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Endocrine Abstracts (2021) 73 OC4.6 | DOI: 10.1530/endoabs.73.OC4.6

1Ghent University Hospital, Department of Endocrinology, Gent, Belgium; 2Ghent University Hospital, Department of Clinical Chemistry, Gent, Belgium


Introduction

Even in healthy men, androgen levels start decreasing from early adulthood and these decreases are more pronounced in men with an increasing body mass index (BMI). It is, however, unclear to what extent changes in other indices of body composition and metabolic health are associated with changes in sex steroid exposure in healthy men over time.

Objective

Investigating longitudinal changes in body composition and metabolic health in relation to sex steroid levels in young adult men.

Methods

Longitudinal, population-based, observational study: 999 healthy men aged 24–46 years of whom 691 were re-evaluated after 12 ± 2 years. Serum sex hormone binding globulin (SHBG) and insulin levels were measured using immuno-assay, glucose by hexokinase method, testosterone (T) using LC-MS/MS, free T (cFT) and homeostasis model for insulin resistance (HOMA-IR) calculated. Body composition was determined using DXA (Hologic) at the whole body minus head. Fat (FM%) and lean mass (LM%) percentages were calculated. Mixed models were used for statistical analyses. All models were adjusted for baseline age.

Results

Baseline age was 34 ± 6 years. Mean BMI increased by 4.7% (25.1 kg/m2 vs 26.3 kg/m2). Mean T levels decreased by 14.2% (20.8 nmol/l vs 17.8 nmol/l), cFT by 19.1% (392 pmol/l vs 317 pmol/l) and SHBG increased by 3.0% (39.8 nmol/l vs 41.0 nmol/l) (all P < 0.001). FM% increased by 10.2% (19.6% vs 21.6%; P < 0.001), especially at the trunk (8.1 kg vs 9.6 kg; P < 0.001). LM% decreased by 1.8% (77.3% vs 75.4%; P < 0.001). HOMA-IR increased from 1.7 to 2.2 (P < 0.001). At baseline, total T, cFT and SHBG were inversely associated with truncal fat, FM% and HOMA-IR and positively associated with LM% (all P < 0.001). Longitudinally, changes in sex steroids were not associated with changes in either FM% and LM%. However, changes in total T, cFT and SHBG were inversely associated with changes in truncal fat and HOMA-IR (all P < 0.018).

Conclusion

In healthy young men, adiposity and insulin resistance increased while LM% decreased over a period of 12 years. We found that a stronger decline in both total and free T levels was associated with stronger increases in truncal adiposity and insulin resistance. Our findings suggest a direct role of sex steroids as determinants of metabolic state. Whether these findings result from residual confounding or are mediated by the intriguing relationship between SHBG levels and metabolic health remains to be established. Moreover, the possibility of a reverse causality between changes in androgen levels and metabolic state should be taken into account.

Volume 73

European Congress of Endocrinology 2021

Online
22 May 2021 - 26 May 2021

European Society of Endocrinology 

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