The Association Of Testosterone Level And Metabolic Sybdrome As Well As Metabolic Syndrome Complicated With Cerebral Infarction In Middle Aged And Elderly Men

Objective:We aimed to investigate the relationship between testosterone level and metabolic syndrome (MetS) as well as its components in middle aged and elderly men ; to evaluate the association of testosterone level and MetS complicated with cerebral infarction; and further to investigate the correlation between testosterone level and cerebral infarction in patients with MetS.Methods:We collected the data of male patients aged over 40 years, who came to the department of neurology in our hospital for treatment during January 1st,2014 to December 31st,2015. Those patients should suffered from MetS or MetS complicated with cerebral infarction. We also collected the data of healthy men who came for routine physical examination in our hospital during January 1st,2015 to December 31st,2015, and those men were regarded as control. The data we collected from all the subjects included age, height, weight, serum lipid levels (Total cholesterol, TC; Triglyceride, TG; High-density lipoprotein cholesterol, HDL-C; Low-density lipoprotein cholesterol, LDL-C), serum total testosterone (TT), serum free testosterone (FT), blood pressure (Systolic blood pressure, SBP; Diastolic blood pressure, DBP) as well as history of hypertension (including treatment), Fasting blood glucose (FBG) as well as history of diabetes (including treatment), other related history, cranium CT or MRI et al. We used Pearson correlation method to analyze the correlation between TT, FT levels and BMI, HDL-C, LDL-C, TC, TG, FBG, SBP as well as DBP. Then we used Logistic regression model to analyze the association of TT, FT and MetS, as well as MetS complicated with cerebral infarction. Furthermore, the TT levels of all subjects were divided into three intervals of low TT group (<10.41 nmol/L), normal TT group (10.41-19.78 nmol/L) and high TT group (> 19.78 nmol/L), according to the clinical normal range. The proportions of patient with MetS and MetS complicated with cerebral infarction in different groups were compared, and correlations between TT, FT levels and MetS, MetS complicated with cerebral infarction in different groups were analyzed by using Logistic regression models. Additionally, we compared the proportions of patients with cerebral infarction in different TT groups among all the patients with MetS (patients with MetS and MetS complicated with cerebral infarction), and we also used the Logistic regression model to analyze the correlation of TT, FT and cerebral infarction in patients with MetS.Results:(1) A total of 484 male subjects were enrolled in this study. The number of subjects with MetS, MetS complicated with cerebral infarction and control were 66, 50 and 368, respectively. Age in groups of MetS, MetS complicated with cerebral infarction and control were 50.9±9.2,52.1 ±7.9 and 54.2±9.3 years, respectively, and the value in control group was significantly higher than that in MetS group (p<0.01) and MetS complicated with cerebral infarction group (p=0.03). BMI in groups of MetS, MetS complicated with cerebral infarction and control were 25.2±3.0,24.6±4.5 and 22.0±2.7, respectively, and the value in control group was significantly lower than that in MetS group (p<0.01) and MetS complicated with cerebral infarction group (p<0.01).(2) The results of Pearson correlation analysis showed a significantly negative correlation between TT and BMI (correlation coefficient r=-0.35), LDL-C (r=-0.13), TC (r=-0.19), TG (r=-0.22), FBG (r=-0.28) as well as SBP (r=-0.15) (all p<0.05). Whereas FT was negatively correlated with HDL-C (r=-0.10), FBG (r=-0.19) and DBP (r=-0.24) (all p< 0.05). Nevertheless, TT was only negatively correlated with BMI (R=-0.33), TG(r=-0.09) and FBG(r=-0.13) after we used a partial correlative analysis which adjusted the potential effect of age (all p<0.05). FT was still negatively correlated with BMI (r=-0.11, p=0.01).(3) The Logistic regression indicated that both lower TT and FT levels were independent risk factor of MetS (TT:OR=0.90,95%CI 0.86-0.95; FT:OR=0.03,95% CI 0.01-0.87). The proportions of patients with MetS among those three TT groups were significantly different, the value in low TT group was significantly higher than that in normal TT group (p<0.001). In TT group, patients with a lower TT value suffered from a higher risk of MetS (OR=0.59,95%CI 0.38-0.93). In normal TT group, patients with a lower TT also suffered from a higher risk of MetS (OR=0.86, 95%CI 0.81,0.92), whereas the risk was much lower than in low TT group. In high TT group, the value of TT was not significantly related to MetS.(4) Lower TT level obviously increased the risk of MetS complicated with cerebral infarction (OR=0.93,95% CI 0.87-0.98), whereas FT level was not significantly related to MetS complicated with cerebral infarction. The proportions of patients with MetS complicated with cerebral infarction in those three TT groups were significantly different, the value in low TT group was obviously higher than that in normal TT group (p=0.017). In low TT group, patients with lower TT levels suffered from a higher risk of MetS complicated with cerebral infarction (OR=0.37,95% CI 0.16-0.86). Whereas in normal TT and high TT groups, the levels of TT were not significantly correlated with the risk of MetS complicated with cerebral infarction.(5) TT level in MetS complicated with cerebral infarction group was significantly lower than that in MetS group (p=0.03). Nevertheless, FT level was similar between these two groups. Among all the patients with MetS (including the patients with MetS and MetS complicated with cerebral infarction), the proportion of patients with cerebral infarction was significantly higher in low TT group than normal TT group (p=0.008) and high TT group (p=0.015). For patients with MetS, lower TT could increase the risk of cerebral infarction (OR=0.92,95% CI 0.86-0.99), whereas FT level was not significantly correlated with the risk of cerebral infarction in patients with MetS.Conclusions:(1) Both lower TT and FT were independent risk factors for MetS in middle aged and elderly men.(2) When TT was below the normal range, lower TT could increase the risk factor of MetS, which was much higher than that in normal TT condition. Whereas when TT was higher than normal range, the level was not correlated with the risk of MetS.(3) Lower TT was an independent risk factor of MetS complicated with cerebral infarction, whereas FT level was not obviously correlated with MetS complicated with cerebral infarction. Lower TT could increase the risk factor of MetS complicated with cerebral infarction only on the condition that TT was below normal range.(4) Lower TT could significantly increase the risk of cerebral infarction of patients with MetS.