The association of obesity with sex hormone‐binding globulin is stronger than the association with ageing – implications for the interpretation of total testosterone measurements

Cooper, Lori A.; Page, Stephanie T.; Amory, John K.; Anawalt, Bradley D.; Matsumoto, Alvin M.

doi:10.1111/cen.12768

Cited by 88 publications

(86 citation statements)

References 33 publications

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“…Although the majority of the studies were conducted in middle‐aged men populations, similar results were observed in male adolescents (age ranged from 14 to 20 years), where free testosterone levels were also inversely related to BMI and insulin resistance . Thus, evidencing that age is not the only factor that leads to decreased testosterone but indeed increased BMI is also important . Interestingly, although the BMI seems to have a deleterious effect on free testosterone levels, the opposite was not verified .…”

Section: Obesity Prompts Hpt Axis Dysfunctionmentioning

confidence: 87%

“…79,80 Thus, evidencing that age is not the only factor that leads to decreased testosterone but indeed increased BMI is also important. 81 Interestingly, although the BMI seems to have a deleterious effect on free testosterone levels, the opposite was not verified. 82 As aforementioned, male hypogonadism results in body composition alterations, but overall, no significant BMI changes are observed.…”

Section: Obesity Prompts Hpt Axis Dysfunctionmentioning

confidence: 96%

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Obesity and male hypogonadism: Tales of a vicious cycle

et al. 2019

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Summary Obesity prevalence, particularly in children and young adults, is perilously increasing worldwide foreseeing serious negative health impacts in the future to come. Obesity is linked to impaired male gonadal function and is currently a major cause of hypogonadism. Besides signs and symptoms directly derived from decreased circulating testosterone levels, males with obesity also present poor fertility outcomes, further evidencing the parallelism between obesity and male reproductive function. In addition, males with androgen deficiency also exhibit increased fat accumulation and reduced muscle and mineral bone mass. Thus, compelling evidence highlights a vicious cycle where male hypogonadism can lead to increased adiposity, while obesity can be a cause for male hypogonadism. On the opposite direction, sustained weight loss can attain amelioration of male gonadal function. In this scenario, a thorough evaluation of gonadal function in men with obesity is crucial to dissect the causes from the consequences in order to target clinical interventions towards maximized improvement of reproductive health. This review will address the causes and consequences of the bidirectional relationship between obesity and hypogonadism, highlighting the implicit male reproductive repercussions.

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Section: Obesity Prompts Hpt Axis Dysfunctionmentioning

confidence: 87%

Section: Obesity Prompts Hpt Axis Dysfunctionmentioning

confidence: 96%

Obesity and male hypogonadism: Tales of a vicious cycle

et al. 2019

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“…There was limited information about the prevalence of hypogonadism among men with early‐onset T2DM. Only a few studies reported that the prevalence of hypogonadism in men with T2DM at the 31–40 years age group reported by others varied from 19.1% to 42% (Chandel et al ., ; Ganesh et al ., ; Al Hayek et al ., ; Cooper et al ., ). The differences might be because of different characteristics of populations (ethnic, duration of T2DM, outpatient, or inpatient), the difference in the cut‐off points used for testosterone, measurement variations, and small sample size.…”

Section: Discussionmentioning

confidence: 97%

“…Free testosterone concentrations were calculated by Sartorius et al . 's formula, which has been widely adopted in the literature (Keelan et al ., ; Cooper et al ., ).…”

Section: Methodsmentioning

confidence: 97%

Correlates and prevalence of hypogonadism in patients with early‐ and late‐onset type 2 diabetes

Zhang

Liu

et al. 2017

Andrology

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This study aims to compare the prevalence of hypogonadism between male patients with early-onset type 2 diabetes mellitus (T2DM) and late-onset type 2 diabetes. A total of 122 male patients with early-onset T2DM (diagnosis age ≤40 years) and 100 male patients with late-onset T2DM (diagnosis age >40 years) were recruited from our in-patient department between 1 January 2013 and 28 December 2015. Serum FSH, LH, testosterone, lipid profile, uric acid, HbA1c, and beta-cell function were determined in blood samples. The diagnosis of hypogonadism was based on the levels of LH, FSH, and total testosterone. The mean onset age was 29.86 ± 6.31 and 54.47 ± 9.97 years old in the early-onset group and late-onset group, respectively. Compared with late-onset T2DM, those with early-onset T2DM had a higher proportion of new-onset diabetes, were more likely to be obese, and had worse glycemic control, lipid control, and lower sex hormone-binding globulin (SHBG). The prevalence of hypogonadism was much higher in the early-onset group than in the late-onset group (48.0% vs. 26.7%, p< 0.05). The rate of secondary hypogonadism in the early-onset group and late-onset group were 44.3% and 25.0%, respectively (p < 0.05). Obesity, waist circumference, and SHBG were significantly associated with serum total testosterone level in all, early-onset, and late-onset T2DM. Both all and early-onset T2DM groups had positive correlations between total testosterone and fasting C-peptide, total cholesterol, triglycerides, and uric acid. Our results indicate that in a population of admission to a large urban hospital in China, the prevalence of hypogonadism was higher in the patients with early-onset T2DM than that of late-onset T2DM. This prevalence might be attributable to greater obesity, worse lipid control, and lower SHBG levels in those patients.

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“…In almost all included studies only total T was presented. However, it has been shown that free T is a more reliable marker for TD than total T. An explanation is that sex‐hormone binding globuline (SHBG) is decreased with obesity resulting in a low total T, whereas free T tends to remain within its normal range (Cooper et al ., ). It is recommended to consider T substitution when T level is low measured on two separate occasions and persistent symptoms of TD are present (Bhasin et al ., ).…”

Section: Discussionmentioning

confidence: 97%

Testosterone deficiency in testicular cancer survivors – a systematic review and meta‐analysis

et al. 2016

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SUMMARYResults concerning treatment of Testicular Germ Cell Cancer (TGCC) and subsequent risk of testosterone deficiency are conflicting. To systematically evaluate and estimate the risk of testosterone deficiency (TD) in TGCC-patients according to treatment to optimize follow-up and for prevention of late effects related to hypogonadism. We performed a critical review of PubMed in January 2015 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Twelve publications were selected for inclusion in this analysis. Eleven studies evaluated the risk of TD in TGCC-patients treated with standard chemotherapy (CT) and the odds ratio for TD was 1.8 (95% CI) (1.3-2.5), (p = 0.0007). Seven studies evaluated the risk of TD in TGCC-patients treated with non-conventional therapy and the odds ratio for TD was 3.1 (95% CI) (2.0-4.8), (p < 0.0001). Six studies evaluated the risk of TD in TGCC-patients treated with infradiaphragmatic radiotherapy (RT), and the odds ratio for TD was 1.6 (95% CI) (1.0-2.4), (p = 0.03). In all treatment groups the risk of TD was compared with TGCC-patients treated with orchiectomy alone. There was no indication of heterogeneity between studies in the three treatment groups. Strong evidence exists that standard CT, non-conventional therapy and infradiaphragmatic RT are associated with an increased risk of TD in TGCC-patients when compared with orchiectomy alone. The risk of testosterone defficiency appears to be highest in patients treated with non-conventional therapy.

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The association of obesity with sex hormone‐binding globulin is stronger than the association with ageing – implications for the interpretation of total testosterone measurements

Cited by 88 publications

References 33 publications

Obesity and male hypogonadism: Tales of a vicious cycle

Obesity and male hypogonadism: Tales of a vicious cycle

Correlates and prevalence of hypogonadism in patients with early‐ and late‐onset type 2 diabetes

Testosterone deficiency in testicular cancer survivors – a systematic review and meta‐analysis

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