Age-related hypogonadism in men with metabolic syndrome

Aim. To elucidate the relationship between testosterone and SSBG levels in men with age-related hypogonadism and metabolic syndrome. Materials and methods. The study included 125 men aged 30-80 years with a diagnosis of age-related hypogonadism. In all the cases, testosterone (T) and SSBG levels were determined, free T fraction calculated, and waist circumference measured. Almost half of the patients (n= 56) presented with metabolic syndrome (MS) and underwent measurement of basal immunoreactive insulin (IRI). Results. Mean age of the patients (n= 125) was 54 [ 46; 65] years, waist circumference 108 [102; 115] cm, total T 8.3 [5.9; 11] nmol/l (norm 12 33.5), free T 140 [99.6; 184] pmol/l (norm <250), SSBG 38,8 [28.2; 63.2] nmol/l (norm 12.9 -61.7). Positive correlation was found between the patients' age, total T and SSBG levels (r=0.33, p<0.001 and r=0.39, p<0.001 respectively) as well as between total T and SSBG levels (r=0.48, p=0.001). The patients were divided into 2 groups depending on the presence or absence of MS. Group 1 (MS, n= 56) was characterized by lower levels of SSBG, total and free T and more pronounced abdominal obesity compared with group 2 (without MS, n= 69). 31 patients in group 1 had mean IRI level of 26,4 [13; 36.6] mcU/ml (norm 2.3-26.4). There was no correlation between SSBG and IRI levels. 18 patients had elevated IRI levels (mean 33.95 [32.4; 62.5] mcU/ml that positively correlated with SSBG levels (r=0.53, p<0.0006). Conclusion. Patients with age-related hypogonadism and metabolic syndrome have lower levels of SSBG, total and free T and greater waist circumference measures compared with age-matched patients without MS. Despite lowered SSBG level in group 1 patients, it remains within normal limits and therefore can not be used as a diagnostic marker of age-specific hypogonadism and MS. In patients with these conditions, there is no correlation between SSBG and IRI levels; in hypogonadic patients the SSBG level is unrelated to waist measures regardless of the presence or absence of MS.