Relationship between serum sex hormones and the glucose-insulin-lipid defect in men with obesity.

It has been hypothesized that an alteration in the sex hormone milieu may underlie coronary heart disease (CHD) and its risk factors. Leading to this hypothesis and important to it was the observation that serum testosterone level correlated negatively and the estradiol to testosterone ratio (E/T) correlated positively with serum insulin and glucose levels in non-obese men. As a test of the validity of this observation, the present study was conducted to investigate these correlations in men with obesity. Obesity in men is associated with hyperestrogenemia, hypotestosteronemia, hyperinsulinemia, hyperglycemia, and CHD. To determine whether the relationships between sex hormone levels and insulin and glucose levels found in non-obese men also occur in obese men independent of obesity, fasting levels of these substances, as well as free testosterone (FT) and sex-hormone-binding globulin (SHBG), were measured in 55 obese men aged 21 to 70. Correlation coefficients of sex hormones with other risk factors for CHD, ie, cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), blood pressure, and waist to hip circumference ratio (W/H), were also calculated. As found previously, testosterone level correlated negatively with insulin (r = -.31, P = .01) and glucose (r = -.23, P < .05) levels and the insulin to glucose ratio ([I/G] r = -.26, P < .05), and E/T correlated positively with insulin (r = .41, P = .001) and glucose (r = .24, P < .05) levels and I/G (r = .37, P < .005). The above correlations were controlled for body mass index (BMI) and age.(ABSTRACT TRUNCATED AT 250 WORDS)