RESUMO
Advances in medicine and progressive improvements in the health of the general population in developed countries have led to considerable increases in life expectancy over recent years. Metabolic syndrome (MetS) affects approximately 25% of the adult population and its prevalence is increasing all over the world. Central obesity plays an important role in emergence of MetS. Some studies have suggested that there may be link between low Total Testosterone levels and emergence of MetS. The objective of this review is to analyze the complex network of interactions between MetS and low testosterone levels in elderly men, considering etiologic, diagnostic, and therapeutic aspects. Recent evidence confirms that central obesity is the independent MetS component correlated to Total Testosterone Levels. Experimental studies suggest a two way road between Low Testosterone Levels and abdominal obesity. Besides that, Testosterone Replacement Therapy should be restricted to men with biochemical and clinical features of late onset hypogonadism.
Assuntos
Envelhecimento/fisiologia , Síndrome Metabólica/fisiopatologia , Testosterona/sangue , Adulto , Fatores Etários , Idoso , Terapia de Reposição Hormonal/métodos , Humanos , Hipogonadismo/tratamento farmacológico , Masculino , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Obesidade Abdominal/complicações , Obesidade Abdominal/epidemiologia , Prevalência , Fatores de Risco , Testosterona/administração & dosagem , Testosterona/deficiênciaRESUMO
INTRODUCTION: Metabolic syndrome (MetS) is a constellation of interrelated risk factors of metabolic origin. Some studies suggest a possible link between low total testosterone (TT) levels and the presence of MetS. AIM: To analyze the strength and independence of associations between TT and MetS components in non-diabetic men. METHODS: In this cross-sectional study, 143 non-diabetic men older than 40 were analyzed. MAIN OUTCOMES MEASURE: Blood samples were collected to evaluate metabolic profile and TT levels. MetS was defined as the presence of three or more of the following characteristics: fasting blood glucose levels ≥ 100 mg/dL, triglyceride ≥ 150 mg/dL, HDL-c < 40 mg/dL, hypertension or blood pressure ≥ 130/85 mmHg, and waist girth > 102 cm. RESULTS: Mean age of the study population was 61.5 ± 8.61 years old. MetS was present in 47.9% of the individuals. Thirty-four men had low TT and MetS was observed in 23 (70%) against 50 (46%) in those with normal TT (≥ 300 ng/dL) (OR 4.94, p < 0.01), adjusted to confounder's factors. In multiple linear regression analysis, only waist circumference (Beta: -0.395; p = 0.03) and HDL-c (Beta: 0.19; p = 0.04) remained significantly correlated with TT levels. CONCLUSIONS: Low TT levels were associated with MetS diagnosis. Abdominal obesity was the MetS component independently correlated to low TT levels.