Med J Aust. 2006 Oct 16;185(8):424-7
Allan CA, Strauss BJ et al.
Much is published on the subject of female fertility and obesity, however, does obesity have an effect on male fertility? This study from Prince Henry's Institute, Melbourne, Australia, examines if there may be a link.
Objective: To determine the influence of obesity on the diagnosis of age-related androgen deficiency (AD) in symptomatic men according to current Australian guidelines.
Design, setting and participants: A community-based cohort of healthy ageing men with symptoms suggestive of AD was studied between May 2001 and February 2003. Men were classified as obese or non-obese according to body mass index (BMI) or waist circumference (WC).
Main outcome measure: Diagnosis of AD according to Endocrine Society of Australia (ESA) guidelines.
Results
223 men aged 54-86 years with mean BMI 27.3 were recruited; 99 men were obese (BMI > or = 30.0 kg/m2 or WC > or = 102 cm) and 124 men were non-obese. Obese men had lower total testosterone (TT) (12.7 +/- 0.4 v 15.0 +/- 0.4 nmol/L); and calculated free testosterone (275.7 +/- 7.8 v 299.3 +/- 7.4 pmol/L); levels than non-obese men. TT levels < 8 nmol/L were recorded in 12% of obese men and 1% of non-obese men. Applying the ESA guidelines for the diagnosis of age-related AD, 15 obese men (15%) and 4 non-obese men (3%) were classified as being androgen deficient; obese men were 1.92 more likely than non-obese men to be androgen deficient.
Conculsion
Obesity is an important determinant of serum TT levels in ageing men. Almost one in seven obese men but only one in 30 non-obese men in this study were eligible for androgen therapy according to Australian guidelines. Studies of testosterone therapy in this group of ageing men are needed to determine whether androgen replacement is beneficial.
