Endocrine Abstracts

Relevance

Androgenic deficiency is an important pathogenetic element in the development of metabolic syndrome and cardiovascular diseases in men. It has been proven that in male patients with type 2 diabetes, hypogonadism develops much more often.

Objective

To study the features of the course of type 2 diabetes mellitus (T2DM) in men with androgen deficiency. Research objectives: 1. To estimate the incidence of hypogonadism in men 35–65 years old with type 2 diabetes. 2. To compare the incidence of non-fatal myocardial infarction and history of stroke in the group of patients with T2DM and hypogonadism with the group of patients with T2DM without hypogonadism. 3. To study the spectrum of late complications of T2DM in these groups. 4. Compare the parameters of carbohydrate and lipid metabolism, the degree of insulin resistance in these groups.

Materials and methods of the research

The study included 84 men with type 2 diabetes. To diagnose hypogonadism, the levels of total testosterone (T), sex hormone binding globulin (SHBG), albumin and luteinizing hormone (LH) were measured. Free testosterone (free T) levels were calculated using a calculator from Ghent University Hospital, Belgium. 43 patients underwent a retrospective analysis of case histories (spectrum of late complications, the presence of heart attacks and strokes, laboratory data – total cholesterol (CS), triglycerides (TG), fasting blood plasma glucose, basal insulin level, glycated hemoglobin (HbA1c)). The HOMA-IR index was used to determine the degree of insulin resistance.

Research results

The average age of men was 56.21 ± 6.26 years. The incidence of laboratory-confirmed hypogonadism is 42.9%. An average positive correlation was found between androgen deficiency and the incidence of non-fatal cardiovascular events (r = 0.45 P < 0.05). There was no statistically significant relationship between the presence of hypogonadism and the incidence and degree of late complications of T2DM. Patients with low T levels tended to have higher HOMA-IR values ​​compared to patients with normal T levels (P < 0.05). At the same time, the indicators of carbohydrate and lipid metabolism did not differ significantly in these groups (P > 0.05).

Conclusions

The revealed incidence of hypogonadism in men with T2DM corresponds to the data of international studies. The presence of a significant correlation between low testosterone levels and cardiovascular events in patients with T2DM suggests that hypogonadism can be used as an additional criterion for cardiovascular risk. Testosterone deficiency exacerbates insulin resistance, which can lead to weight gain and impair carbohydrate metabolism.