Metabolic and cardiovascular outcomes of fatherhood: results from a cohort of study in subjects with sexual dysfunction.
BACKGROUND
Previous cross-sectional and longitudinal studies reported a negative correlation between fatherhood and testosterone (T) levels, likely due to a centrally mediated downregulation of the hypothalamic-pituitary-gonadal axis. Moreover, epidemiological data indicate that fatherhood might affect metabolic and cardiovascular outcomes, although different results have been reported. Up to now, no studies have evaluated these associations in a population of men seeking treatment for sexual dysfunction (SD).


OBJECTIVE
To explore biological and clinical correlates of number of children (NoC) and its possible associations with forthcoming major cardiovascular events (MACE) in a sample of men with SD.


METHODS
A consecutive series of 4,045 subjects (mean age 52 ± 13.1 years old) attending the Outpatient Clinic for SD was retrospectively studied. A subset of the previous sample (N = 1,687) was enrolled in a longitudinal study.


METHODS
Information on MACE was obtained through the City of Florence Registry Office.


RESULTS
Among patients studied, 31.6% had no children, while 26.3% reported having one child, 33.4% two, and 8.8% three or more children. Although fatherhood was negatively related with follicle-stimulating hormone levels and positively with testis volume, we found a NoC-dependent, stepwise decrease in T plasma levels, not compensated by a concomitant increase in luteinizing hormone. NoC was associated with a worse metabolic and cardiovascular profile, as well as worse penile blood flows and a higher prevalence of metabolic syndrome (MetS). In the longitudinal study, after adjusting for confounders, NoC was independently associated with a higher incidence of MACE. However, when the presence of MetS was introduced as a further covariate, the association was no longer significant.


CONCLUSIONS
This study supports the hypothesis that bond maintenance contexts and fatherhood are associated with an adaptive downregulation of the gonadotropin-gonadal axis, even in a sample of men with SD. Moreover, our data suggest that NoC predicts MACE, most likely because of an unfavorable, lifestyle-dependent, parenthood-associated behavior.
Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy.
Alessandra D
AD
Fisher
Giulia
G
Rastrelli
Elisa
E
Bandini
Giovanni
G
Corona
Daniela
D
Balzi
Cecilia
C
Melani
Matteo
M
Monami
Vanessa
V
Matta
Edoardo
E
Mannucci
Mario
M
Maggi
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D054541:Family Conflict / Q000523:psychology; D005220:Fathers / Q000523:psychology*; D006801:Humans; D007006:Hypogonadism / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D018783:Impotence, Vasculogenic / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D008875:Middle Aged; D011388:Prolactin / Q000097:blood; D016016:Proportional Hazards Models; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D012907:Smoking / Q000009:adverse effects / Q000503:physiopathology; D013739:Testosterone / Q000097:blood*
D013739:Testosterone; D011388:Prolactin