Abbreviations: MetS, metabolic syndrome; TT, total testosterone; FDEMC, faiha specialized diabetes, endocrine, and metabolism center; HOMA, homeostasis model assessment; ROC, receiver operating characteristic; SBP, systolic blood pressure; DBP, diastolic blood pressure.
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AbstractBackground: Metabolic syndrome (MetS) is an important public health target for disease prevention. Studies on MetS among obese people alone are few. In this study we aimed to see whether total testosterone (TT) and sex hormone-binding globulin (SHBG) have a role in the prediction of MetS in obese adult people from Basrah.
Methods:A cross-sectional study conducted during the period from October 2016 to the end of October 2017 in Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC) in Basrah. Participants were obese adults referred to the Center from other hospitals, Primary Care Centers, and private clinics. The total enrolled patients in this study were 169 patients (89 women.52.66% and 80 men.47.33%). A short history and clinical examination were taken from each participant for age, gender, blood pressure, weight, height, waist circumference, blood pressure and body mass index (BMI). A fasting morning blood sample was taken for measurement of basal serum TT, serum SHBG, serum C-peptide, plasma insulin, plasma sugar and serum lipid profile.Results: Both TT and SHBG were significantly lower in obese men with MetS in comparison with men without (P =0.0002 and P =0.003 respectively). Mean TT in ng/dL in obese men with MetS was (250.08 ±96.07) vs. (400.37 ±149.37) in obese men without. While mean SHBG in nmoL/L in obese men with MetS was (28.95 ±14.21) vs. (42.49 ±24.11) in obese men without. In obese women, there was no significant different in SHBG levels when compared between those with MetS and without (P =0.8). On univariate and multivariate analysis for obese men, both TT and SHBG remained significantly and independently lower in obese men with MetS, for TT (OR 6.4 CI (-321.9--157.9) P< 0.00001), and for SHBG (OR 1.39,.6) P= 0.00001). In men with no MetS, both TT and SHBG were significantly higher in men with severe in insulin resistance (IR) when compared with normal and moderate IR, (P=0.01, P=0.01 respectively). Mean TT was (396.09±19.3) in men with severe IR as compared with (311.4±26) and (274.6±23.9) in normal and moderate IR respectively. Mean SHBG in men with severe IR was (41.1±3.5) as compared with (28.2±4.7) and (31.9±4.3) in normal and moderate IR respectively.
Conclusion:Both TT and SHBG were significantly and independently lower in obese men with MetS than those with no MetS, but not in obese women with MetS. The effect of MetS overcomes the effect of IR in decreasing the level of both TT and SHBG among obese men in the presence of MetS.