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Abstract
Purpose — to study the effect of hypoandrogenemia (HA) on the formation of metabolic syndrome (MS) components in boys with delayed puberty. Material and methods. A comprehensive study was carried out in 55 adolescents aged 14-18 years with clinical signs of delayed puberty and laboratory-confirmed
decreased testosterone levels (<12.0 nmol/l) (main group). The comparison group consisted of 44 practically healthy peers with a normal level of puberty. The sexual and physical development of boys was assessed. The levels of total testosterone (TT) and estradiol (E2), sex hormone-binding globulin (SHBG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), fasting glucose and immunoreactive insulin in serum were determined.
The ratio (T/E2), free androgen index (FAI), low-density lipoprotein cholesterol (LDL-C) and atherogenic coefficient (AC), and insulin resistance index (HOMA-IR) were calculated. Statistical analysis was performed using SPSS17.00 software. Results. In adolescents with HA, a decrease in TT level was combined with a significant decrease in the T/E2 ratio (40.35±28.02 c.u., p<0.05) and FAI (22.08±6.05 c.u., p<0.05) against the background of a decrease in the level of SHBG
(28.11±3.64 nmol/l, p <0.05). Individual analysis showed signs of insulin resistance in 23.6% of patients with HA. It was found that boys with HA had significantly higher levels of TC (4.91±0.17 nmol/l, p<0.05), TG (1.15±0.12 nmol/l, p<0.05) and LDL-C (2.65±0.19 nmol/l, p<0.05) compared with healthy peers. The presence of negative relationships between the levels of TT, SHBG with the content of TC and a positive relationship of E2 with TC, which did not depend on age and body mass index (BMI), was proved. Conclusions. Low TT levels in boys already in adolescence are associated with abnormalities in the lipid profile, which may be a predictor of MS formation. Adolescents with HA require dynamic observation and complex treatment aimed at improving the reproductive potential and preventing the progression of metabolic disorders.
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