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- Title
Low sex hormone-binding globulin, total testosterone, and symptomatic androgen deficiency are associated with development of the metabolic syndrome in nonobese men.
- Authors
Kupelian, Varant; Page, Stephanie T; Araujo, Andre B; Travison, Thomas G; Bremner, William J; McKinlay, John B
- Abstract
<bold>Background: </bold>The metabolic syndrome (MetS), characterized by central obesity, lipid and insulin dysregulation, and hypertension, is a precursor state for cardiovascular disease. The purpose of this analysis was to determine whether low serum sex hormone levels or clinical androgen deficiency (AD) predict the development of MetS.<bold>Methods: </bold>Data were obtained from the Massachusetts Male Aging Study, a population-based prospective cohort of 1709 men observed at three time points (T1, 1987-1989; T2, 1995-1997; T3, 2002-2004). MetS was defined using a modification of the ATP III guidelines. Clinical AD was defined using a combination of testosterone levels and clinical signs and symptoms. The association between MetS and sex hormone levels or clinical AD was assessed using relative risks (RR), and 95% confidence intervals (95% CI) were estimated using Poisson regression models.<bold>Results: </bold>Analysis was conducted in 950 men without MetS at T1. Lower levels of total testosterone and SHBG were predictive of MetS, particularly among men with a body mass index (BMI) below 25 kg/m2 with adjusted RRs for a decrease in 1 sd of 1.41 (95% CI, 1.06-1.87) and 1.65 (95% CI, 1.12-2.42). Results were similar for the AD and MetS association, with RRs of 2.51 (95% CI, 1.12-5.65) among men with a BMI less than 25 compared with an RR of 1.22 (95% CI, 0.66-2.24) in men with a BMI of 25 or greater.<bold>Conclusions: </bold>Low serum SHBG, low total testosterone, and clinical AD are associated with increased risk of developing MetS over time, particularly in nonoverweight, middle-aged men (BMI, <25). Together, these results suggest that low SHBG and/or AD may provide early warning signs for cardiovascular risk and an opportunity for early intervention in nonobese men.
- Subjects
MASSACHUSETTS; ANDROGENS; BODY weight; CARDIOVASCULAR diseases; GLYCOPROTEINS; LONGITUDINAL method; REFERENCE values; RESEARCH funding; TESTOSTERONE; SOCIOECONOMIC factors; METABOLIC syndrome
- Publication
Journal of Clinical Endocrinology & Metabolism, 2006, Vol 91, Issue 3, p843
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2005-1326