DECREASED ANDROGEN LEVELS associated with aging cause various symptoms, termed late-onset hypogonadism (LOH) [1][2][3]. LOH is characterized by (i) somatovegetative symptoms and conditions, including weakness, fatigue, sleep disturbance, visceral obesity, sarcopenia and osteopenia (or osteoporosis), (ii) psychological symptoms, including disturbed sense of well-being, depressed mood, irritability and anxiety and (iii) sexual symptoms, including decreased libido and erectile dysfunction.Visceral obesity has been proposed to be caused by vice circulation. Specifically, decreased androgen lev-A higher score on the Aging Males' Symptoms scale is associated with insulin resistance in middle-aged men Abstract. An age-associated androgen decrease and its pathological conditions are defined as late-onset hypogonadism (LOH). Among the various symptoms associated with LOH, a visceral fat increase is strongly associated with relatively low levels of testosterone. However, few studies have investigated the relationship between the Aging Males' Symptoms (AMS) scores and metabolic abnormalities. Thus, we aimed to clarify this relationship by investigating the relationship between AMS scores and various markers in blood. During routine health examinations in 241 middle-aged males (52.7±7.5 years of age, mean±SD), 150 males (62.2%) displayed higher AMS values than normal. No statistical association was observed between total AMS scores and any testosterone value. All mental, physical and sexual AMS subscales were significantly positively correlated with insulin levels and HOMA-IR. Only sexual subscale scores were significantly inversely associated with free or bioavailable testosterone level. Males with insulin resistance (HOMA-IR≥2.5) demonstrated significantly higher AMS scores than those with normal insulin sensitivity (HOMA-IR<2.5). AMS values were positively correlated with fasting blood glucose, insulin and HOMA-IR values. Interestingly, univariate and multivariate analyses revealed that HOMA-IR≥2.5 was a significant predictor for detection of moderately severe AMS values (AMS≥37), whereas AMS≥37 was not a predictor of metabolic syndrome by International Diabetes Federation (IDF) criterion. In conclusion, almost 60% of healthy male subjects displayed abnormal AMS scores. AMS values were not associated with testosterone values but rather were related to insulin resistance, particularly in subjects with moderately severe AMS values. Insulin resistance-related general unwellness might be reflected by AMS values.Key words: Testosterone, Late-onset hypogonadism, Insulin resistance, Metabolic syndrome els result in visceral obesity, which then leads to the suppression of gonadotropin and subsequent testosterone deficiency [4]. We have reported that male ARKO mice develop visceral obesity because of decreased energy expenditure [5]. Metabolic syndrome (MetS) is characterized by multiple cardiovascular risk complications, including visceral obesity, hypertension, glucose tolerance and dyslipidemia. MetS incidence is rapidly incre...