title: High prevalence of hypogonadism and associated impaired metabolic and bone mineral status in subfertile men.
abstract: It is yet unknown to which degree young subfertile men present with signs of hypogonadism and whether low testosterone concentration, like in older men, is associated with risk of osteoporosis and metabolic derangements in those subjects. The objective was therefore to investigate the prevalence of hypogonadism and its association with metabolic and bone parameters in young subfertile men.
  
  
  
  Cross-sectional case-control study.
  
  
  
  Men from infertile couples (n = 192); 18-50 years; sperm concentration <20 × 10(6) /ml and population-based age-matched controls (n = 199).
  
  
  
  Blood sampling, anthropometrics, blood pressure, ankle-brachial index and assessment by dual-energy X-ray absorptiometry were undertaken. Odds ratios of biochemical hypogonadism (total testosterone <8·0 nmol/l and/or luteinizing hormone ≥8·6 IU/l and/or ongoing androgen replacement therapy) were calculated. Serum concentrations of sex hormones, lipids, glucose, insulin and HbA1c were assessed and bone mineral density (BMD) evaluated.
  
  
  
  Compared to controls, the risk of hypogonadism was increased among subfertile men (OR 10; 95% CI, 5·1, 22), being highest in those with nonobstructive azoospermia. Hypogonadal men had higher HbA1c concentration (mean diff. 2·8 mmol/mol; 95% CI, 0·64, 4·9; P = 0·011) and lower lumbar spine BMD (mean diff. 0·05 g/cm(2) ; 95% CI, 0·01, 0·10; P = 0·032) compared to eugonadal subfertile men, even more pronounced in subfertile men with subnormal testosterone levels.
  
  
  
  Young subfertile men have 10 times increased OR of hypogonadism, which is linked to increased HbA1c and decreased bone mineralization. Endocrine assessment and, if needed, measures to prevent metabolic sequelae and osteoporosis should be included in the routine management of men from infertile couples.
authors: Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden.|Department of Urology, Skåne University Hospital, Malmö, Sweden.|Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden.
authors: Johannes
authors: J
authors: Bobjer
authors: Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden.|Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden.|Department of Oncology, Skåne University Hospital, Malmö, Sweden.
authors: Karolina
authors: K
authors: Bogefors
authors: Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden.|Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden.|Department of Oncology, Skåne University Hospital, Malmö, Sweden.
authors: Sigrid
authors: S
authors: Isaksson
authors: Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden.|Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden.
authors: Irene
authors: I
authors: Leijonhufvud
authors: Department of Orthopedics, Skåne University Hospital, Malmö, Sweden.|Molecular Osteoporosis Research Unit, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
authors: Kristina
authors: K
authors: Åkesson
authors: Molecular Genetic Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden.
authors: Yvonne Lundberg
authors: YL
authors: Giwercman
authors: Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden.|Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden.
authors: Aleksander
authors: A
authors: Giwercman
mesh_terms: D000293:Adolescent; D000328:Adult; D015519:Bone Density; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007006:Hypogonadism / Q000150:complications*; D007248:Infertility, Male / Q000150:complications; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000209:etiology; D015995:Prevalence; D013739:Testosterone / Q000097:blood; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D013739:Testosterone; C517652:hemoglobin A1c protein, human