Measurement of Serum Testosterone in Nondiabetic Young Obese Men: Comparison of Direct Immunoassay to Liquid Chromatography-Tandem Mass Spectrometry (original) (raw)
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Rawal Medical Journal, 2020
Objective: To analysed the serum Testosterone in obese and Diabetes Mellitus Type-II Males individuals. Study design: A Cross-Sectional Comparative Study. Place and Duration of Study: The patients were recruited from Department of Medicine unit-II Liaquat hospital Jamshoro and analysis at Institute of Biotechnology and Genetic Engineering, University of Sindh, Jamshoro during the period of April 2018 to September 2018. Methodology: Total 150 males were included in this study and divided into three group, out of which Group A: n=50 were healthy normal males, Group B: n=50 were obese males(BMI>25) and Group C: n=50 were Type II- diabetic males ages 20-70 years old. Blood sample were collected from the all participants for performing various biochemical tests Fasting blood sugar (FBS)and Random blood sugar (RBS), HbA1c, Insulin, Testosterone by filling Performa and written consent by explaining them about study purpose. The ANOVA test was applied for the analysis of continuous varia...
Total Serum Testosterone Level in Obese Patients with Type -2 Diabetes Mellitus
International Journal of Life Science and Pharma Research, 2021
Both obesity and type 2 diabetes mellitus (T2DM) are independently associated with reduced serum testosterone. The additive effect of obesity and T2DM on reducing testosterone levels need to be investigated. Their combined additive effects may place obese T2DM patients at higher risk of decreased testosterone and the associated increased morbidity and mortality. The aim of this study was to screen obese T2DM patients for biochemical hypogonadism regardless of the presence of overt clinical symptoms to consider testosterone replacement therapy. 152 adult male aged 40 to 68 years with T2DM were recruited through simple random sampling. The study participants were grouped based on their BMI into lean (n=48); overweight (n=57), obese (n=37) and morbidly obese (n=11). Total serum testosterone (TST), BMI and waist circumference (WC) were measured in all patients and luteinizing hormone (LH) was measured in 103 of them. Low TST was defined as TST<9nmol/L and the normal range for LH was...
Andrologia, 2018
Male obesity is associated with decreased testosterone levels but the pathophysiological mechanisms behind this association are not completely understood. This study aimed to investigate the impact of hyperglycaemia/insulin resistance and sex hormone-binding globulin (SHBG) levels on testosterone levels in a population of obese men. We investigated the impact of several clinical, anthropometric and analytic measures on testosterone levels in 150 obese males. Testosterone deficiency was present in 52.0% of the enrolled patients. This percentage dropped to 17.6% when only calculated free testosterone (FT) was accounted, as SHBG levels were correlated negatively with body mass index (r = -.20; p < .05). Older age (p < .05) and higher homoeostasis model assessment of insulin resistance (HOMA-IR) (p < .01) and lower SHBG levels (p < .05) were independently correlated with lower FT. Weight and fasting plasma glucose lost their statistical significance after multivariate adjust...
Obesity, 2019
Objective: Obesity-associated hypoandrogenemia is increasing in parallel to the obesity epidemic. The prevalence of hypoandrogenemia in nondiabetic young men with obesity is not known. This study aimed to evaluate the prevalence of hypoandrogenemia and associated risk factors in this population. Methods: This cross-sectional study included 266 nondiabetic men < 50 years of age with obesity who were referred from primary care. Total testosterone (high-performance liquid chromatography mass spectrometry), sex hormone-binding globulin, free testosterone (FT), luteinizing hormone (LH), high-sensitivity C-reactive protein, and homeostatic model assessment of insulin resistance were determined. Body composition and erectile function were also assessed. Hypoandrogenemia was defined as FT level < 70 pg/mL. Results: Subnormal FT concentrations were found in 25.6% of participants. Hypoandrogenemia prevalence was different along the BMI continuum, being > 75% in individuals with BMI ≥ 50 kg/m 2. A multivariate regression analysis indicated that increasing BMI (P < 0.001), age (P = 0.049), and reduced LH levels (P = 0.003) were independent risk factors for hypoandrogenemia. Conclusions: In a primary care-based cohort of nondiabetic young men with obesity, hypoandrogenemia was a very prevalent finding and was directly associated with adiposity. Obesity, age, and reduced LH levels were independent risk factors associated with hypoandrogenemia. Further prospective studies are needed to evaluate the long-term consequences of hypoandrogenemia in this population.
Clinical Endocrinology, 2015
Objective-Total testosterone concentrations are influenced by sex hormone-binding globulin (SHBG) concentrations, which are decreased by obesity and increased with ageing. Therefore, we sought to understand and compare the associations of ageing and obesity with SHBG. Design-We performed a retrospective, cross-sectional analysis of the associations of obesity and age on SHBG and testosterone measurements in men being evaluated for hypogonadism. Patients, Measurements and Analysis-A total of 3671 men who underwent laboratory testing for testosterone deficiency from the Veterans Administration Puget Sound Health Care System from 1997 through 2007 was included. Univariate and multivariate linear regression modelling of the associations between age and body mass index (BMI) and SHBG was performed. Results-Obesity was associated with a significantly lower SHBG [β = −1•26 (95% CI −1•14, −1•38) nmol/l] per unit increase in BMI. In contrast, ageing was associated with a significantly increased SHBG [β = 0•46 (95% CI 0•39, 0•53) nmol/l per year] (P < 0•001 for both effects). The association of obesity with lower SHBG was two to three times larger than the association of ageing with increased SHBG in both univariate and multivariate modelling. On average, obese men (BMI >30 kg/m 2) had significantly lower SHBG and total testosterone concentrations than nonobese men [(mean ± SD) SHBG: 36 ± 22 vs 50 ± 27 nmol/l and total testosterone: 10•5 ± 5•4 nmol/l vs 14•1 ± 7•4 nmol/l; (P < 0•001 for both comparisons)], but calculated free testosterone concentrations did not differ between obese and nonobese men. Conclusions-We found that the association between obesity and lowered SHBG is greater than the association of ageing with increased SHBG. These competing effects may impact total testosterone measurements for the diagnosis of low testosterone, particularly in obese men.
Diabetes Care, 2004
OBJECTIVE-Previous reports of an association between low testosterone levels and diabetes risk were often confounded by covariation of sex hormone-binding globulin (SHBG) and testosterone measurements. Measurements of bioavailable and free testosterone, more reliable indexes of biologically active testosterone, were examined for their associations with markers of insulin resistance and body fat measures in 221 middle-aged nondiabetic men. RESEARCH DESIGN AND METHODS-Bioavailable and free testosterone were calculated from the concentrations of total testosterone, SHBG, and albumin, and they were not significantly correlated with SHBG (r ϭ 0.07-0.1). In contrast, total testosterone correlated significantly with SHBG (r ϭ 0.63). We evaluated the relationship between these measures of circulating testosterone and markers for insulin resistance (i.e., fasting insulin, C-peptide, and homeostasis model assessment for insulin resistance [HOMA-IR]) as well as total body fat (assessed by dual-energy X-ray absorptiometry [DEXA]) and abdominal fat distribution (assessed by single-slice computed tomography [CT]). RESULTS-Bioavailable, free, and total testosterone and SHBG all correlated significantly with fasting insulin (age-adjusted r ϭ Ϫ0.15 [P ϭ 0.03], Ϫ0.14 [P ϭ 0.03], Ϫ0.32 [P Ͻ 0.0001], and Ϫ0.38 [P Ͻ 0.0001], respectively), fasting C-peptide (r ϭ Ϫ0.18 [P ϭ 0.009] to Ϫ0.41 [P Ͻ 0.0001]), HOMA-IR (r ϭ Ϫ0.15 [P ϭ 0.03] to-0.39 [P Ͻ 0.0001]), and body fat measures (r ϭ Ϫ0.17 [P ϭ 0.008] to Ϫ0.44 [P Ͻ 0.0001]). Only SHBG and total testosterone were significantly associated with fasting glucose (r ϭ Ϫ0.20 [P ϭ 0.003] to Ϫ0.21 [P ϭ 0.002]). In multivariate analysis, bioavailable or free testosterone was significantly and inversely associated with insulin, C-peptide, and HOMA-IR, but this was not independent of total body or abdominal fat. SHBG was a significant determinant of insulin, C-peptide, and HOMA-IR, independent of body fat. The associations between total testosterone and insulin resistance were confounded by SHBG. CONCLUSIONS-The inverse association between testosterone and insulin resistance, independent of SHBG, was mediated through body fat.
Clinical endocrinology, 2018
Limited evidence supports the use of free testosterone (FT) for diagnosing hypogonadism when sex hormone binding globulin (SHBG) is altered. Low total testosterone (TT) is commonly encountered in obesity where SHBG is typically decreased. We aimed to assess the contribution of FT in improving the diagnosis of symptomatic secondary hypogonadism (SH), identified initially by low total testosterone (TT), and then further differentiated by normal FT (LNSH) or low FT (LLSH). Prospective observational study with a median follow-up of 4.3 years. 3369 community-dwelling men aged 40-79 years from eight European centres. Subjects were categorised according to baseline and follow-up biochemical status into persistent eugonadal (referent group; n=1880), incident LNSH (eugonadism to LNSH; n=101) and incident LLSH (eugonadism to LLSH; n=38). Predictors and clinical features associated with the transition from eugonadism to LNSH or LLSH were assessed. The cumulative incidence of LNSH and LLSH over...