title: Adverse effects of psychosocial stress on gonadal function and insulin levels in middle-aged males.
abstract: OBJECTIVE
  To investigate the relationship between gonadal function, insulin and psychosocial stress in middle-aged men.
  
  
  METHODS
  A population-based, cross-sectional, observational study.
  
  
  METHODS
  Glostrup Hospital, Copenhagen, Denmark.
  
  
  METHODS
  Four hundred and thirty-nine males, all aged 51 years.
  
  
  METHODS
  Body-mass index (BMI), waist-to-hip ratio (WHR), insulin, C-peptide, free testosterone, luteinizing hormone (LH), lipids, fibrinogen, lung function tests (FVC, FEV1, PEF), blood pressure, a self-administered questionnaire with questions on psychosocial variables, lifestyle and self-rated health.
  
  
  RESULTS
  Free testosterone correlated inversely (P < 0.05) with weight, BMI, WHR, and fibrinogen, and positively with FEV1. An independent correlation between free testosterone and insulin (P < or = 0.03), but not with C-peptide, was seen after controlling for BMI and WHR. Subjects with low levels of free testosterone, or those in the lowest quintile of the distribution of the hypogonadal index (HI: free testosterone/LH), showed a cluster of negative psychosocial variables, and psychological as well as health-related problems. Furthermore, hypogonadal men had lower (P < 0.05) levels of FEV1, peak flow and FVC, but higher (P < 0.01) levels of fibrinogen and higher pulse pressure than men with normal gonadal function. This gradient of variables, relative to HI, was not seen for possible confounders like BMI, WHR, and tobacco or alcohol consumption.
  
  
  CONCLUSIONS
  Psychosocial stress may be associated with a process of premature ageing in middle-aged males, corresponding to a hypogonadal state as well as to indirect signs of increased insulin resistance.
authors.affiliation: Health Sciences Centre, University of Lund, Sweden.
authors.forename: P M
authors.initials: PM
authors.lastname: Nilsson
authors.forename: L
authors.initials: L
authors.lastname: Møller
authors.forename: K
authors.initials: K
authors.lastname: Solstad
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003718:Denmark; D005837:Genitalia, Male / Q000503:physiopathology*; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012129:Respiratory Function Tests; D013315:Stress, Psychological / Q000097:blood / Q000503:physiopathology*; D011795:Surveys and Questionnaires
chemical_list: D002096:C-Peptide; D012739:Gonadal Steroid Hormones; D007328:Insulin