Hypogonadism in males with type 2 diabetes mellitus

• Tatyana Yu. Demidova
• Skuridina Darya V.
• Aleksandr A. Kozhevnikov

Abstract

Type 2 diabetes mellitus (T2DM) and testosterone deficiency are associated with an increased health risk, primarily for the cardiovascular system. We decided to conduct a retrospective study to observe the effect of hypogonadism on the course of T2DM in 40-65 years old men, which included 50 people with T2D of at Least 3 months in a history and the absence of prepubertal and trau-matic/iatrogenic hypogonadism. Patients completed the Aging Males Symptoms (AMS) questionnaire, we measured body mass index (BMI) and waist circumference (WC), determined the concentration of total testosterone (T), sex steroid-binding protein (SSBP), luteinizing hormone (LH), total cholesterol (TH), triglycerides (TG), glycated hemoglobin (HbA_1c). The level of free testosterone (fT) was computed by the calculator from Ghent University Hospital, Belgium. The frequency of laboratory-confirmed hypogonadism is 34%. The T level and the presence of hypogonadism significantly correlated with BMI (r=-0.32 and 0.29 respectively), but not with the duration of T2DM (p>0.05). WC had a negative association with T concentration (r=-0.3, p<0.05). Androgen deficiency was diagnosed more often in obese participants than in those who was overweight or had normal body weight (0.76 vs 0.42, p=0.022). No statistically significant association was found between the HbA_1c level and the T level, fT, the frequency of hypogonadism. The sensitivity of AMS was 82.4%, specificity - 30%. The frequency of hypogonadism was not significantly different in patients who showed to conduct laboratory tests for hypogonadism (AMS≥27 points) and which is not required (AMS<27 points): 0.38 vs 0.23, p=0.34. The presence of significantly higher WC and BMI among participants with hypogonadism suggests that abdominal obesity contributes to the development of testosterone deficiency rather than the duration of type 2 diabetes or the HbA_1c level. The sensitivity and specificity of the AMS questionnaire are comparable to those for patients without T2DM (83 and 39% respectively), which makes it possible to use for screening hypogonadism in people with T2DM, although its effectiveness as a predictor of androgenic deficiency in patients with T2DM in this study was doubtful.

Keywords:type 2 diabetes, hypogonadism, testosterone deficiency, androgen deficiency, Aging Males Symptoms

References

1. Dandona P., Dhindsa S. Update: hypogonadotropic hypogonadism in type 2 diabetes and obesity. J Clin Endocrinol Metab. 2011; 96 (9): 2643-51. doi: 10.1210/jc.2010-2724

2. Chueh K.S., Huang S.P., Lee Y.C., Wang C.J., et al. The comparison of the aging male symptoms (AMS) scale and androgen deficiency in the aging male (ADAM) questionnaire to detect androgen deficiency in middle-aged men. J Androl. 2012; 33 (5): 817-23.

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