Prediction of Metabolic Syndrome by Low Serum Testosterone Levels in Men Results From the Study of Health in Pomerania

OBJECTIVE-The aim of this analysis was to assess the prospective association of serum testosterone and dehydroepiandrosterone sulfate (DHEAS) levels with incident metabolic syndrome (MetS) in men. RESEARCH DESIGN AND METHODS-Data were obtained from the Study of Health in Pomerania (SI-HP), a population-based prospective cohort of adults aged 20-79 years. Analyses were conducted in 1,004 men without, baseline MetS defined National Cholesterol Education Program Adult Treatment Pan I III guidelines. Testosterone and DHEAS were categorized age-specific quartiles and Poisson regression models with relative risks (RRs) and 95% CIs were estimated. RESULTS-After a median follow-up time of 5.0 years, 480 men (47.8%) developed MetS. Testosterone levels decreased with increasing number of MetS components. Testosterone in the lowest quartile predicted MetS (RR 1.38 [95% CI 1.13-1.69]), particularly among men aged 20-39 years (2.06 [1.29-3.29]), even after adjustment for age, smoking, alcohol consumption, physical activity, waist circumference, self-related health, and time of blood sampling. DHEAS levels were not related to incident MetS (0.99 [0.83-1.19]). CONCLUSIONS-Low testosterone but not DHEAS predicts development of MetS in a population-based cohort of 1,004 men aged 20-79 years. Especially in young men aged 20-39 years, results suggest low testosterone as a strong predictor for incident MetS. Assessment of testosterone in young and middle-age men may allow early interventions in the general population. Diabetes 58:2027-2031, 2009