title: Marked testosterone deficiency-related symptoms may be associated to higher metabolic risk in men with low testosterone levels.
abstract: BACKGROUND
  Testosterone deficiency syndrome (TDS) is usually suspected on the basis of signs/symptoms. However, some men with low testosterone levels (low T) are asymptomatic or present mild, unnoticed symptoms. Would they have the same cardiovascular risk as symptomatic men?
  
  
  OBJECTIVE
  This study aims to assess the relationship between presence/severity of low T-related symptoms and the likelihood of metabolic syndrome (MetS).
  
  
  METHODS
  Data were taken from a multicenter, cross-sectional study conducted in Spain among men visiting men's healthcare offices aged ≥45 with low T (total T <8 nmol/L or <12 nmol/L and calculated free T <250 nmol/L). Only subjects whose MetS components and symptoms had been assessed were selected. Data available included anthropometrics, toxic habits, comorbidities, and total testosterone (TT) levels.
  
  
  METHODS
  MetS was defined using the harmonized definition. Erectile dysfunction was classified using the International Index of Erectile Function questionnaire. The Ageing Male Symptoms (AMS) scale assessed symptoms. Symptom severity was classified as "none/mild" and "moderate/severe." Bivariate and multivariate logistic regression analyses were performed to calculate the effect of moderate/severe symptoms on the odds ratio (OR) for MetS.
  
  
  RESULTS
  Mean age (SD) was 61.2 (8.1) years. Erectile dysfunction (ED), AMS, and MetS prevalence were 97.4%, 94.9%, and 69.6%. Prevalence of MetS was higher in men with moderate/severe symptoms vs. men with no/mild ones (75.3% vs. 57.9%, P < 0.001). Age and prevalence of TT <8 nmol/L, moderate/severe ED, and obesity were significantly higher in men with moderate/severe symptoms. Multivariate analysis showed that besides obesity and moderate/severe ED, moderate/severe symptoms increased the likelihood of MetS. This effect disappeared in men with severe ED and in the nonobese. Three symptoms showed relationship with MetS after adjusting for all confounding factors.
  
  
  CONCLUSIONS
  Severity of TDS symptoms may indicate higher cardiovascular risk in men with low T.
authors: Department of Urology, Hospital Clinic, Barcelona, Spain; Red Española de Investigación en Salud del Hombre (Spanish Net of Men's Health Research), Barcelona, Spain.
authors: Eduard
authors: E
authors: García-Cruz
authors: Asier
authors: A
authors: Leibar-Tamayo
authors: Javier
authors: J
authors: Romero-Otero
authors: Ignacio
authors: I
authors: Asiaín
authors: Albert
authors: A
authors: Carrión
authors: Roberto
authors: R
authors: Castañeda
authors: Laura
authors: L
authors: Mateu
authors: Pilar
authors: P
authors: Luque
authors: Oscar
authors: O
authors: Cardeñosa
authors: Antonio
authors: A
authors: Alcaraz
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D015995:Prevalence; D013030:Spain / Q000453:epidemiology; D013739:Testosterone / Q000097:blood / Q000172:deficiency*
chemical_list: D013739:Testosterone
keywords: Abdominal Obesity; Cardiovascular Diseases; Diabetes Mellitus; Erectile Dysfunction; Hypercholesterolemia; Hypertension; Hypogonadism; Metabolic Syndrome X; Testosterone; Testosterone Deficiency