Obesity: Gooren LJ

Wang C, Nieschlag E, Swerdloff R, Behre HM, Hellstrom WJ, Gooren LJ, Kaufman JM, Legros JJ, Lunenfeld B, Morales A, Morley JE, Schulman C, Thompson IM, Weidner W, Wu FC, Anonymous00084, Anonymous00085, Anonymous00086, Anonymous00087, Anonymous00088. · Division of Endocrinology, Department of Medicine, Harbor-UCLA Medical Center, and Los Angeles BioMedical Research Institute, Torrance, CA 90509, USA. · J Androl. · Pubmed #18772485 No free full text.

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Goncharov NP, Katsya GV, Chagina NA, Gooren LJ. · Endocrinology Research Center, Moscow, Russia. · Andrologia. · Pubmed #19260842 No free full text.

Abstract: The study assessed anthropometric and laboratory variables, in particular testosterone (T) in a group of obese men of <40 years. Of 60 men with a body mass index (BMI) of >27 kg m(-2), 34 met the criteria of the metabolic syndrome (MS). Twenty men <40 years (with a BMI <25 kg m(-2)) were studied for comparison. It was found that with increasing BMI, levels of serum leptin, triglycerides, insulin, the ratio high-density lipoprotein (HDL) cholesterol/low-density liporotein (LDL) cholesterol, the waist circumference (WC), the area of visceral fat and systolic/diastolic blood pressure were higher, whereas insulin sensitivity (HOMA) and serum T were lower. Obesity (BMI 27-30 kg m(-2)) was associated with a decline in plasma T, but not with a decline in plasma sex hormone-binding globulin (SHBG). The latter was the case in more severe obesity (>30 kg m(-2)) qualifying as MS. In patients with MS, 58% variability of T levels could be predicted by combination of independent factors - SHBG, ratio LDL/HDL, insulin and leptin. On the other hand, in men with MS, 80% variance of concentrations of SHBG were predicted by triglycerides, HDL, glucose, leptin and surface of visceral adipose tissue. It is concluded that plasma T is significantly correlated with a number of features of the MS and, therefore, plasma T could serve as a marker of the MS.

Haider A, Gooren LJ, Padungtod P, Saad F. · Endocrinology, VUMC, Amsterdam, The Netherlands. · Andrologia. · Pubmed #19143723 No free full text.

Abstract: Central obesity in adulthood, the metabolic syndrome, erectile failure and lower urinary tract symptoms (LUTS) are all associated with lower-than-normal testosterone levels, although the relationship between testosterone and LUTS appears weak. The metabolic syndrome is associated with an overactivity of the autonomic nervous system. Alternatively, the metabolic syndrome is associated with markers of inflammation, such as C-reactive protein (CRP), maybe signalling intraprostatic inflammation. A large cohort of 95 middle-aged to elderly hypogonadal men (T levels 5.9-12.1 nmol l(-1)) were treated with parenteral testosterone undecanoate and its effects on the metabolic syndrome {waist circumference, cholesterol, CRP and LUTS [residual bladder volume (RBV), International Prostate Symptoms Score (IPSS), prostate volume, prostate-specific antigen (PSA)]} were evaluated. Along with the improvements of the metabolic syndrome, there was a significant decline of the values of the IPSS, RBV and CRP. There was a (low) level of correlation between the decline of waist circumference and residual volume of urine but not with IPSS and prostate size. Along with the improvement of the metabolic syndrome upon testosterone administration, there was also an improvement of the IPSS and of RBV of urine and CRP. The mechanism remains to be elucidated.

Yassin AA, Saad F, Gooren LJ. · Clinic of Urology and Andrology, Segeberger Kliniken, Norderstedt-Hamburg, Germany. · Andrologia. · Pubmed #18727737 No free full text.

Abstract: Until a decade ago the ailments of elderly men, such as atherosclerosis, hypertension, diabetes mellitus, lower urinary tract symptoms and erectile dysfunction (ED), were regarded as distinct diagnostic/therapeutic entities but there is a growing awareness that these entities are not disparate and, to improve the health of the ageing male, require an integral approach. There is an inter-dependence between the metabolic syndrome, ED and patterns of testosterone in ageing men. The main features of the metabolic syndrome are abdominal obesity, insulin resistance, hypertension and dyslipidaemia, significant factors in the aetiology of erectile function. The metabolic syndrome is associated with lower-than-normal testosterone levels. A new concept of the role of testosterone in male physiology suggests that testosterone plays also a significant role in the development and maintenance of bone and muscle mass and is a determinant of glucose homeostasis and lipid metabolism. Testosterone is not only a factor in libido but exerts also essential effects on the anatomical and physiological substrate of penile erection. With these recent insights, the health problems of elderly men must be placed in a context that allows an integral approach. Treatment of testosterone deficiency is to become part and parcel of this approach.

Goncharov NP, Katsya GV, Chagina NA, Gooren LJ. · Endocrinology Research Center, Moscow, Russia. · Aging Male. · Pubmed #18609309 No free full text.

Abstract: This study tested 60 men, aged <40 years, with a BMI 27-35 kg/m(2) to determine whether they had metabolic syndrome. The three definitions used to test this were from the National Cholesterol Education Program (NCEP), the World Health Organization (WHO) and the International Diabetes Federation (IDF). Further, the relationship between a positive definition and plasma testosterone (T) and calculated free T was analysed. Using the above three definitions of metabolic syndrome (MetS), there was a large degree of overlap of identifying obese men as having the syndrome, but there were quantitatively significant differences as well. So, it is relevant in studies to identify which of the present definitions of the syndrome has been used. With aging there is an increasing prevalence of the syndrome and age itself might be a factor in the lower T levels encountered in these men. But low plasma total T and calculated free T were also consistent features of men <40 years with metabolic syndrome, regardless of which definition had been applied. Including low T levels in the definition of metabolic syndrome, may be helpful.

Duschek EJ, Gooren LJ, Netelenbos C. · Department of Endocrinology, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. · Maturitas. · Pubmed #15978972 No free full text.

Abstract: OBJECTIVE: In aging men serum levels of testosterone and insulin-like growth factor-1 (IGF-1) decline, potential factors in the reduced muscle strength, abdominal obesity, sexual dysfunction and impaired general well being of aging. The partial oestrogen agonist and antagonist raloxifene increase serum testosterone levels in aging men, but the effect of raloxifene on serum IGF-1 levels in men is unknown. In this study the effects of raloxifene on IGF-1 levels and the associated increase in serum testosterone were compared to the effects of oral testosterone supplementation. DESIGN AND PATIENTS: Thirty healthy elderly men between 60 and 70 years received raloxifene 120 mg/day or placebo in a randomised double blind fashion for 3 months. Secondly, seven female to male (F to M) transsexuals undergoing hormonal sex reassignment received testosterone undecanoate 160 mg/day. Measurement: At baseline and after three months serum levels of testosterone, IGF-1 and its most important binding protein, IFGBP-3 was measured. In the group transsexuals also serum gonadotrophins and 17beta-oestradiol was measured. RESULTS: Compared to placebo raloxifene increased serum testosterone by 20% but it decreased serum IGF-1 levels by 24.5% (95% confidence interval (CI): -13.0 to -36.1%). No significant change in serum IGFBP-3 levels was found. The effect of raloxifene on serum IGF-1 has been observed with other oral oestrogens, and, therefore, is likely to be ascribed to the partial oestrogen agonist activity of raloxifene. In the F to M transsexuals, serum testosterone levels increased from median <1.0 nmol/l to 6.2 nmol/l, without significant changes in serum gonadotrophins and 17beta-oestradiol levels. Serum IGF-1 levels increased by 12.1% (95% CI: 1.9-22.3%) versus baseline. No effect was observed on serum IGFBP-3 levels. CONCLUSION: Both raloxifene and oral testosterone increased serum testosterone, but raloxifene significantly decreased serum IGF-1 levels without affecting IGFBP-3. By contrast, oral testosterone supplementation in F to M transsexuals increased IGF-1 levels. In both treatment groups no significant change in serum IGFBP-3 was found.

Giltay EJ, Toorians AW, Sarabdjitsingh AR, de Vries NA, Gooren LJ. · Department of Endocrinology, Andrology Unit, Vrije University Medical Center, Amsterdam, The Netherlands. · J Endocrinol. · Pubmed #14709149 links to  free full text

Abstract: A high scalp sensitivity to androgens is part of the pathophysiology of male-pattern baldness (MPB). Androgens affect established risk factors for coronary heart disease (CHD), and a supposedly heightened impact on these risk factors is hypothesized to explain the epidemiological association between MPB and CHD. In this retrospective, observational study we studied 81 female-to-male transsexual (F-->M) subjects, mean age 36.7 years (range 21-61), treated with testosterone esters (n=61; 250 mg i.m./2 weeks) or testosterone undecanoate (n=20; 160-240 mg/day orally). The degree of MPB was self-assessed using a 5-point scale (i.e. type I (no hair loss) to type V (complete hair loss)). Body mass index, blood pressure and levels of lipid and insulin were retrospectively assessed at the start of testosterone administration (0.5-24 years before) and between 3 and 4 months of follow-up. We found that 31 of 81 (38.3%) F-->M transsexuals had MPB type II-V. Thinning of hair was related to the duration of androgen administration and present in about 50% of F-->M transsexuals after 13 years. None of the CHD risk factors at follow-up, nor proportional changes, was associated with the degree MPB, except that there was an unexpected tendency of lower fasting glucose levels in balding subjects. Therefore, our findings do not support the idea that MPB serves as an indicator of increased CHD risk through androgenic effects on classic CHD risk factors.