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Objectives: To investigate the relationship between sex hormones and metabolic syndrome (MS) in an Asian population. Methods: A cross-sectional study was conducted in 237 men aged 20-88 years (mean age 52 years). Serum lipids, glucose, insulin, total testosterone (TT), estradiol (E2), sex hormone-binding globulin (SHBG), and dehydroepiandosterone sulfate (DHEA-S) were measured along with body height, weight, waist circumference, and blood pressure. Free testosterone (FT) and bioavailable testosterone (BT) were calculated. Correlations were determined using univariate and multivariate regression analyses. Results: Men with MS had lower levels of TT, BT, FT, SHBG and DHEA-S than men without MS. Multivariate analysis, after adjusting for age and smoking status, indicated that TT (OR: 0.909, 95% CI: 0.836-0.988, p == 0.003) and SHBG (OR: 0.948, 95% CI: 0.913-0.985, p == 0.006) were significantly associated with MS ( R2 == 0.314). TT was associated with waist circumference ( p == 0.008) and abnormal triglycerides level ( p == 0.006); SHBG was associated with blood pressure ( p == 0.003), blood glucose ( p == 0.043) and abnormal triglycerides ( p == 0.048). A significant trend was observed between decreasing levels of TT, BT, FT, and SHBG and increasing numbers of MS components. Conclusion: Results show that serum testosterone and SHBG levels inversely correlate with MS in an Asian population applying the Asian MS definition. [ABSTRACT FROM AUTHOR]