Hypogonadism in Patients with Metabolic Syndrome (According to New IDF Definition)

Back Ground and Aim of the Work: The numerous deleterious effects of metabolic syndrome are being investigated throughout the medical community, as metabolic syndrome may potentially affect many aspects of human physiology due to its systemic nature. Hypoandrogenism in men is associated with features of the metabolic syndrome, even it may predict the metabolic syndrome, but the association with the metabolic syndrome itself using an accepted definition has not been described. This study aims to investigate the relation of hypogonadism with the parameters of metabolic syndrome. A subgroup of 12 men with hypogonadism was then assessed. Research Design and Method: This case controlled study was conducted on 40 men with metabolic syndrome as defined by new International Diabetes Federation (IDF) definition, with an average age of 53 ±6.3 years. Selection of the patients was from subject attending Diabetes-Endocrinology Center for management of different clinical aspects of the syndrome. They were compared to 20 healthy control volunteers. All patients underwent clinical and laboratory assessment including serum levels of insulin, fasting blood sugar, lipid profile, endogenous testosterones, sex hormone binding globulin (SHBG), follicle stimulating hormone (FSH), luteinizing hormone (LH) and prolactin (PRL). Results: In this group of men with metabolic syndrome we found a high incidence of hypogonatotrophic hypogonadism (30%). Total testosterone (TT), calculated free testosterone (cFT), and sex hormone binding globulin (SHBG) were inversely associated with body mass index (BMI) r=-0.49 (p=0.02), r=-0.25 (0.03), r=-0.62 (p=0.17), systolic blood pressure r=-0.32 (p=0.05), r=-0.26 (p=0.05), r=-0.32 (p=0.04), diastolic blood pressure r=-0.21 (p=0.2), r=-0.34 (p=0.01), r=-0.29 (p=0.06), fasting serum insulin level r=-0.42 (p=0.006), r=-0.28 (p=0.05), r=-0.18 (p=0.25), fasting blood glucose r= -0.41 (p=0.007), r=-0.38 (p=0.02), r=-0.19 (p=0.26), serum triglycerides level r=.043 (p=0.02), r=-0.49 (p=0.001), r= -0.07 (p=0.68), and directly correlated with high-density lipoprotein cholesterol r=0.26 (p=0.03), r=0.42 (p=0.04), r=0.23 (p=0.15). Conclusions: Hypogonatotrophic hypogonadism occurs commonly in patients with metabolic syndrome, and may contribute to its pathogenesis.