Metabolic Syndrome Common In Obese Men

Heli J. Roy  |  10/29/2005 12:53:49 AM

News You Can Use For November 2005

Obese and inactive men in their 40s and 50s often have a condition called metabolic syndrome, which is a set of six symptoms that occur together.

LSU AgCenter nutritionist Dr. Heli Roy lists the symptoms:

• Abdominal obesity (excessive fat tissue in and around the abdomen).

• High blood lipids – high triglycerides (fatty acids), low HDL (the "good" cholesterol) and high LDL (the "bad" cholesterol) – that foster plaque buildups in artery walls.

• Elevated blood pressure.

• Insulin resistance or glucose intolerance (the body can’t properly use insulin or blood sugar).

• Prothrombotic (elevated clotting) state (high fibrinogen or plasminogen activator inhibitor-1 in the blood)

• Proinflammatory (acute inflammation) state (elevated C-reactive protein in the blood)

Roy says there may also be hormonal imbalances that contribute to the metabolic syndrome. Testosterone levels decrease in men on average about 1 percent a year after age 25, and dehydroepiandrosterone (DHEA) decreases about 2.3 percent a year.

Metabolic syndrome, on the other hand, increases from about 6.7 percent from ages 20-29 to about 60 percent age 60 and older.

Pennington Biomedical Research Center scientist Dr. Claude Bouchard and researchers from other institutions measured androgen (male sex hormone) levels in men to see if there was a relationship between increased incidence of the metabolic syndrome and androgen levels.

The study included 130 healthy men ages 20 to 71. The subjects were assessed for DHEA and testosterone levels. Assessments were also done on body composition and abdominal fat.

A glucose tolerance test was done to see how well the men were able to use sugars.

The subjects were considered to be overweight on average with a body mass index (BMI) of 26.8 kg/m2. Thirty-one subjects had more than three features of the metabolic syndrome.

DHEA and testosterone were negatively associated with body fat, waist circumference and visceral adipose tissue. When testosterone levels decreased over time, body fat, waist circumference and visceral adipose (fatty) tissue increased significantly.

Testosterone levels were correlated with metabolic variables. When testosterone decreased over time, blood pressure, blood glucose and insulin levels, c-peptide and blood lipids increased.

When the men were divided into tertiles (groups of three) based on testosterone and DHEA levels, those that had the highest level of testosterone and DHEA had the lowest incidence of metabolic syndrome (8.9 percent versus 44.2 percent in the lowest tertile).

Roy says the study confirms that testosterone levels appear to be associated with the metabolic syndrome independent of age. Testosterone levels are strongly associated with cardiovascular risk factors, and low testosterone levels are related to altered cardiovascular risk profile.

Whether androgen supplementation should be considered for men with low testosterone levels and presence of features of the metabolic syndrome is yet to be determined, according to Roy.

The American Heart Association and the National Heart, Lung and Blood Institute recommend that the metabolic syndrome be identified as the presence of three or more of these components:

• Elevated waist circumference: men – equal to or greater than 40 inches (102 cm); women – equal to or greater than 35 inches (88 cm).

• Elevated triglycerides: equal to or greater than 150 mg/dL (deciliter).

• Reduced HDL ("good") cholesterol: men – less than 40 mg/dL; women – less than 50 mg/dL.

• Elevated blood pressure: equal to or greater than 130/85 mm Hg (mercury level).

• Elevated fasting glucose: equal to or greater than 100 mg/dL.

To prevent and modify risk factors for the metabolic syndrome, Roy recommends certain lifestyle modifications:

• Weight loss to achieve a desirable weight (BMI less than 25 kg/m2).

• Increased physical activity, with a goal of at least 30 minutes of moderate-intensity activity on most days of the week.

• Healthy food habits that include reduced intake of saturated fat, trans fat and cholesterol.

For information on related nutrition, family and consumer topics, click on the Family and Home link at the LSU AgCenter Web site at www.lsuagcenter.com. For local information and educational programs, contact an extension agent in your parish LSU AgCenter office.

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On the Internet: LSU AgCenter: http://www.lsuagcenter.com/

Source: Heli Roy (225) 578-3329, or HRoy@agcenter.lsu.edu

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