Endocrine Abstracts

Background: Abdominal obesity, which in fact is a metabolic syndrome (MS), is related to decreased testosterone, insulin resistance (IR), increased inflammatory factors, non-alcoholic fat liver disease (NAFLD) and risk of early atherosclerosis. Elevated inflammatory markers (CRP) may interfere with insulin signal transduction at the neuronal level inducing hypogonadotropic hypogonadism.

Objective: To examine testosterone relationship with abdominal obesity, lipid status, blood pressure, IR and NAFLD in obese young males with pre-MS and MS.

Methods: The study included 52 obese male individuals with pre-MS or MS (age16–30) classified in two groups: I-with low testosterone <12.0 nmol/l; II-with testosterone ≥12,0 nmol/l. The following parameters were observed: waist circumference (WC), blood pressure, lipids, microalbuminuria. SGOT, SGPT and γ-GT were liver function parameters. ATP III classification was applied for diagnosing MS. Patients with less than three above criteria were considered pre-MS. IR was determined by HOMA IR. OGTT was used to evaluate glycoregulation disorder. Testosterone was determined by radioimmunoassay.

Results: BMI:I-35.7±35, II-33.0±4.9 kg/m²; WC:I-117.3±15.5, II-109.9±14.2 cm; HDL:I-0.96±0.18, II-1.04±0.2 mmol/l; triglycerides: I-2.74±1.6, II-1.8±1.0 mmol/l; insulin 0’:I-113±128. II-40.1±61.2 IU/l; insulin 30’:I-199.8±124.II-124.1±90 IU/l; insulin 120’:I-119.8±114. II-53.9±70.8 IU/l; HOMA IR:I-26.8±31, II-9.1±14 μmol/mU/ml; SGOT:I-50.5±39.3, II-26.8±7.8;SGPT:I-81.8±48.2, II-40.2±18.0 U/l; γ-GT:I-49.8±19.3 U/l, II-39.7±21.9 U/l.CRP:I-5.2±2.5, II- 5.25±5.8 mg/l.

Correlations: Testosterone negative with body weight, BMI and WC (P<0.05). Decreased testosterone (<12.0 nmol/l) was found in 13.5% obese young males (8.5±2.6 nmol/l), with normal FSH, LH and estradiol. A statistically important difference between groups was found for 0, 30 and 120 minute insulin values (P<0.05) and for liver function parameters SGOT and SGPT (P<0.001).

Conclusion: Low testosterone is characterized by obesity, MS parameters, hyperinsulinism, IR and NAFLD. Negative correlation of testosterone with WC and statistical importance of insulinemia and liver function parameters differences confirm the important effect of visceral obesity and IR on the occurrence of erectile dysfunction, NAFLD and risk of early atherosclerosis in obese adolescents and youth.