Total Testosterone to Estradiol Ratio as a Predictor Marker of Metabolic Syndrome in Males

Nowadays, metabolic syndrome (MetS) represents a global health challenge in developed and developing countries. The sex hormones disorders in males are related to many clinical co-morbidities. This study aimed to evaluate the total testosterone (TT) to estradiol (E2) ratio as a predictor marker of MetS. This case-control study included 88 MetS patients and 88 healthy individuals (control), in the age range of 18-69 years who were selected among patients who were referring to an outpatient clinic, using a convenience sampling method. The study participants were selected based on their medical history and physical examination, which included waist circumference, blood pressure, serum E2, TT, fasting blood glucose (FBG), triglyceride (TG), and high-density lipoprotein-cholesterol (HDL-C). Diagnosis of MetS was confirmed according to the National Cholesterol Education Program Adult Treatment Panel III guidelines. The findings revealed that the mean TT level was significantly lower among patients with MetS (P<0.001), while the mean E2 level was significantly higher among patients with MetS (P<0.001). The mean TT to E2 ratio was significantly lower among patients with MetS (OR=9.6, P<0.001). There was a significant correlation between MetS components and TT to E2 ratio and waist circumference (WC) (r = - 0.49, P<0.0001). The means of weight, WC, blood pressure, and FBG levels were significantly higher in patients with MetS (P<0.001, P<0.001, P<0.001, P=0.04, respectively), and the lipid profile of patients with MetS was abnormal (TG, P<0.001, HDL-C, P<0.001). Eventually, it can be concluded that the TT to E2 ratio can be regarded as a significant predictor of MetS in males.