM et al (2013) Age-associated changes in hypothalamic-pituitary-testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European male ageing study. Eur J Endocrinol 168(3):445–455. https://doi.org/10.1530/eje-12-0890CrossRefPubMed

34.

Bhattacharya RK, Khera M, Blick G, Kushner H, Nguyen D, Miner MM (2011) Effect of 12 months of testosterone replacement therapy on metabolic syndrome components in hypogonadal men: data from the Testim Registry in the US (TRiUS). BMC Endocr Disord 11:18. https://doi.org/10.1186/1472-6823-11-18CrossRefPubMedCentralPubMed

35.

Grossmann M, Hoermann R, Wittert G, Yeap BB (2015) Effects of testosterone treatment on glucose metabolism and symptoms in men with type 2 diabetes and the metabolic syndrome: a systematic review and meta-analysis of randomized controlled clinical trials. Clin Endocrinol 83(3):344–351. https://doi.org/10.1111/cen.12664CrossRef

36.

Ervin RB (2009) Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States, 2003–2006. Nat Health Stat Rep 13:1–7

Titel: Looking beyond hypogonadism: association between low testosterone and metabolic syndrome in men 20–59 years
verfasst von: Stephanie Gleicher
Michael Daugherty
Elizabeth Ferry
Timothy Byler
Publikationsdatum: 02.07.2020
Verlag: Springer Netherlands
Erschienen in: International Urology and Nephrology / Ausgabe 12/2020
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-020-02557-0

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 12/2020

Chronic kidney disease and concomitant sleep apnea are associated with increased overall mortality: a meta-analysis

Red cell differential width (RDW) as a predictor of survival outcomes with palliative and adjuvant chemotherapy for metastatic penile cancer

Clinical significance of phenotyping and karyotyping of detecting circulating tumor cells in renal cell carcinoma using subtraction enrichment and immunostaining-fluorescence in situ hybridization (SE-iFISH)

Renal protective effect of N-acetylcysteine with stepwise ramping voltage against extracorporeal shock wave lithotripsy-induced renal injury: a prospective randomized trial

Comparison of ischemic and ischemic/reperfused kidney injury via clamping renal artery, vein, or pedicle in anesthetized rats