ECE2022 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (202 abstracts)
The bidirectional relationship between testosterone and metabolic disorders: testosterone deficiency as an early marker of cardiovascular risk in young men
Davide Menafra 1 , Cristina De Angelis 1 , Francesco Garifalos 2 , Michele Castoro 2 , Nunzia Verde 2 , Mariangela Piscopo 2 , Giacomo Galdiero 2 , Claudia Pivonello 2 , Renata Simona Auriemma 2 , Paolo Chiodini 3 , Annamaria Colao 2,4 & Rosario Pivonello 2,4
1Università Federico II di Napoli, Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile (FERTISEXCARES), Naples, Italy; 1Università Federico II di Napoli, Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile (FERTISEXCARES), Naples, Italy; 3University of Campania “Luigi Vanvitelli”, Medical Statistics Unit, Naples, Italy; 4Federico II University of Naples, Unesco Chair for Health Education and Sustainable Development, Naples, Italy
In the last years an increasing incidence of cardiovascular diseases (CVD) has been reported in young adults (18-45 yrs), probably accounted by the significant increase in CV risk (CVR) factors. Observational and interventional studies, mainly focused on middle-aged and elderly men, demonstrated that metabolic CVR (mCVR) factors and CVD manifestations are common in hypogonadal men and, conversely, testosterone deficiency is highly prevalent in metabolic disorders; the lack of corresponding robust evidence in younger adults requires more focused investigation. The current single centre, observational, cross-sectional study aimed at better defining the mutual relationship between androgenic status and the prevalence of mCVR factors in a large cohort of 720 young (18-35 yrs) adult men, subjected to physical examination and fasting morning venous blood sampling for the assessment of anthropometric, metabolic and hormonal parameters. Body weight, BMI and waist circumference (WC) significantly decreased across total testosterone (TT) (P<0.0001), SHBG (P<0.01; P<0.01; P<0.0001) and calculated free testosterone (cFT) (P<0.05) tertiles, whereas systolic blood pressure (SBP) and triglycerides (TG) significantly decreased across TT (P<0.05; P<0.01) and SHBG (P<0.05; P<0.0001) tertiles, and diastolic blood pressure (DBP) across SHBG (P<0.05) tertiles. Spearman correlation analysis revealed a negative association of TT, SHBG and cFT with BMI (r=-0.204; P<0.001)(r=-0.165; P<0.05)(r=-0.132; P<0.05), and of TT and SHBG with WC (r=-0.234; P<0.001)(r=-0.225; P<0.01), SBP (r=-0.112; P<0.05)(r=-0.142; P<0.05) and TG (r=-0.017; P<0.01)(r=-0.204; P<0.001), whereas a positive association of TT and SHBG with HDL-cholesterol (r=0.167; P<0.01)(r=0.251; P<0.001) was demonstrated. In multiple linear regression analysis in models adjusted for age, BMI and WC, TT and SHBG were strong independent predictors of serum HDL-cholesterol (β=0.151; P<0.01) (β=0.186; P<0.01), and SHBG was an independent predictor of SBP and DBP (β=-0.177; P<0.05) (P=0,008; β=-0,204). Lastly, in the subgroup of men with hypotestosteronemia (TT ≤ 12.1 nM), the prevalence of normal weight was significantly lower and that of obesity, visceral obesity (WC>102 cm), hypertension and metabolic syndrome was significantly higher, compared to normal-testosterone subgroup. Consistently, in the subgroup of overweight/obese men, the prevalence of hypotestosteronemia was significantly higher, compared to normal weight subgroup. In conclusion, the current study demonstrated that in young adult men a bidirectional relationship between testosterone deficiency and metabolic disorders exists, and that a worse androgenic status is associated to a worse cardiometabolic profile and might represent a strong early predictor of mCVR factors, potentially associated to the onset of future CVD.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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