O-3: Obesity, Insulin Resistance and Their Correlation with Testosterone Levels in Male Patients

Background: Obesity and insulin resistance refer to a clustering of various medical conditions, with a number of pathological components that contribute to the development of diabetes and cardiovascular disease. Some studies have shown that free testosterone levels are low in obese men and are inversely correlated with the degree of obesity. In addition, leptin levels increases with obesity that causes a further reduction in androgen levels in men. The objective of the study is to show correlation of obesity and insulin resistance and testosterone levels in male patients. We also study the influence of testosterone replacement therapy on obesity and insulin resistance in men. Materials and Methods: Total of 98 male patients with the age range 30-65 years and BMI 27,0 - 48,0 kg/m2 were enrolled in the study. The following analyses were done: anthropometric study, OGTT, functional tests of liver, fasting insulin, free testosterone, leptin, HOMA-IR. Results: In all patients abnormal lipid profile and increased level of leptin was observed; 54 patients had impaired glucose tolerance test; 62 patients had decreased level of free testosterone and had inversely correlated with the degree of obesity and insulin resistance; 71 patients had increased HOMA-IR index. The appropriate treatment was prescribed to all patients individually. The patients were divided into groups 1) group I- obesity, 2) group II - obesity and insulin resistance, 3) group III - androgen deficiency, insulin resistance and obesity After three months of treatment we repeated the diagnostic assessments in all three groups: In the first group the positive result was achieved in ≈ 42 % of patients, in the second group which the goal was achieved in ≈ 53% of patients, and in patients from third group the goal was achieved in ≈ 82%. Conclusion: These observations suggest that an inverse relationship exists between serum androgens, obesity and insulin sensitivity. Low testosterone levels have also been found to be associated with dyslipidaemia and hypertension. Testosterone treatment has also been shown to reduce insulin resistance and obesity in male patients and decrease total cholesterol level.