ADVERSE-EFFECTS OF PSYCHOSOCIAL STRESS ON GONADAL-FUNCTION AND INSULIN LEVELS IN MIDDLE-AGED MALES

Objectives, To investigate the relationship between gonadal function, insulin and psychosocial stress in middle-aged men, Design. A populati on-based, cross-sectional, observational study. Setting. Glostrup Hosp ital, Copenhagen, Denmark. Subjects, Pour hundred and thirty-nine male s, all aged 51 years, Main variables. Body-mass index (BMI), waist-to- hip ratio (WHR), insulin, C-peptide, free testosterone, luteinizing ho rmone (LH), lipids, fibrinogen, lung function tests (FVC, FEV(1), PEF) , blood pressure; a self-administered questionnaire with questions on psychosocial variables, lifestyle and self-rated health. Results, Free testosterone correlated inversely (P < 0.05) with weight, BMI, WHR, a nd fibrinogen, and positively with FEV(1). An independent correlation between free testosterone and insulin (P less than or equal to 0.03), but not with C-peptide, was seen after controlling for BMI and WHR, Su bjects with low levels of free testesterone, or those in the lowest qu intile of the distribution of the hypogonadal index (HI: free testoste rone/LH), showed a cluster of negative psychosocial variables, and psy chological as well as health-related problems, Furthermore, hypogonada l men had lower (P < 0.05) levels of FEV(1), peak now and FVC, but hig her (P < 0.01) levels of fibrinogen and higher pulse pressure than men with normal gonadal function. This gradient of variables, relative to HI, was not seen for possible confounders like BMI, WHR, and tobacco or alcohol consumption. Conclusion. Psychosocial stress may be associa ted with a process of premature ageing in middle-aged males, correspon ding to a hypogonadal state as well as to indirect signs of increased insulin resistance.