Association Between Low Serum Testosterone and the Development of Metabolic Syndrome in Elderly Taiwanese Men

Abstract

Purpose: To assess the association between serum testosterone (T) and metabolic syndrome (MS) in different age groups in Taiwanese men. Materials and Methods: Male participants, regardless of age or any underlying disease, were identified from MJ Health Screening Center in Taiwan from 2007 to 2016 for this crosssectional study. They were divided into three groups according to age, and further classified according to MS diagnosis. Basic patient characteristics with relevant parameters were obtained. One-way ANOVA of mean T values between different numbers of measures that exceeds the cut-off values of MS components was performed to assess the relationship of T and MS. Logistic regression analysis was also used to estimate the risk for MS with each increment in T, age, and BMI. Results: A total of 4,931 men were included. The MS group had significantly lower serum T levels compared to the non-MS group in each age group. The one-way ANOVA found the mean value of T was significantly higher in patients without MS component (6.19±2.12 ng/ mL) than those with 1-5 MS components (with one MS component: 5.48±2.13 ng/mL, two MS components: 4.93±2.03 ng/mL, three MS components: 4.37±1.60 ng/mL, four MS components: 4.13±2.89 ng/mL, five MS components: 3.74±1.27 ng/mL, and P<0.001). There was no significant difference between the patients with three components and the patients with four or five components. Logistic regression models with age stratification showed T with lower odds ratio (OR) for MS after adjusting for BMI in those ≥65 years old (OR=0.693; 95% CI=0.559-0.858; P<0.001); 50-64 years old (OR=0.868; 95% CI=0.802-0.940; P<0.001) and <50 years old (OR=0.810; 95% CI=0.758-0.865; P<0.001). Conclusion: Lower serum T was strongly associated with MS, with the predictive value increasing with age in Taiwanese men.

Waist Circumference Is More Closely Associated with Hypogonadism than Is Hyperglycemia, Independent of BMI in Middle-Aged Men

“…Thus, if we can prove that WC is better than HbA1c for predicting the risk of male hypogonadism, WC will be an easier method for detecting participants who may have a higher risk of hypogonadism in the future. After identifying such high-risk participants, earlier lifestyle interventions through exercise and diet control can offer this higher risk of hypogonadism group a chance to prevent the disadvantages associated with hypogonadism, such as a higher risk of metabolic syndrome [ 12 ], incident cardiovascular disease [ 13 ], and erectile dysfunction [ 14 ]. The question thus arises as to how abnormal WC and diabetes lead to hypogonadism.…”

“…This cross-sectional study retrieved data from a large private health examination institute (MJ Health Screening Center) in Taiwan from 2007 to 2016. Given that this institute provides self-paid health examination services in major districts in Taiwan with a general payment of approximately 200-730 USD (about 17 USD, specifically on serum T), the demographic characteristics of the included patients were believed to be similar to those of the general Taiwanese population [ 12 ].…”

“…Personal identification data were removed from the MJ Health Research Foundation, so the participants remained anonymous throughout the entire research process. The details of the study population and data collection are described and reported elsewhere [ 12 ].…”

“…Many studies have indicated that male hypogonadism is associated with a higher risk of metabolic syndrome [ 12 ], incident cardiovascular disease [ 13 ], and erectile dysfunction [ 14 ]. These conditions may also develop in people with abnormal HbA1c levels and increased WC because both factors are inversely associated with TT [ 7 , 15 ].…”

Association between hypertriglyceridemic waist phenotype and hypogonadism in Taiwanese adult men

“…All identifiable participant data were removed to maintain participant anonymity. The data collection procedure and detailed characteristics of the study population are reported elsewhere [ 5 ]. The research protocol was approved by the Institutional Review Board of the Tri-Service General Hospital, National Defense Medical Center (A202005160).…”