Testosterone, sex hormone-binding globulin and the metabolic syndrome: a systematic review and meta-analysis of observational studies

Brand, Judith S.; Tweel, Ingeborg van der; Grobbee, Diederick E.; Emmelot-Vonk, Mariëlle H.; Schouw, Yvonne T. van der

doi:10.1093/ije/dyq158

Cited by 271 publications

(226 citation statements)

References 111 publications

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“…Several meta-analyses have demonstrated an association between low testosterone levels and the metabolic syndrome. [241][242][243][244] In male individuals, low testosterone levels are also strongly associated with an increased risk of developing type 2 diabetes mellitus. 245 However, few studies have examined metabolic risk specifically in patients with CHH.…”

Section: Reducing Long-term Health Effects Of Chhmentioning

confidence: 99%

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

et al. 2015

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| Congenital hypogonadotropic hypogonadism (CHH) is a rare disorder caused by the deficient production, secretion or action of gonadotropin-releasing hormone (GnRH), which is the master hormone regulating the reproductive axis. CHH is clinically and genetically heterogeneous, with >25 different causal genes identified to date. Clinically, the disorder is characterized by an absence of puberty and infertility. The association of CHH with a defective sense of smell (anosmia or hyposmia), which is found in ~50% of patients with CHH is termed Kallmann syndrome and results from incomplete embryonic migration of GnRHsynthesizing neurons. CHH can be challenging to diagnose, particularly when attempting to differentiate it from constitutional delay of puberty. A timely diagnosis and treatment to induce puberty can be beneficial for sexual, bone and metabolic health, and might help minimize some of the psychological effects of CHH. In most cases, fertility can be induced using specialized treatment regimens and several predictors of outcome have been identified. Patients typically require lifelong treatment, yet ~10-20% of patients exhibit a spontaneous recovery of reproductive function. This Consensus Statement summarizes approaches for the diagnosis and treatment of CHH and discusses important unanswered questions in the field.

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Section: Reducing Long-term Health Effects Of Chhmentioning

confidence: 99%

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

et al. 2015

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“…[49][50][51][52][53][54][55][56][57][58][59][60] In addition to poor QoL, both GHD and hypogonadism can contribute to decreased lean body mass, increased fat mass (in particular, visceral fat), and poor exercise capacity that further contribute to poor QoL, obesity, and MetS, increasing cardiovascular disease (CVD) risk. 51,54,57,[61][62][63][64][65][66][67][68][69][70] Studies have shown that MetS is associated with, and predicts the development of, low serum testosterone levels in men. 62,64,65,71 Five of 6 subjects with hypogonadism had MetS and obesity.…”

Section: Previous Studies On Postconcussive Hypopituitarismmentioning

confidence: 99%

“…51,54,57,[61][62][63][64][65][66][67][68][69][70] Studies have shown that MetS is associated with, and predicts the development of, low serum testosterone levels in men. 62,64,65,71 Five of 6 subjects with hypogonadism had MetS and obesity. However, whereas obesity was present in 65% of subjects and MetS in 49% of subjects, these rates were statistically not different in subjects with and without any hormonal deficiency.…”

Section: Previous Studies On Postconcussive Hypopituitarismmentioning

confidence: 99%

Prevalence of Pituitary Hormone Dysfunction, Metabolic Syndrome, and Impaired Quality of Life in Retired Professional Football Players: A Prospective Study

Kelly

Chaloner

Evans

et al. 2014

Journal of Neurotrauma

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Hypopituitarism is common after moderate and severe traumatic brain injury (TBI). Herein, we address the association between mild TBI (mTBI) and pituitary and metabolic function in retired football players. Retirees 30-65 years of age, with one or more years of National Football League (NFL) play and poor quality of life (QoL) based on Short Form 36 (SF-36) Mental Component Score (MCS) were prospectively enrolled. Pituitary hormonal and metabolic syndrome (MetS) testing was performed. Using a glucagon stimulation test, growth hormone deficiency (GHD) was defined with a standard cut point of 3 ng/mL and with a more stringent body mass index (BMI)-adjusted cut point. Subjects with and without hormonal deficiency (HD) were compared in terms of QoL, International Index of Erectile Function (IIEF) scores, metabolic parameters, and football career data. Of 74 subjects, 6 were excluded because of significant non-football-related TBIs. Of the remaining 68 subjects (mean age, 47.3 -10.2 years; median NFL years, 5; median NFL concussions, 3; mean BMI, 33.8 -6.0), 28 (41.2%) were GHD using a peak GH cutoff of < 3 ng/mL. However, with a BMI-adjusted definition of GHD, 13 of 68 (19.1%) were GHD. Using this BMI-adjusted definition, overall HD was found in 16 (23.5%) subjects: 10 (14.7%) with isolated GHD; 3 (4.4%) with isolated hypogonadism; and 3 (4.4%) with both GHD and hypogonadism. Subjects with HD had lower mean scores on the IIEF survey ( p = 0.016) and trended toward lower scores on the SF-36 MCS ( p = 0.113). MetS was present in 50% of subjects, including 5 of 6 (83%) with hypogonadism, and 29 of 62 (46.8%) without hypogonadism ( p = 0.087). Age, BMI, median years in NFL, games played, number of concussions, and acknowledged use of performance-enhancing steroids were similar between HD and non-HD groups. In summary, in this cohort of retired NFL players with poor QoL, 23.5% had HD, including 19% with GHD (using a BMI-adjusted definition), 9% with hypogonadism, and 50% had MetS. Although the cause of HD is unclear, these results suggest that GHD and hypogonadism may contribute to poor QoL, erectile dysfunction, and MetS in this population. Further study of pituitary function is warranted in athletes sustaining repetitive mTBI.

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“…Overall, women with normal androgen levels appear to be part of the milder PCOS spectrum, but this might be due to the less frequently elevated blood glucose level, which is related with lower health-risk-related factors. It has also been found that subclinical atherosclerosis expressed as low-grade inflammation (increased hs-CRP levels) could be a factor for an increased risk of cardiovascular disease and DM type 2 in women with PCOS (50)(51)(52). Moreover, an elevation in circulating hs-CRP irrespective of obesity is evidence that chronic low-grade inflammation may have an effect on the pathogenesis of PCOS, particularly in hyperanderogenemic phenotypes (4,53).…”

Section: Discussionmentioning

confidence: 99%

Metabolic and carbohydrate characteristics of different phenotypes of polycystic ovary syndrome

Çelik¹,

Türkçüoğlu²,

Ata³

et al. 2016

J Turkish German Gynecol Assoc

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Testosterone, sex hormone-binding globulin and the metabolic syndrome: a systematic review and meta-analysis of observational studies

Cited by 271 publications

References 111 publications

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

Prevalence of Pituitary Hormone Dysfunction, Metabolic Syndrome, and Impaired Quality of Life in Retired Professional Football Players: A Prospective Study

Metabolic and carbohydrate characteristics of different phenotypes of polycystic ovary syndrome

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