Abstract

Objective: The aim of this analysis was to assess the prospective association of serum testosterone and dehydroepiandrosterone sulfate (DHEAS) levels with incident metabolic syndrome (MetS) in men.

Research Design and Methods: Data were obtained from the Study of Health in Pomerania (SHIP), a population-based prospective cohort of adults aged 20-79 years. Analyses were conducted in 1,004 men without baseline MetS, defined by National Cholesterol Education Program Adult Treatment Panel III guidelines. Testosterone and DHEAS were categorized by age-specific quartiles and Poisson regression models with relative risks (RR) and 95% confidence intervals (95% CI) were estimated.

Results: After a median follow-up time of 5.0 years, 480 men (47.8%) had developed MetS. Testosterone levels decreased with increasing number of MetS components. Testosterone in the lowest quartile predicted MetS (RR 1.38, 95% CI 1.13-1.69), particularly among men aged 20 -- 39 years (RR 2.06, 95% CI 1.29-3.29), even after adjustment for age, smoking, alcohol consumption, physical activity, waist circumference, self-related health, and time of blood sampling. DHEAS levels were not related to incident MetS (RR 0.99; 95% CI 0.83-1.19).

Conclusions: Low testosterone but not DHEAS predict development of MetS in a population-based cohort of 1,004 men aged 20-79 years. Especially in young men aged 20-39 years, results suggest low testosterone as a strong predictor for incident MetS. Assessment of testosterone in young and middle old men may allow early interventions in the general population.