Association Between Low Serum Testosterone and the Development of Metabolic Syndrome in Elderly Taiwanese Men

PURPOSE: To assess the association between serum testosterone (T) and metabolic syndrome (MS) in different age groups in Taiwanese men. MATERIALS AND METHODS: Male participants, regardless of age or any underlying disease, were identified from MJ Health Screening Center in Taiwan from 2007 to 2016 for this cross-sectional study. They were divided into three groups according to age, and further classified according to MS diagnosis. Basic patient characteristics with relevant parameters were obtained. One-way ANOVA of mean T values between different numbers of measures that exceeds the cut-off values of MS components was performed to assess the relationship of T and MS. Logistic regression analysis was also used to estimate the risk for MS with each increment in T, age, and BMI. RESULTS: A total of 4,931 men were included. The MS group had significantly lower serum T levels compared to the non-MS group in each age group. The one-way ANOVA found the mean value of T was significantly higher in patients without MS component (6.19±2.12 ng/mL) than those with 1–5 MS components (with one MS component: 5.48±2.13 ng/mL, two MS components: 4.93±2.03 ng/mL, three MS components: 4.37±1.60 ng/mL, four MS components: 4.13±2.89 ng/mL, five MS components: 3.74±1.27 ng/mL, and P<0.001). There was no significant difference between the patients with three components and the patients with four or five components. Logistic regression models with age stratification showed T with lower odds ratio (OR) for MS after adjusting for BMI in those ≥65 years old (OR=0.693; 95% CI=0.559–0.858; P<0.001); 50–64 years old (OR=0.868; 95% CI=0.802–0.940; P<0.001) and <50 years old (OR=0.810; 95% CI=0.758–0.865; P<0.001). CONCLUSION: Lower serum T was strongly associated with MS, with the predictive value increasing with age in Taiwanese men.