TOPLINE

In young men, lower total testosterone and sex hormone-binding globulin (SHBG) levels were associated with higher BMI, waist circumference (WC), triglyceride levels, and blood pressure as well as lower high-density lipoprotein (HDL) cholesterol levels. Men with total testosterone levels ≤ 12 nmol/L had a higher prevalence of generalized obesity and abdominal obesity than men with normal total testosterone levels.

METHODOLOGY

• Although observational studies have suggested that low testosterone and SHBG levels are associated with metabolic cardiovascular (CV) risk in young men, persuasive clinical evidence is lacking, particularly given the rising metabolic CV risk in younger populations.
•  Researchers conducted a retrospective observational cohort study employing a cross-sectional design at a center in Italy to examine the link between androgenic profile and metabolic CV risk factors among 659 men aged 18-35 years (mean age, 22.7 years) recruited through an awareness campaign between 2013 and 2018.
• Androgenic profile comprised serum levels of total testosterone, SHBG, and calculated free testosterone (cFT).
• Participants underwent a comprehensive evaluation of anthropometric parameters (height, weight, BMI, WC), clinical parameters (systolic and diastolic blood pressure), biochemical parameters (fasting glucose, total cholesterol, HDL cholesterol, low-density lipoprotein cholesterol, triglycerides), and hormonal parameters (total testosterone, SHBG, cFT, and others).
• The primary outcomes were anthropometric, clinical, and biochemical metabolic CV risk parameters assessed at a single timepoint; the secondary outcomes comprised differences in these parameters and the prevalence of obesity, dyslipidemia, hyperglycemia, hypertension, and metabolic syndrome between men with total testosterone levels ≤ 12 nmol/L (n = 111) vs those with total testosterone levels > 12 nmol/L (n = 548).

TAKEAWAY

• Weight (P < .0001), BMI (P < .0001), WC (P < .0001), diastolic blood pressure (P < .05), and triglyceride levels (P < .01) progressively decreased and HDL cholesterol levels (P < .0001) progressively increased across total testosterone tertiles.
• Weight (P < .01), BMI (P < .01), WC (P < .0001), triglyceride levels (P < .0001), and systolic and diastolic blood pressure (P < .05 for both) showed a decreasing trend, and HDL cholesterol levels (P < .0001) showed an increasing trend, across SHBG tertiles.
• Total testosterone and SHBG were independently associated with HDL cholesterol (beta = 0.151; P < .01 and beta = 0.186; P < .01, respectively) in multiple linear regression adjusted for age, WC, and BMI. SHBG was also associated with systolic (beta = -0.177; P < .05) and diastolic (beta = -0.204; P < .01) blood pressure.
• Men with total testosterone levels ≤ 12 nmol/L had a significantly higher prevalence of abdominal obesity (13.86% vs 4.94%; P < .01) and generalized obesity (14.43% vs 3.68%; P < .0001) than men with total testosterone levels > 12 nmol/L. Those with overweight or obesity had lower total testosterone levels than those with normal weight (16.5 vs 18.3 nmol/L; P < .0001).

IN PRACTICE

"[The study] findings support a consistent association between androgenic profile and mCVR [metabolic cardiovascular risk] factors in young men, as well as the clinical relevance of assessing androgenic profile in young men, particularly in those with overweight or obesity, especially visceral obesity. Moreover, they also suggest that careful metabolic profiling may be clinically relevant in young men with testosterone deficiency; however, sexual symptoms remain essential for the diagnosis of clinically defined hypogonadism," the authors wrote.

SOURCE

The study was led by Davide Menafra, Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Diabetologia ed Andrologia, Università Federico II di Napoli in Naples, Italy. It was published online in the Journal of Endocrinological Investigation.

LIMITATIONS

This retrospective cross-sectional study could not establish cause-and-effect relationships. Low testosterone was determined using one total testosterone measurement taken in the morning without follow-up verification or a thorough symptom evaluation, particularly sexual symptoms essential for diagnosing clinical hypogonadism. The community-based sample may inadequately reflect the broader population of young men, while the relatively young participant age precluded the investigation of major adverse CV events.

DISCLOSURES

The study did not receive any specific funding. The authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.