The negative correlation between triglyceride glucose‐body mass index and hormone levels in young and middle‐aged patients with clinical varicocoele: A cross‐sectional study

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BACKGROUND: Varicocoele may influence testosterone levels; however, their relationship remains controversial. Insulin resistance (IR) is a significant factor in metabolic disorders that may affect sex hormone levels. Triglyceride glucose-body mass index (TyG-BMI) is an important indicator of IR, but its relationship with sex hormones in patients with varicocoele and its clinical significance require further investigation. OBJECTIVE: To investigate whether different severity grades of clinically palpable varicocoeles are associated with changes in testosterone levels. This study also seeks to explore the association between TyG-BMI and sex hormones and to evaluate the effectiveness of TyG-BMI compared to other IR indicators in predicting testosterone deficiency. MATERIALS AND METHODS: This cross-sectional study included 431 patients with palpable varicocoeles. Varicocoele severity was classified based on clinical grading, color Doppler ultrasound grading, and reflux status. Additionally, TyG-BMI was categorized according to interquartile ranges, and linear regression analysis was used to examine the relationship between TyG-BMI and sex hormones, along with a subgroup analysis. Additionally, four IR indices were used to predict testosterone deficiency. RESULTS: In young and middle-aged patients with clinically palpable varicocoeles, testosterone levels did not differ significantly across varying degrees of severity. TyG-BMI significantly and negatively correlated with testosterone, inhibin B (INHB), and prolactin levels, particularly in patients with higher TyG-BMI. However, no linear relationships were found between TyG-BMI and follicle-stimulating hormone, luteinizing hormone, or estradiol levels. The linear association between TyG-BMI and testosterone levels remained significant across different levels of varicocoele severity. Additionally, TyG-BMI demonstrated a superior predictive capability for testosterone deficiency compared to other IR indices. DISCUSSION AND CONCLUSION: Varicocoele severity was not associated with variations in testosterone levels. TyG-BMI was significantly negatively correlated with testosterone and INHB levels, and this relationship suggests a factor beyond the hypothalamic-pituitary-gonadal axis.

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