Associations between visceral adipose tissue, inflammation and sex steroid concentrations in men
Gautier A, Bonnet F, Dubois S, Massart C, Grosheny C, Bachelot A, Aubé C, Balkau B, Ducluzeau PH. Clin Endocrinol (Oxf). 2012 Apr 3. doi: 10.1111/j.1365-2265.2012.04401.x. [Epub ahead of print]


Département d'Endocrinologie-Diabétologie-Nutrition, CHU Rennes, Université Rennes1, Hôpital Sud, 16 boulevard de Bulgarie, 35203, Rennes, France, INSERM U991.



In men, obesity and the metabolic syndrome are accompanied by decreased testosterone levels, but little is known about the associations between visceral adipose tissue (VAT), VAT-related inflammation and sex steroids.


To examine the relative impact of VAT, abdominal subcutaneous adipose tissue (SAT) and interleukine-6 (IL-6), a marker of VAT-induced inflammation, on testosterone (T) and 17β-oestradiol (E2) levels in dysmetabolic men.


We study the NUMEVOX cohort of 229 men, 27-77 years who all had at least one metabolic syndrome criterion (on average three). IL-6, C-reactive protein, HOMA insulin resistance index (HOMA-IR), liver enzymes, E2, LH, SHBG, T, waist circumference and BMI were measured; bioavailable testosterone (BT) was calculated from T and SHBG; MRI-assessed VAT and SAT were analysed in 109 of these men.


VAT was strongly correlated with E2 (Spearman r=0.38, p<0.001) and with BT/E2 (r=-0.42, p<0.001) while SAT was not correlated with either. IL-6 was correlated with E2 (r=0.19, p=0.007), BT (r=-0.19, p=0.006) and BT/E2 (r=-0.30 p<0.001). In multivariate linear analysis, the relation between VAT and E2 was independent of age, BMI (p=0.008), leptin (p<0.001), T and SHBG. Log(IL-6) was significantly inversely related with log(BT) (p=0.032) independently of age, VAT, leptin and HOMA-IR.


E2 levels were positively associated with VAT, but not with SAT, while T and BT were negatively and independently associated with IL-6. The significant inverse association between IL-6 and T suggests an important role of low-grade visceral fat inflammation in the central hypogonadism associated with the metabolic syndrome.