MON-717 The Impact of Obesity on Testosterone Deficiency and Cardiometabolic Health: A NHANES-Based Analysis

Abstract Disclosure: F. Ahmed: None. A. Fayyaz: None. K. Aman: None. M. Hashim: None. H. Zahid: None. I. Nayyab: None. M. Abid: None. S. Haider: None. N. Gohar: None. A. Sohail: None. R. Ali: None. H. Ahmad: None. R. Haider: None. A. Ullah: None. H. Abid: None. T. Mirza: None. S. Eltawansy: None. M. Bakr: None. Introduction: Obesity is a key risk factor for testosterone deficiency, metabolic dysfunction, and cardiovascular disease. This study explores the link between obesity severity, testosterone, SHBG, and cardiometabolic health using NHANES data. Methods: A total of 1,895 men were categorized based on BMI: normal weight (n=514), overweight (n=720), Grade I obesity (n=394, BMI 30.7-33.1), Grade II obesity (n=134, BMI 35.7-37.58), and Grade III obesity (n=104, BMI 41.68-48.12). An additional 29 underweight men (BMI ≤18.1) were included for reference. Testosterone, SHBG, lipid profiles, blood pressure, and fasting glucose were analyzed. Statistical significance was set at p < 0.05. Results: Age varied significantly across BMI groups (p < 0.001), with the youngest in the underweight category (median 29.00 years, IQR 23.00-50.00) and the oldest in the overweight group (median 53.00 years, IQR 37.00-66.00), while Mexican Americans were overrepresented in Grade I obesity (20.3%) compared to normal weight (8.2%). Cardiometabolic profiles worsened with increasing BMI; systolic blood pressure was highest in Grade III obesity (129.00 mmHg, IQR 117.83-135.33) versus normal weight (120.00 mmHg, IQR 111.33-130.67; p < 0.001). Triglyceride levels were significantly elevated in Grade II obesity (124.50 mg/dL, IQR 84.00-185.00) compared to normal weight (76.50 mg/dL, IQR 53.00-111.00; p < 0.001). HDL cholesterol was lowest in Grade III obesity (41.00 mg/dL, IQR 35.00-48.00) compared to normal weight (55.00 mg/dL, IQR 46.00-66.00; p < 0.001), while LDL cholesterol was highest in Grade III obesity (115.50 mg/dL, IQR 92.00-133.00; p = 0.005). Fasting glucose was highest in Grade III obesity (110.00 mg/dL, IQR 99.00-127.25) versus normal weight (99.00 mg/dL, IQR 93.00-107.00; p < 0.001). Testosterone levels showed a stepwise decline with increasing BMI, with Grade III obesity having the lowest median testosterone (278.00 ng/mL, IQR 213.50-399.50), reflecting a 58% reduction compared to normal weight (530.50 ng/mL, IQR 421.50-674.75; p < 0.001), with intermediate values in Grade I obesity (386.00 ng/mL) and Grade II obesity (328.00 ng/mL). SHBG levels also decreased with BMI, with the lowest levels in Grade III obesity (31.38 nmol/L, IQR 19.93-44.95) compared to normal weight (49.96 nmol/L, IQR 34.85-67.72; p < 0.001), highlighting a strong correlation between increasing obesity, testosterone deficiency, and SHBG suppression. Conclusions: Severe obesity is linked to lower testosterone and SHBG levels, likely due to increased aromatization, insulin resistance, and chronic inflammation. Given the metabolic and cardiovascular risks, early hormonal screening and weight management are crucial. Long-term studies are needed to assess obesity’s impact on endocrine function. Presentation: Monday, July 14, 2025