• 2008 Training Grants
• Franjic
• McPherson
• Ong
• Phillips

Metabolic

Cynthia Ong

Androgen Deficiency in Obese Men

Background

Androgen deficiency (AD) is often associated with poor libido, low energy levels, depression and loss of muscle and bone mass. Interestingly it has been long observed that testosterone levels in obese men are lower than their age matched lean controls. However, current literature is unclear if this biochemical abnormality necessarily translates into true AD. If it is a true condition, most of the existing data suggests that AD is a secondary phenomenon, possibly due to hypothalamic dysfunction2However, there is also evidence that low serum testosterone concentrations predicts future development of obesity, suggesting that relative AD may be a contributing factor for the development of obesity. As AD alters body composition and contributes to a reduction in absolute and relative lean body mass, the appropriate identification of the condition in obese men may have important clinical implications and sequelae.

Hypotheses

1. Obese men are androgen deficient biochemically and clinically.
2. AD is associated with anthropometric and metabolic parameters in obese men.

Aim

1. To determine if the biochemical abnormalities in the gonadal axis of obese males represent clinically significant AD through:

   developing a robust and highly sensitive assay for serum testosterone analysis
   assessing the bioactivity of the measured testosterone
   correlating the biochemical levels and functionality of testosterone with reliable clinical measures of androgen status

2. To determine if anthropometric and metabolic parameters are correlated to AD in obese men

Goals

1. To establish a new laboratory method for reliable and reproducible measurement of testosterone since the current available assays have significant limitations.
2. To define clinical markers and associations of relative AD in obese men
3. To examine whether coding for malnutrition as a comorbidity would have an impact on changing the DRG assigned for the patient’s admission to one with a higher weight and hence, potentially increase the financial reimbursement to the PAH under casemix funding
4. To provide an algorithm for the appropriate assessment and management of AD in obese men
5. To obtain data that may direct the set up of future intervention studies