JHSM

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

EndNote Style
Index
Original Article
The prevalence of hypogonadism in male patients with type 2 diabetes mellitus and clinically relevant factors
Aims: Hypogonadism has been reported at high rates in male patients with type 2 diabetes mellitus (T2DM). However, the origin of male hypogonadism in patients with T2DM is poorly known. The aim of this study was to determine the prevalence of hypogonadism and to investigate the potential impact of certain clinical and biochemical variables on hypogonadism in patients with T2DM.
Methods: The study included a total of 513 consecutive males (aged 30 - 60 years) with T2DM who presented at the endocrinology outpatient clinic. The demographic and clinical characteristics of the patients were recorded. Biochemical parameters, total testosterone (TT), gonadotrophins, prolactin, serum lipids, and hemoglobin A1c (HbA1c) were measured. Correlations between metabolic and clinical conditions and T levels were analyzed.
Results: The mean age of the study population was 45.5±12.6 years. Hypogonadism was present in 122 (23.7%) patients, of which 24 (23.3%) were determined with primary hypogonadism. Compared with participants with normal testosterone, those with hypogonadism had lower estimated glomerular filtration rate (eGFR), and the liver function test results, HbA1c and triglycerides levels, and duration of diabetes were higher. Correlation analyses showed that TT was negatively correlated with body mass index (BMI), waist circumference, age, fasting blood glucose, HbA1c, uric acid and triglycerides, and positively correlated with eGFR and high density lipoprotein cholesterol (HDL-C). Multivariate logistic regression analysis revealed that BMI, age, diabetes course, hypertrglyceridemia, hyperuricemia and eGFR <60 ml/min/1.73 m2 are independent risk factors for hypogonadism in male patients with type 2 diabetes.
Conclusion: The current study results demonstrated that the prevalence of hypogonadism is higher in men with type 2 diabetes than in the general population and age, diabetes duration, BMI, triglycerides and uric elevation are independent risk factors.


1. Boyko EJ, Magliano DJ. IDF Diabetes Atlas. 10th ed. InternationalDiabetes Federation; 2021.
2. Mushtaq S, Khan K, Abid S, Umer A, Raza T. Frequency ofhypogonadism and erectile dysfunction in type-II diabeticpatients. Cureus. 2018;10(5):e2654.
3. Kapoor D, Aldred H, Clark S, Channer KS, Jones TH. Clinicaland biochemical assessment of hypogonadism in men with type2 diabetes: correlations with bioavailable testosterone and visceraladiposity. Diabetes Care. 2007;30(4):911-917.
4. Anupam B, Shivaprasad C, Vijaya S, Sridevi A, Aiswarya Y, NikhilK. Prevalence of hypogonadism in patients with type 2 diabetesmellitus among the Indian population. Diabetes Metab Syndr.2020;14(5):1299-1304.
5. Al Hayek AA, Khader YS, Jafal S, Khawaja N, Robert AA, AjlouniK. Prevalence of low testosterone levels in men with type 2diabetes mellitus: a cross-sectional study. J Family CommunityMed. 2013;20(3):179-186.
6. Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy inmen with hypogonadism: an endocrine society clinical practiceguideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744.
7. Dandona P, Dhindsa S. Update: hypogonadotropic hypogonadismin type 2 diabetes and obesity. J Clin Endocrinol Metab.2011;96(9):2643-2651.
8. Grossmann M. Low testosterone in men with type 2diabetes: significance and treatment. J Clin Endocrinol Metab.2011;96(8):2341-2353.
9. Herrero A, Marcos M, Galindo P, Miralles JM, Corrales JJ.Clinical and biochemical correlates of male hypogonadism intype 2 diabetes. Andrology. 2018;6(1):58-63.
10. Alberti KG, Zimmet PZ. Definition, diagnosis and classificationof diabetes mellitus and its complications. part 1: diagnosis andclassification of diabetes mellitus provisional report of a WHOconsultation. Diabetic Medicine. 1998;15(7):539-553
11. The Expert Committee on the Diagnosis and classification of diabetesmellitus. report of the expert committee on the diagnosis andclassification of diabetes mellitus. Diabetes Care. 1999;22(1):5-19.
12. Agarwal PK, Singh P, Chowdhury S, et al. A study to evaluatethe prevalence of hypogonadism in Indian males with Type-2diabetes mellitus. Indian J Endocrinol Metab. 2017;21(1):64-70.
13. Costanzo PR, Knoblovits P. Male gonadal axis function in patientswith type 2 diabetes. Horm Mol Biol Clin Investig. 2016;26(2):129-134.
14. Ugwu TE, Ikem RT, Kolawole BA, Ezeani IU. Clinicopathologicassessment of hypogonadism in men with type 2 diabetes mellitus.Indian J Endocr Metab. 2016;20(5):667-673.
15. Corona G, Bianchini S, Sforza A, Vignozzi L, Maggi M.Hypogonadism as a possible link between metabolic diseases anderectile dysfunction in aging men. Hormones. 2015;14(4):569-578.
16. Shi Z, Araujo AB, Martin S, O&rsquo;Loughlin P, Wittert GA. Longitudinalchanges in testosterone over five years in community-dwellingmen. J Clin Endocrinol Metab. 2013;98(8):3289-3297.
17. Camacho EM, Huhtaniemi IT, O&rsquo;Neill TW, et al. Age-associatedchanges in hypothalamic-pituitary-testicular function in middle-aged and older men are modified by weight change and lifestylefactors: longitudinal results from the European Male AgeingStudy. Eur J Endocrinol. 2013;168(3):445-455.
18. Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR.Longitudinal effects of aging on serum total and free testosteronelevels in healthy men. Baltimore Longitudinal Study of Aging. JClin Endocrinol Metab. 2001;86(2):724-731.
19. Song, S.H. and C.A. Hardisty, Early-onset Type 2 diabetesmellitus: an increasing phenomenon of elevated cardiovascularrisk. Exp Rev Cardiovasc Ther. 2008;6(3):315- 322.
20. Zoungas S, Woodward M, Li Q, et al. ADVANCE Collaborativegroup. Impact of age, age at diagnosis and duration of diabetes onthe risk of macrovascular and microvascular complications anddeath in type 2 diabetes. Diabetologia. 2014;57(12):2465-2474.
21. Nanayakkara N, Ranasinha S, Gadowski A, et al. Age, age atdiagnosis and diabetes duration are all associated with vascularcomplications in type 2 diabetes. J Diabetes Complications.2018;32(3):279-290.
22. Dhindsa S, Prabhakar S, Sethi M, Bandyopadhyay A, ChaudhuriA, Dandona P. Frequent occurrence of hypogonadotropichypogonadism in type 2 diabetes. J Clin Endocrinol Metab. 2004;89(11):5462- 5468.
23. Haghighatpanah M, Nejad ASM, Haghighatpanah M, Thunga G,Mallayasamy S. Factors that correlate with poor glycemic controlin type 2 diabetes mellitus patients with complications. OsongPublic Health Res Perspect. 2018;9(4):167-174.
24. Khattab M, Khader YS, Al-Khawaldeh A, et al. Factors associatedwith poor glycemic control among patients with type 2 diabetes. JDiabetes Complications. 2010;24(2):84-89.
25. Tomar R, Dhindsa S, Chaudhuri A, Mohanty P, Garg R, DandonaP. Contrasting testosterone concentrations in type 1 and type 2diabetes. Diabetes Care. 2006;29(5):1120 -1122.
26. Dimopoulou C, Goulis DG, Corona G, Maggi M. Thecomplex association between metabolic syndrome and malehypogonadism. Metabolism. 2018;86:61-68. doi.org/10.1016/j.metabol.2018.03.024
27. Shulman GI. Ectopic fat in insulin resistance, dyslipidemia, andcardiometabolic disease. N Engl J Med. 2014;371(12):1131-1141.
28. Loves S, Ruinemans-Koerts J, de Boer H. Letrozole once aweek normalizes serum testosterone in obesity-related malehypogonadism. Eur J Endocrinol. 2008;158(5):741-747.
29. Gautier A, Bonnet F, Dubois S, et al. Associations between visceraladipose tissue, inflammation and sex steroid concentrations inmen. Clin Endocrinol. 2013;78(3):373-378.
30. Br&uuml;ning JC, Gautam D, Burks DJ, et al. Role of brain insulinreceptor in control of body weight and reproduction. Science.2000;289(5487):2122-2125.
31. Wittert G, Grossmann M. Obesity, type 2 diabetes, and testosteronein ageing men. Rev Endocr Metab Disord. 2022;23(6):1233-1242.
32. Langer C, Gansz B, Goepfert C, et al. Testosterone up-regulatesscavenger receptor BI and stimulates cholesterol efflux frommacrophages. Biochem Biophys Res Commun. 2002;296(5):1051-1057.
33. Hern&aacute;ndez-Mijares A, Garc&iacute;a-Malpartida K, Sol&aacute;-Izquierdo E,et al. Testosterone levels in males with type 2 diabetes and theirrelationship with cardiovascular risk factors and cardiovasculardisease. J Sex Med. 2010;7(5):1954-1964.
34. Cameron MA, Maalouf NM, Adams-Huet B, Moe OW, SakhaeeK. Urine composition in type 2 diabetes: predisposition to uricacid nephrolithiasis. J Am Soc Nephrol. 2006;17(5):1422-1428.
35. Zong J, Sun Y, Zhang Y, et al. Correlation between serum uricacid level and central body fat distribution in patients with type2 diabetes. Diabetes Metab Syndr Obes. 2020;13:2521-2531. doi:10.2147/DMSO.S260891
36. Hussain A, Latiwesh OB, Ali F, Younis MYG, Alammari JA.Effects of body mass index, glycemic control, and hypoglycemicdrugs on serum uric acid levels in type 2 diabetic patients. Cureus.2018;10(8):e3158.
Volume 7, Issue 1, 2024
Page : 53-57
_Footer