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High prevalence of hypogonadism and associated impaired metabolic and bone mineral status in subfertile men
Author(s) -
Bobjer Johannes,
Bogefors Karolina,
Isaksson Sigrid,
Leijonhufvud Irene,
Åkesson Kristina,
Giwercman Yvonne Lundberg,
Giwercman Aleksander
Publication year - 2016
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13038
Subject(s) - medicine , testosterone (patch) , endocrinology , bone mineral , osteoporosis , luteinizing hormone , androgen deficiency , infertility , population , body mass index , anthropometry , male infertility , free androgen index , androgen , sex hormone binding globulin , hormone , pregnancy , biology , genetics , environmental health
Summary Objective 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. Design Cross‐sectional case–control study. Patients Men from infertile couples ( n = 192); 18–50 years; sperm concentration <20 × 10 6 /ml and population‐based age‐matched controls ( n = 199). Measurements 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. Results 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. Conclusion 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.