Male Hypogonadism and Metabolic Syndrome

Andrologia. 2015 Jun;47(5):579-86. doi: 10.1111/and.12305. Epub 2014 Jul 9.


The role of androgens in cardiovascular disease is still controversial in men. In this study, we investigated metabolic disorders in Tunisian hypogonadal men compared with healthy controls. Forty hypogonadal men and 80 control subjects were enrolled. Patients with a history of pre-existing panhypopituitarism, thyroid dysfunction or inflammatory disease were excluded. Glycaemia, glycated haemoglobin (HbA1c), high-sensitive C-reactive protein (hsCRP), lipid profile, insulin, testosterone and gonadotrophins were measured. Insulin resistance was assessed by homoeostasis model assessment of insulin resistance (Homa IR). Waist circumference, body mass index and blood pressure were significantly higher in patients compared with controls. Glycemia, HbA1c, fasting serum insulin and Homa IR were significantly increased among hypogonadal men. In univariate analysis, testosterone levels were inversely correlated with body mass index, waist circumference, blood pressure, glycaemia, HbA1C, insulin, Homa IR and hsCRP. In multivariate analysis including all significant variables, initial testosterone level was the only independent risk factor for developing dyslipidaemia. With logistic regression, male hypogonadism was an independent risk factor for MS (P < 0.001). We conclude that low testosterone level plays a central role in the development of metabolic syndrome. Further prospective data are required to establish the causative link.

Keywords: Cardiovascular disease; insulin resistance; male hypogonadism; metabolic syndrome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Blood Pressure
  • Body Mass Index
  • C-Reactive Protein / metabolism
  • Case-Control Studies
  • Cholesterol, HDL / metabolism
  • Cholesterol, LDL / metabolism
  • Cross-Sectional Studies
  • Dyslipidemias / epidemiology*
  • Dyslipidemias / metabolism
  • Eunuchism / epidemiology*
  • Eunuchism / metabolism
  • Glycated Hemoglobin A / metabolism
  • Gonadotropins / metabolism
  • Humans
  • Hypertension / epidemiology*
  • Hypertension / metabolism
  • Insulin / metabolism
  • Insulin Resistance*
  • Logistic Models
  • Male
  • Metabolic Syndrome / epidemiology*
  • Metabolic Syndrome / metabolism
  • Multivariate Analysis
  • Risk Factors
  • Testosterone / metabolism*
  • Triglycerides / metabolism
  • Tunisia / epidemiology
  • Waist Circumference


  • Blood Glucose
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Glycated Hemoglobin A
  • Gonadotropins
  • Insulin
  • Triglycerides
  • hemoglobin A1c protein, human
  • Testosterone
  • C-Reactive Protein