Influence of androgenic deficiency and the disbalance of the immune system on the formation of hydrochair exchanger disorders in men with obesity

• Dzantieva E.O.
• Gusova Z.R.
• Irina A. Khripun
• Sergey V. Vorobyev

Abstract

Androgen deficiency is actively discussed as one of the main pathogenetic factors in the formation of violations of carbohydrate metabolism in men, as well as the role of disorders of the adaptive immunity in the pathogenesis of metabolic diseases and their vascular complications

Objective. To assess the effect of androgen deficiency and imbalance of the immune system on the formation of violations of carbohydrate metabolism in obese men.

Materials and metods. There were examine 120 men with obesity aged 29-66 years, who consider them­selves healthy, were examined. Patients are divided into two groups: the first consisted of 56 people with a normal level of total testosterone (T), the second - 64 people with a total T level of less than 12.1 mmol/l. In each of the main groups, subgroups are distinguished depending on the state of carbohydrate metabolism: 1a subgroup - obese patients without carbohydrate metabolism disorder, 1b subgroup - with obesity and car­bohydrate metabolism disorder, 2a subgroup - with obesity and androgen deficiency and 2b subgroup - with obesity , carbohydrate metabolism disorder and androgen deficiency. The key indicators of carbohydrate, lipid, purine metabolism, and the level of sex hormones were studied. The main characteristics of adaptive immunity (CD3⁺, СD4⁺, СD8⁺, СDl6⁺, СD25⁺) and the level of secretion of pro-inflammatory cytokines TNFa and IL-6 were evaluated. The control group consisted of 25 healthy men with normal body weight.

Results. Analysis of the metabolic and immune status of obese patients revealed an increase in total cholesterol, triglycerides, ALT, an increase in the insulin resistance marker HOMA-IR, a decrease in the level of 25-OH vitamin D, an increase in CRP, and a decrease in СD4⁺-lymphocytes, cytotoxic СDl6⁺-lymphocytes in comparison with the control group. At the same time, the greatest changes were detected in a subgroup of patients with a deficiency of testosterone and carbohydrate metabolism disorder. In addition, these patients showed a marked imbalance in the content of the main pro-inflammatory cytokines TNFa and IL-6.

Conclusion. Visceral obesity in men is a factor of high risk of metabolic disorders and androgen deficiency in men. The current androgen deficiency leads to the formation of more severe metabolic and immunological changes in obese patients. Nonspecific systemic inflammation, activation of the cytotoxic link of immunity, hyperproduction of proinflammatory cytokines can be considered as a modifying factor of the progression of the initial carbohydrate metabolism disorder before the development of the manifest form of type 2 diabetes.

Keywords:obesity, testosterone, type 2 diabetes, testosterone deficiency, pro-inflammatory cytokines, TNFa, IL-6

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