Endocrine Abstracts

Metabolic syndrome-associated hypogonadism is an important problem in men and is thought to occur by complex pathogenetic pathways. 26 men with metabolic syndrome-related hypogonadism, 26 men with metabolic syndrome with normal testosterone levels, and 26 healthy men were included in this study to examine the factors that may affect these pathogenetic pathways. Plasma nesfatin-1, kisspeptin, 5 alpha reductase-1 and aromatase levels and plasma 5 alpha reductase-1 and aromatase gene expressions were examined. As a result, plasma nesfatin-1 and kisspeptin levels of men with metabolic syndrome-related hypogonadism and only metabolic syndrome were found to be lower than healthy men (P = 0.001). There was no statistically significant difference for plasma nesfatin-1 and kisspeptin levels between the two groups with metabolic syndrome, with and without hypogonadism. Plasma 5 alpha reductase-1 and aromatase levels were also lower in men with metabolic syndrome-associated hypogonadism than healthy men (P = 0.006 and P = 0.0001, respectively). Plasma 5 alpha reductase-1 levels were not statistically significant in the metabolic syndrome group compared to the control group or the hypogonadism group. The difference between the aromatase levels between the two groups with metabolic syndrome with and without hypogonadism was not statistically significant. There was no statistically significant difference between the groups for 5 alpha reductase-1 and aromatase gene expressions (P = 0.8 and P = 0.5, respectively). A positive correlation was found between kisspeptin, nesfatin-1, plasma 5 alpha reductase-1 and plasma aromatase levels in all groups (P = 0.0001). Considering these findings, it can be thought that nesfatin-1 is an important mediator in the pathogenesis of metabolic syndrome and indirectly affects the development of metabolic syndrome-related male hypogonadism. Although it has been shown in studies that kisspeptin is a regulator of the Hypothalamic-Pituitary-Gonadal axis at the hypothalamus level, it can be considered to be an important marker for the development of metabolic syndrome, and when the metabolic syndrome is associated with male hypogonadism, it is not effective in the pathogenesis alone, but may have a role in this pathogenesis through metabolic syndrome. It can be said that plasma 5 alpha reductase-1 levels are one of the important points in the development of metabolic syndrome-associated male hypogonadism. For aromatase, contrary to the classical view, it would be more appropriate to say it is a parameter that is affected by the process rather than the cause of hypogonadism and to review what we know about it.