ECEESPE2025 ePoster Presentations Reproductive and Developmental Endocrinology (128 abstracts)
Severe obstructive sleep apnea syndrome and continuous positive airways pressure therapy impact on testosterone levels in male patients with severe obesity
Alessandro Amodeo 1 , Nicoletta Del Duca 2 , Alessandro Chilà 1 , Antonio Musolino 1 , Ilinka Garavaglia 1 , Elisa Delle Donne 1 , Ilaria Gentile 1 , Silvia Federici 1 , Luca Persani 1,3 , Massimo Scacchi 4,5 , Marco Bonomi 1,3 & Biagio Cangiano 1,3
1University of Milan, Department of Medical Biotechnology and Translational Medicine, Milan, Italy; 2Istituto Auxologico Italiano, IRCCS, Division of General Medicine, Ospedale San Giuseppe, Oggebbio-Piancavallo, Verbania, Italy; 3Istituto Auxologico Italiano, IRCCS, Division of Endocrine and Metabolic Diseases, Milan, Italy; 4University of Milan, Department of Clinical Sciences and Community Health, Milan, Italy; 2Istituto Auxologico Italiano, IRCCS, Division of General Medicine, Ospedale San Giuseppe, Oggebbio-Piancavallo, Verbania, Italy
JOINT2547
Background: To date, the relationship between Obstructive Sleep Apnea Syndrome (OSAS) and testosterone levels in males has not yet been fully elucidated. Some studies reported a correlation between severe OSAS and hypogonadism in patients with obesity, regardless of body mass index (BMI). However, few data from longitudinal studies show the effect of continuous positive airways pressure (CPAP) on gonadal function.
Aim: To investigate the factors related to low testosterone levels in a large cohort of males with severe/complicated obesity, the role of the OSAS in the diagnosis and severity of hypogonadism, and the effects of ventilation therapy on hormonal status.
Subjects and methods: 210 male inpatients with grade II (BMI ≥ 35 Kg/m2) complicated or grade III (BMI ≥ 40 Kg/m2) obesity were included in this cross-sectional study. Polysomnography or overnight oximetry and blood tests for inflammation indices, metabolic and hormonal profiles were performed during admission. Decompensated OSAS was defined as Apnea/Hypopnea Index (AHI) in newly diagnosed, or Oxygen Desaturation Index (ODI) in treated patients, above 30 events/hour. Univariate analyses were performed to investigate the conditions related to the decrease in testosterone levels (inflammation, diabetes, eating disorders, waist circumference, previous diagnosis of OSAS, decompensated OSAS). A logistic regression and a multiple linear regression were carried out to identify the independent factors associated with hypogonadism (i.e. testosterone ≤ 10.4 nmol/l)and to continuous testosterone levels respectively. Lastly, a prospective longitudinal study of 15 newly diagnosed patients was performed to evaluate the effects of CPAP therapy on hormonal control after 3-6 months of treatment.
Results: 130 out of 210 patients showed low testosterone levels. Type 2 diabetes mellitus and C-reactive Protein (CRP) were independently associated with hypogonadism (p-value 0.03 and 0.01, respectively). The correlation between decompensated OSAS and hypogonadism was significant in the univariate, but with only a trend to significance in multivariate analysis (p-value 0.02 and 0.06, respectively). Only waist circumference, CRP, and T2DM were significantly associated with the progressive decline in testosteronemia at linear regression. After 3-6 months of CPAP therapy, ODI was significantly associated with the improvement in testosterone levels, independently from BMI, at multivariate regression (p-value 0.04).
Conclusions: decompensated OSAS, rather than its diagnosis, was found to correlate with low testosterone values also in male patients with severe obesity. As expected, our findings confirmed the contribution of T2DM, waist circumference and inflammation to the deflection of gonadal function. In addition, CPAP therapy was shown to improve testosterone levels.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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