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Occurrence of erectile dysfunction, testosterone deficiency syndrome and metabolic syndrome in patients with abdominal obesity. Where is a sufficient level of testosterone?

  • Urology – Original Paper
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Abstract

Aim

The aim of this study was to determine the prevalence of erectile dysfunction (ED), testosterone deficiency syndrome (TDS), and metabolic syndrome in patients with abdominal obesity (AO) and the prevalence of morbidity at different levels of testosterone (TST).

Background

Male sex hormones play an important role in ED and variety of TDS and may have influence on the development of metabolic syndrome. The number of men with AO which constitutes a serious health risk is continuously growing. Currently, there are different views that TST levels are already insufficient, and the patient should benefit from treatment.

Objectives

This study examined the association between ED, testosterone level and metabolic syndrome in men with AO.

Design, setting, and participants

The study was carried out in an outpatient urology center of Urology Clinic and Obesity Center of the Clinic of Internal Medicine. There were 167 participants—men with AO which were examined as part of preventive examination.

Methods

Hormonal, a complete urological and internal evaluation was carried out in every patient.

Results and limitations

We found some degree of ED in 73% (122/167) in men with AO. The TST levels below 14 nmol/l had of these 122 patients 84 patients (68.9%) and 49 patients (40.2%) below 10 nmol/l. In this group of patients, we found 103/167 patients (61.7%) with metabolic syndrome. When we compared TST level and morbidity, we found significantly more patients with diabetes mellitus (DM), hypertension and dyslipidemia in group with TST below 10 nmol/l. We also found difference in the levels of HDL cholesterol and triglycerides in the group of patients with TST 10–14 and over 14 nmol/l.

Conclusion

Patients over 40 years of age with AO and ED should also be examined for TDS and metabolic syndrome. In this group of patients we found that 113/167 patients (67.6%) had total TST below 14 nmol/l, and sufficient level of TST seems to be above this level.

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References

  1. Nicolsi A, Moreira ED Jr, Shirai M, Bin Mohd Tambi MI, Glasser DB (2003) Epidemiology of erectile dysfunction in four countries: cross-national study of prevalence and correlates of erectile dysfunction. Urology 61:201–206

    Article  Google Scholar 

  2. Melman A, Gingel JC (1999) The epidemiology and pathophysiology of erectile dysfunction. J Urol 161:5–11

    Article  PubMed  CAS  Google Scholar 

  3. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinley IB (1994) Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 151(1):54–61

    PubMed  CAS  Google Scholar 

  4. Parazzini F, Menchini Fabris F, Bortolotti A, Calabro A, Chatenoud L, Colli E (2003) Frequency and determinant of erectile dysfunction in Italy. Eur Urol 37:43–49

    Article  Google Scholar 

  5. Makhsida N, Shah J, Yan G, Fish H, Shabsigh R (2005) Hypogonadism and metabolic syndrome: implications for testosterone therapy. J Urol 174:827–834

    Article  PubMed  CAS  Google Scholar 

  6. Kaufman JM, Vermeulen A (2005) The decline of androgen levels in elderly men and its clinical and therapeutic implications. Endocrinol Rev 26:833–876

    Article  CAS  Google Scholar 

  7. Gooren LJ, Saad F (2006) Recent insight into androgen action on the anatomical and physiological substrate of penile erection. Asian J Androl 8:3–9

    Article  PubMed  CAS  Google Scholar 

  8. Nieschlag E, Swerdloff R, Behre HM, Gooren LJ, Kaufman JM, Legros J–J et al (2005) Investigation treatment and monitoring of late-onset hypogonadism in males. ISA, ISSAM and EAU recommendations. Eur Urol 48:1–4

    Article  PubMed  CAS  Google Scholar 

  9. The Endocrine Society: 2nd annual consensus meeting on andropause. J Clin Endocrinnol Metab.http://www.endo-society.org/,2001.in. Jockenhovel F Male hypogonadism. 1. Auflage- Bremen, UNI-MED 2004:(188):118–123

  10. Feldman HA (2002) Age trends in the levels of serum testosterone and other hormones in the middle-aged men: longitudinal results from the Massachusetts Male Aging study. J Clin Endorcrinol Metab 87:589–591

    Article  CAS  Google Scholar 

  11. Isidori AM, Caprio M, Strollo F et al (1999) Leptin and androgens in male obesity: evidence for leptin contribution to reduced androgens levels. J Clin Endrocrinol Metab 84:3673–3680

    Article  CAS  Google Scholar 

  12. Khaw K, Dowsett M, Folkerd E, Bingham S, Wareham N, Luben R, Welch A, Day N (2007) Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men European prospective investigation into cancer in Norfolk (EPIC-Norfolk) prospective population study. Circulation 116:2694–2701

    Article  PubMed  CAS  Google Scholar 

  13. Laaksonen DE, Niskanen I, Punnonen K et al (2004) Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-aged men. Diabetes Care 27:1036–1041

    Article  PubMed  CAS  Google Scholar 

  14. Tsai E, Boyko EG, Leonetti DL, Fujimoto WY (2000) Low testosterone level as a predictor of increased visceral fat in Japanese-American men. Int J Obes Relat Metab disord 24:485

    Article  PubMed  CAS  Google Scholar 

  15. Makinen J, Jarvisalo J, Pollanen P, Perheentupa A, Irjala K, Kosekenvuo M, Makinen J, Huhtaniemi I, Raitakari OT (2005) Increased carotid atherosclerosis in Andropausal middle-aged men. J Am Coll Cardiol 45:1603–1608

    Article  PubMed  Google Scholar 

  16. Mulligan T, Frick MF, Zuraw QC, Stemhagen A, Mcwhirter C (2006) Prevalence of hypogonadism in males aged at least 45 years: the HIM study. Int J Clin Pract 60:762–769

    Article  PubMed  CAS  Google Scholar 

  17. Fung M, Bettencoast R, Barrett-Connor R (2004) Heart disease risk factors predict erectile dysfunction 25 years later: the Rancho Bernardo Study. J Am Coll Cardiol 1405–1411

  18. Corona G, Mannucci E, Schulman C, Petrone L, Mansani R, Cilotti A, Balercia G, Ghiarini V, Forti G, Maggi M (2006) Psychologic correlates of metabolic syndrome and associated sexual dysfunction. Eur Urol 50:595–604

    Article  PubMed  Google Scholar 

  19. Kupelian V, Page ST, Araujo AB, Travison TG, Bremner WJ, McKinlay JB (2006) Low sex hormone binging globulin, total testosterone and symptomatic androgen deficiency are associated with development of the metabolic syndrome in nonobese men. J Clin Endocrinol Metab 91:843–950

    Article  PubMed  CAS  Google Scholar 

  20. Khan R, Buse J, Ferranni E, Stern M (2005) The metabolic syndrome: time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the study of diabetes. Diabetes Care 28:2289–2304

    Article  Google Scholar 

  21. Shores MM, Matsumoto AM, Sloan KL, Kivlahan DR (2006) Low serum testosterone and mortality in male veterans. Arch Intern Med 166:1660–1665

    Article  PubMed  CAS  Google Scholar 

  22. Corona G, Mannucci E, Petrone L, Schulman C, Balercia G, Fisher AD, Chiarini V, Forti G, Maggi M (2007) A comparison of NCEP -ATPIII and IDF metabolic syndrome definitions with relation to metabolic syndrome associated sexual dysfunction. J Sex Med 4:789–796

    Article  PubMed  Google Scholar 

  23. Mäkinen JI, Perheentupa A, Irjala K, Pöllänen P, Mäkinen J, Huhtaniemi I, Raitakari OT (2008) Endogenous testosterone and serum lipids in middle-aged men. Atherosclerosis 197(2):688-693

    Google Scholar 

  24. Eaton CB (2005) Hyperlipidemia. Prim Care 32:1027–1055

    Article  PubMed  Google Scholar 

  25. Billups KL, Kaiser DR, Lelly AS, Wetterling RA, Tsai MY, Hanson N, Bank AJ (2003) Relation of C- reactive protein and other cardiovascular risk factors to penile vascular disease in men with erectile dysfunction. Int J Impot Res 15:231–236

    Article  PubMed  CAS  Google Scholar 

  26. Kolodny L (2003) Erectile dysfunction and vascular disease. What is the connection? Postrad Med 114:30–34

    Google Scholar 

  27. De Angelis L, Marfella MA, Sinisclchi M, Marion L, Napppo F, Giugliano F, De Lucia D, Giugliano D (2001) Erectile and endothelial dysfunction in type II diabetes. A possible link. Diabetologia 44:1155–1160

    Article  PubMed  Google Scholar 

  28. Billups K, Bank AJ, Padma-Nathan H, Katz S, Wiliams R (2005) Erectile dysfunction is a marker for cardiovascular disease: results of the Minority Health Institute Expert Advisory Panel. J Sex Med 2:40–50

    Article  PubMed  Google Scholar 

  29. Heinemann LAJ, Zimmermann T, Vermeulen A, Thiel C, Hummel W (2001) A new aging males’ symptoms rating scale. Ageing Male 2:105–114

    Article  Google Scholar 

  30. Rosen RC (2006) Research instruments for the diagnosis and treatment of patients with erectile dysfunction. Urology 68(sup. 3A):6–16

    Google Scholar 

  31. Eckel HR, Grundy SM, Zimmert PZ (2005) The metabolic syndrome. Lancet 365:1415–1428

    Article  PubMed  CAS  Google Scholar 

  32. Tkáč I (2005) New recommendations from expert panel. Diagnosis and possibilities of influencing the metabolic syndrome. Curr Clin Praxis (Súčasná klin prax) 1:12–15

    Google Scholar 

  33. Sattar N, Gaw A, Scherbakova O, Ford I, O’Reilly DS, Haffner SM, Isles C, Macfarlane PW, Packard CJ, Cobbe SM, Sepherd J (2003) Metabolic syndrome with and without C reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 108:414–419

    Article  PubMed  CAS  Google Scholar 

  34. Lauglin GA, Barett-Connor E, Bergstrom J (2008) Low serum testosterone and mortality in older men. J Clin Endocrinol Metab 93:68–75

    Article  Google Scholar 

  35. Ford ES, Abbassi F, Reaver GM (2005) Prevalence of insulin resistance and the metabolic syndrome with alternative definitions of impaired fasting glucose. Atherosclerosis 181:143–148

    Article  PubMed  CAS  Google Scholar 

  36. Mokaň M, Galajda P, Pridavkova D (2006) Prevalencia diabetes mellitus a metabolického syndromu na Slovensku. Diabetes a obezita 6(12):10–17

    Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Comenius University, Bratislava, Slovakia

    Juraj Fillo & Jan Breza

  2. Department of General Medicine, Comenius University, Bratislava, Slovakia

    Michaela Levčíkova, Jan Luha & Anna Vachulova

  3. Department of Surgery, Comenius University, Bratislava, Slovakia

    Štefan Durdík & Peter Labaš

  4. Department of Urology, University Hospital Bratislava, Mickiewiczova street 13, 81369, Bratislava, Slovakia

    Juraj Fillo

Authors
  1. Juraj Fillo
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  2. Jan Breza
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  3. Michaela Levčíkova
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  4. Jan Luha
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Correspondence to Juraj Fillo.

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Fillo, J., Breza, J., Levčíkova, M. et al. Occurrence of erectile dysfunction, testosterone deficiency syndrome and metabolic syndrome in patients with abdominal obesity. Where is a sufficient level of testosterone?. Int Urol Nephrol 44, 1113–1120 (2012). https://doi.org/10.1007/s11255-012-0132-1

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  • DOI: https://doi.org/10.1007/s11255-012-0132-1

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