title: The metabolic syndrome and smoking in relation to hypogonadism in middle-aged men: a prospective cohort study.
abstract: In men, hypoandrogenism is associated with features of the metabolic syndrome. It is not known whether men with the metabolic syndrome are at a higher risk of developing hypogonadism. We therefore assessed whether the metabolic syndrome predicts development of hypogonadism 11 yr later in 651 middle-aged Finnish men participating in a population-based cohort study. Men with the metabolic syndrome at baseline as defined by the World Health Organization (n = 114, 20%) had a 2.6-fold increased risk of developing hypogonadism as defined by total testosterone levels less than 11 nmol/liter at the 11-yr follow-up independent of age, smoking, and other potential confounders. Further adjustment for body mass index (OR, 2.0; 95% CI, 1.1-3.8) or baseline total testosterone levels (OR, 1.9; 95% CI, 1.0-3.4) attenuated the association. The association of the metabolic syndrome with hypogonadism as defined by calculated free testosterone levels less than 225 pmol/liter was similar, but weaker. The adjusted decrease in testosterone concentrations during the 11-yr follow-up was also greater in men with than without the metabolic syndrome. Smokers had a nonsignificantly lower risk of developing hypogonadism during follow-up, whereas a decrease in smoking increased the risk of hypogonadism. The metabolic syndrome predisposes to development of hypogonadism in middle-aged men. Prevention of abdominal obesity and the accompanying metabolic syndrome in middle age may decrease the risk of hypogonadism in men, especially in those who quit smoking.
authors.affiliation: Department of Medicine, Kuopio University, P.O. Box 1627, FIN-70211 Kuopio, Finland.
authors.forename: David E
authors.initials: DE
authors.lastname: Laaksonen
authors.forename: Leo
authors.initials: L
authors.lastname: Niskanen
authors.forename: Kari
authors.initials: K
authors.lastname: Punnonen
authors.forename: Kristiina
authors.initials: K
authors.lastname: Nyyssönen
authors.forename: Tomi-Pekka
authors.initials: TP
authors.lastname: Tuomainen
authors.forename: Veli-Pekka
authors.initials: VP
authors.lastname: Valkonen
authors.forename: Jukka T
authors.initials: JT
authors.lastname: Salonen
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D007006:Hypogonadism / Q000503:physiopathology*; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology*; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000503:physiopathology*; D013739:Testosterone / Q000097:blood*; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D014280:Triglycerides; D013739:Testosterone