title: NCEP-ATPIII-defined metabolic syndrome, type 2 diabetes mellitus, and prevalence of hypogonadism in male patients with sexual dysfunction.
abstract: BACKGROUND
  Type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) are characterized by insulin resistance and often associated with male hypogonadism.
  
  
  OBJECTIVE
  To discriminate the specific contribution of T2DM and MetS to male hypogonadism.
  
  
  METHODS
  A consecutive series of 1,134 (mean age 52.1 +/- 13 years) male patients with sexual dysfunction was studied.
  
  
  METHODS
  Several hormonal and biochemical parameters were studied along with ANDROTEST, a 12-item validated structured interview, specifically designed for the screening of hypogonadism (total testosterone [TT] <10.4 nmol/L or free testosterone [FT] <37 pmol/L) in a male population with sexual dysfunction.
  
  
  RESULTS
  Irrespective of the criteria used to define hypogonadism, MetS was associated with a significantly higher prevalence of the condition, both in subjects with and without T2DM (41% and 29% vs. 13.2% and 77.1% and 58% vs. 40.6%, respectively, for TT and FT in patients with MetS and with or without T2DM, when compared with subjects without MetS and T2DM; both P < 0.0001). Conversely, T2DM was associated with a higher prevalence of hypogonadism in subjects with MetS but not in those without MetS. Patients with MetS, with or without T2DM, also showed a higher ANDROTEST score when compared with patients without MetS. Logistic multivariate regression analysis, incorporating the five components of MetS, identified a significant association of elevated waist circumference and hypertriglyceridemia with hypogonadism both in patients, with or without T2DM.
  
  
  CONCLUSIONS
  Our study demonstrated that MetS, and in particular visceral adiposity (as assessed by increased waistline and hypertriglyceridemia), is specifically associated with hypogonadism in subjects consulting for sexual dysfunction.
authors.affiliation: Andrology Unit, Department of Clinical Physiopathology, University of Florence, Fiale Pieraccini 6, 50139 Florence, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corona
authors.forename: Edoardo
authors.initials: E
authors.lastname: Mannucci
authors.forename: Luisa
authors.initials: L
authors.lastname: Petrone
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Balercia
authors.forename: Francesca
authors.initials: F
authors.lastname: Paggi
authors.forename: Alessandra D
authors.initials: AD
authors.lastname: Fisher
authors.forename: Francesco
authors.initials: F
authors.lastname: Lotti
authors.forename: Valerio
authors.initials: V
authors.lastname: Chiarini
authors.forename: Domenico
authors.initials: D
authors.lastname: Fedele
authors.forename: Gianni
authors.initials: G
authors.lastname: Forti
authors.forename: Mario
authors.initials: M
authors.lastname: Maggi
mesh_terms: D000328:Adult; D015331:Cohort Studies; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000145:classification* / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007006:Hypogonadism / Q000145:classification* / Q000453:epidemiology*; D018783:Impotence, Vasculogenic / Q000453:epidemiology* / Q000209:etiology; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000145:classification* / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index