Author: Contreras P., Vigil P., and Salgado A.M. (2017)
A cohort of 141 males (18-80 yo, 42.9±12.9) suspected of being Insulin Resistant (IR) was prospectively studied by determining their insulin sensitivity (Pancreatic Suppression Test, PST) and testicular function (total testosterone and SHBG). The subjects were considered IR when their Steady State Plasma Glucose (SSPG) was ≥ 150 mg/dL and Non-Insulin Resistant (NIR) when their SSPG was < 150 mg/dL; similarly, the subjects were labeled as Hypogonadal (HYPOG) when their total testosterone was ≤3.0 ng/mL and Eugonadal (EUG) when their total testosterone was > 3.0 ng/mL. Subjects n=141 IR n=94 (66.66%) NIR n=47 (33.33%) HYPOG n= 37 (26,24%) 30 7 EUG n=104 (73.76%) 64 40 Chi-square was 4.69 and p was 0.0303, indicating a significant interdependence between insulin resistance and hypogonadism. Age (>43 yo) predicted hypogonadism (AUROC 0.606, p=0.0308). Neither Weight nor BMI predicted hypogonadism, while Waist Perimeter (>110 cm) was a predictor of hypogonadism (AUROC 0.640, p=0.009). SSPG (>224 mg/dL) was a significant predictor of hypogonadism (AUROC 0.709, p=0.002). Age did not predict insulin resistance, while Weight (>99 kg), BMI (>29), and specially, Waist Perimeter (> 100 cm, AUROC 0.812, p< 0.0001) were all significant predictors of insulin resistance. In conclusion, Waist Perimeter predicted both insulin resistance (> 100 cm) and hypogonadism (> 110 cm), suggesting that the first hit of abdominal obesity is insulin resistance and the second hit is male hypogonadism.