Diabetes mellitus link with hypogonadism in male patients with type 2 diabetes mellitus aged 40-50 years

Abstract

Objective Testosterone levels are frequently low in men with type 2 diabetes mellitus (DM), and the majority of these men have symptoms of hypogonadism. Obesity is associated with low testosterone levels in diabetic men. The aim of our work was to study the link between type 2 DM in men aged 40-50 years and the increased incidence of hypogonadism. Patients and methods Our study included two groups of patients: group A, which included 40 male diabetic patients (type 2) aged 40-50 years, and group B, which included 40 healthy age-matched control individuals. All patients and controls were subjected to a medical questionnaire and examination of BMI, waist-hip ratio (WHR), and laboratory investigations for evaluation of total testosterone, free testosterone, sex hormone binding globulin (SHBG), luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, and glycosylated Hb (HbA1c). Results The patient group showed a significant decrease in serum total testosterone (3.83 ± 2.18 ng/ml), free testosterone (4.15 ± 2.08 pg/ml), and SHBG (27.48 ± 10.07 nmol/l) in comparison with the control group (6.14 ± 1.37 ng/ml, 13.82 ± 5.14 pg/ml, and 62.85 ± 9.17 nmol/l, respectively), a highly significant decrease in LH and FSH (2.35 ± 1.98 mIU/ml and 4.79 ± 2.72 IU/ml, respectively, vs. 4.56 ± 1.22 mIU/ml and 6.88 ± 1.69 IU/ml in the control group), and significant increase in prolactin and HbA1c (19.014 ± 8.65 ng/ml and 6.85 ± 2.12%, respectively, vs. 6.51 ± 2.2 and 4.3 ± 1.16 in the control group). In addition, there was a significant increase in BMI (35.2 ± 3.56 kg/m 2 ) and WHR (1.02 ± 0.12) in comparison with the control group (22.22 ± 1.76 kg/m 2 and 0.8 ± 0.04, respectively). Total testosterone concentration showed a positive nonsignificant correlation with SHBG ( r = 0.076) but significant positive correlation with FSH and LH ( r = 0.672 and 0.696, respectively) and significant negative correlation with serum HbA1c, BMI, and WHR ( r = −0.324, −0.442, and −0.306, respectively) and highly significant negative correlation with prolactin ( r = −0.783) in male patients with type 2 DM. Free testosterone showed a nonsignificant negative correlation with SHBG ( r = −0.0229) and significant negative correlation with HbA1c, BMI, and WHR ( r = −0.311, −0.373, and −0.374, respectively) but a highly significant negative correlation with prolactin ( r = −0.740) and a highly significant positive correlation with FSH and LH ( r = 0.798 and 0.762) in male patients with type 2 DM. Conclusion This study demonstrates that significant number of men with type 2 DM aged between 40 and 50 years have testosterone insufficiency and symptoms of hypogonadism.