Effect of Testosterone Therapy on Renal and Endothelial Functions in Men with Type 2 Diabetes Mellitus

Abstract

Recently, the attention of researchers is attracted to the problem of testosterone (T) deficiency in men. Its negative effect on the cardiovascular system has been established, but the data about the effect of T deficiency on the renal function in patients with type 2 diabetes mellitus (T2DM) haven’t been studied yet. Aim: Evaluate the effect of T therapy on glycemic control, the renal function and the biochemical parameters of endothelial function in men with T2DM having an androgen deficiency. Materials and Methods: The study included 80 men (mean age 51.5±6.3 years), with T2DM and T deficiency. Patients were randomized into 2 groups: the 1st-40 men receiving transdermal T (Androgel 50 mg/day) during 9 months and the 2nd group - 40 men who were not assigned to T. Patients underwent a clinical examination, analysis of biochemical parameters of carbohydrate metabolism (fasting glycemia, HbA1c), renal (creatinin, glomerular filtration rate (GFR)) and endothelial functions (p-, e-selectins, ICAM-1, VCAM-1). Statistical analysis was performed with Mann-Whitney and Wilcoxon tests using the Statistica 10 software package. Results: T therapy in men with T2DM, along with a decrease in body weight by 5.02±0.99 kg (p=0.003) and waist circumference by 6.5±1.6 sm, led to an improvement in carbohydrate metabolism - fasting glycemia by 22.2% and HbA1c by 1% (p=0.00001). At the same time, a statistically significant decrease in the creatinine concentration and an increase in the GFR by 12.5% ​​(p=0.01), as well as a decrease in the levels of endothelial dysfunction markers (ICAM-1 by 56% and p -selectin by 7.7 times (p=0.01)) were found. No significant changes in the 2nd group were found. Conclusion: T therapy in men with T2DM and androgen deficiency leads not only to a decrease of visceral obesity and an improvement in carbohydrate metabolism, but also ameliorates the renal and endothelial functions, which could reduce the rate of progression of vascular complications of diabetes. Disclosure I.A. Khripun: None. E.V. Bova: None. S.V. Vorobyev: None.