The negative correlation between triglyceride glucose-body mass index and hormone levels in young and middle-aged patients with clinical varicocoele: A cross-sectional study

BackgroundVaricocoele may influence testosterone levels; however, their relationship remains controversial. Insulin resistance (IR) is a significant factor in metabolic disorders that may affect sex hormone levels. Triglyceride glucose-body mass index (TyG-BMI) is an important indicator of IR, but its relationship with sex hormones in patients with varicocoele and its clinical significance require further investigation. ObjectiveTo investigate whether different severity grades of clinically palpable varicocoeles are associated with changes in testosterone levels. This study also seeks to explore the association between TyG-BMI and sex hormones and to evaluate the effectiveness of TyG-BMI compared to other IR indicators in predicting testosterone deficiency. Materials and methodsThis cross-sectional study included 431 patients with palpable varicocoeles. Varicocoele severity was classified based on clinical grading, color Doppler ultrasound grading, and reflux status. Additionally, TyG-BMI was categorized according to interquartile ranges, and linear regression analysis was used to examine the relationship between TyG-BMI and sex hormones, along with a subgroup analysis. Additionally, four IR indices were used to predict testosterone deficiency. ResultsIn young and middle-aged patients with clinically palpable varicocoeles, testosterone levels did not differ significantly across varying degrees of severity. TyG-BMI significantly and negatively correlated with testosterone, inhibin B (INHB), and prolactin levels, particularly in patients with higher TyG-BMI. However, no linear relationships were found between TyG-BMI and follicle-stimulating hormone, luteinizing hormone, or estradiol levels. The linear association between TyG-BMI and testosterone levels remained significant across different levels of varicocoele severity. Additionally, TyG-BMI demonstrated a superior predictive capability for testosterone deficiency compared to other IR indices. Discussion and conclusionVaricocoele severity was not associated with variations in testosterone levels. TyG-BMI was significantly negatively correlated with testosterone and INHB levels, and this relationship suggests a factor beyond the hypothalamic-pituitary-gonadal axis.