Low levels of testosterone, hypogonadism, have several common features with the metabolic syndrome such as disturbances in glucose metabolism and insulin secretion, overweight and abdominal fat distribution, dyslipidemia and hypertension. In the Tromsų Study, a population-based health survey, we found that testosterone levels were inversely associated with anthropometrical measurements. The lowest levels of total and free testosterone were found in men with the most pronounced central obesity, measured as waist circumference. Total testosterone was inversely associated with systolic blood pressure, and men with hypertension had lower levels of both total and free testosterone. Furthermore we found that men with diabetes had lower testosterone levels compared to men without a history of diabetes, and an inverse association between testosterone levels and percent glycosylated haemoglobin was found. Our results are in harmony with other epidemiological studies, which in addition have reported a positive relationship with HDL-cholesterol and a more favourable lipid profile.
In a recent publication from Finland, low concentration of total testosterone and to a lesser extent free testosterone predicted the development of the metabolic syndrome in middle-aged men. It was also suggested, in another publication from the same Finnish group, that the metabolic syndrome itself could be a cause of low total and free testosterone levels and hypogonadism. Thus, lifestyle intervention in men with or at risk for the metabolic syndrome may prevent not only diabetes but also hypogonadism.
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