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Minerva Medica 2007 April;98(2):101-7


Partial androgen deficiency of the aging male and clinical response to conventional medical therapy in patients with metabolic syndrome

La Vignera S. 1, Calogero A. E. 1, Condorelli R. 1, Giammusso B. 2, Vicari E. 1

1 Sezione di Endocrinologia Andrologia e Medicina Interna Dipartimento di Scienze Biomediche Ospedale Garibaldi Università degli Studi di Catania, Catania 2 Dipartimento di Urologia Ospedale Vittorio Emanuele Università degli Studi di Catania, Catania


Aim. Analytical study (longitudinal) able to examine the modifications relative to some of the main metabolic parameters: body mass index (BMI); waist measurement; cholesterol HDL; triglicerydes, medium arterial pressure and some insulin sensitivity indicators deduced (index HOMA and index Quicki) in patients with full clinical expression of metabolic syndrome (SM) and comparison of the results in relation to the condition of testosteronemia.
Methods. Fifty-six male patients aged between 52 and 59 years old; 23/56 with full expression of SM, assignable (SM) to 3 different groups: group A n=8 (35%) with T normal (>346 ng/dL); group B n=9 (39%) with values of T at low limits (231-346 ng/dL); group C, n=6 (26%) with low values(<231 ng/dL) of T. All patients (SM) were subjected to an educational-therapeutic phase of 6 months divided into 3 intervention levels: 1) dietotherapy: -20% from the ideal daily caloric needs calculated on the base of parameters such as: age, working activity, physical activity performed; 2) physical activity: heart rate (HR) included between 40% and 60% of the HRmax; three times a week; 3) pharmacological therapy: metmorfin 1 500 mg/die and olmesartan 20 mg/die. The condition of hypoandrogenism (group C) was not pharmacologically corrected for: a) lack of suitability to the therapeutic scheme (2/6); b) presence of controindications absolute and/or relative (4/6). Revaluation in 6 months: BMI, waist measurement, serum levels of cholesterol HDL and triglicerydes, glycemia, medium arterial pressure, HOMA, Quicki, total testosteronemia.
Results. Group C (hypoandrogenism) after 6 months shows statistically significant differences (Student’s T for coupled data), down (P<0.05) relative to the following parameters (intragroup comparison): waist measurement and serum levels of triglycerides. On the contrary, it doesn’t show any significant difference regarding: BMI, serum levels of cholesterol HDL, mean arterial pressure, HOMA index (found in groups A and B) and Quicki (not found in groups A and B).
Conclusion. The condition of acquired hypoandrogenism of the adult serves as an amplifier of an already known condition of dysmetabolism. The same condition, when not properly pharmacologically corrected becomes responsible for refractoriness to the common pharmacological therapies.

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