The Age Related Decrease in Testosterone is Significantly Exacerbated in Obese Men With the Metabolic Syndrome. What are the Implications for the Relatively High Incidence of Erectile Dysfunction Observed in These Men?

Kaplan, Steven A.; Meehan, Alan G.; Shah, Arvind

doi:10.1016/j.juro.2006.06.003

Cited by 152 publications

(109 citation statements)

References 13 publications

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“…48 An uncontrolled prospective study of men for the assessment of sexual dysfunction reported that the presence of hypogonadism in men with metabolic syndrome was associated with worse sexual dysfunction and anxiety than in men with metabolic syndrome but without hypogonadism. 43 For example, in 864 men (mean age 52 years) participating in two lipid treatment studies, 49 testosterone decreased with increasing BMI (Po 0.0001). Mean baseline total serum testosterone levels in obese and severely obese aging men with the metabolic syndrome were around 150 and 300 ng per 100 ml, respectively, less than that in aging, lean men with no metabolic syndrome.…”

Section: Hypogonadism and The Metabolic Syndromementioning

confidence: 99%

Obesity and sexual dysfunction, male and female

et al. 2008

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Obesity has become a worldwide public health problem of epidemic proportions, as it may decrease life expectancy by 7 years at the age of 40 years: excess bodyweight is now the sixth most important risk factor contributing to the overall burden of disease worldwide. Overweight and obesity may increase the risk of erectile dysfunction (ED) by 30-90% as compared with normal weight subjects. On the other hand, subjects with ED tend to be heavier and with a greater waist than subjects without ED, and also are more likely to be hypertensive and hypercholesterolemic. The metabolic syndrome, characterized by a clustering of risk factors associated with insulin resistance and abdominal obesity, associates with ED. Moreover, women with the metabolic syndrome have an increased prevalence of sexual dysfunctions as compared with matched control women. Lifestyle changes aimed at reducing body weight and increasing physical activity induce amelioration of both erectile and endothelial functions in obese men. Moreover, preliminary evidence suggests that a Mediterranean-style diet might be effective in ameliorating sexual function in women with the metabolic syndrome. Lifestyle changes, mainly focussing on regular physical activity and a healthy diet, are effective and safe ways to reduce cardiovascular diseases and premature mortality in all population groups; they may also prevent and treat sexual dysfunctions in both sexes.

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Section: Hypogonadism and The Metabolic Syndromementioning

confidence: 99%

Obesity and sexual dysfunction, male and female

et al. 2008

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“…Insulin resistance and obesity are inversely related with sex hormone-binding globulin and total testosterone [18]. Kaplan et al [19] showed that aging men with obesity and metabolic syndrome have a significant decrease in total serum testosterone levels compared with aging metabolically healthy men. Recently, the phenomenon that total testosterone level decreases in these metabolic circumstances of men was explained by the hypogonadal-obesityadipocytokine cycle [4].…”

Section: Discussionmentioning

confidence: 99%

Relationship between insulin resistance, obesity and serum prostate-specific antigen levels in healthy men

Han¹,

Lee²,

Kwak³

et al. 2010

Asian J Androl

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The purpose of this study was to determine the relationship between insulin resistance, obesity and serum prostate-specific antigen (PSA) levels in healthy men with serum PSA level below 4 ng mL -1 . The men included in the study cohort were 11 827 healthy male employees of the Korea Hydro and Nuclear Power Co., LTD who had undergone medical checkups including fasting glucose, fasting insulin and serum PSA between January 2003 and December 2008. Insulin resistance was calculated by homeostasis model assessment (HOMA [fasting glucose × fasting insulin]/22.5) and quantitative insulin sensitivity check index (QUICKI; 1/[log (fasting insulin) + log (fasting glucose)]). Age-adjusted body mass index (BMI) was significantly increased according to increasing quartile of insulin resistance as determined by HOMA and QUICKI, respectively, in analysis of variance (ANOVA) test and Duncan's multiple comparison test (P < 0.001), but age-adjusted serum PSA concentration was significantly decreased according to increasing quartile of insulin resistance as determined by HOMA and QUICKI (P < 0.001). Age, BMI, insulin resistance by HOMA or QUICKI were significantly independent variables to serum PSA level in a multivariate linear regression analysis (P < 0.001). Insulin resistance was a significant independent variable to serum PSA level along with BMI. Insulin resistance and BMI were negatively correlated with serum PSA level in healthy men. Insulin resistance was positively correlated with BMI.

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“…[20][21][22] Thus, many components of metabolic syndrome are adversely affected, especially in relation to cardiovascular risk in the presence of hypogonadism. Low T status and metabolic syndrome both appear to be independently associated with increased all-cause and cardiovascular mortality.…”

Section: Body Composition and Cardiovascular Healthmentioning

confidence: 99%

“…19 Moreover, it has been shown that aging men with obesity and/or metabolic syndrome experience a significant decrease in T serum levels compared to aging, metabolically healthy men. [20][21][22] These data suggest that obesity could be more important than age per se in the pathophysiology of the aging-associated decline of T. 23,24 Clinical features of andropause include increased body fat, loss of muscle and bone mass, fatigue, depression, anemia, poor libido, erectile dysfunction, insulin resistance, and a higher risk of cardiovascular disease. [25][26][27][28][29][30] However, the diagnosis of andropause is to a large extent dependent on biochemical assessment of T in blood.…”

Section: Introductionmentioning

confidence: 99%

Testosterone Replacement Therapy in Reversing “Andropause”: What Is the Proof-of-Principle?

Lang

Samaras

2012

Rejuvenation Research

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Testosterone replacement therapy is often equated with the macho male physique and virility and is viewed by some as an antiaging tonic. The growth in testosterone's reputation and its increased use by men of all ages has seemed to outpace the scientific evidences. This review will aim to examine the uncertainty regarding the nature and the clinical importance of the age-related reduction in the testosterone levels. Considerations will be given both to clinical symptoms, biochemical and clinical diagnostic criteria, and to the risk-to-benefit ratio of reversing late-onset hypogonadism in aging and older men.

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The Age Related Decrease in Testosterone is Significantly Exacerbated in Obese Men With the Metabolic Syndrome. What are the Implications for the Relatively High Incidence of Erectile Dysfunction Observed in These Men?

Cited by 152 publications

References 13 publications

Obesity and sexual dysfunction, male and female

Obesity and sexual dysfunction, male and female

Relationship between insulin resistance, obesity and serum prostate-specific antigen levels in healthy men

Testosterone Replacement Therapy in Reversing “Andropause”: What Is the Proof-of-Principle?

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