LBODP054 Hypogonadism in Diabetes Mellitus: Insulin Resistance, The Connecting Link?

Abstract

Abstract Background Hypogonadism is commonly found in men with type 2 diabetes mellitus (T2DM) and insulin resistance may play a role in its pathogenesis. There is an inverse relationship between testosterone and insulin resistance. This relationship is often confounded by effects of obesity, metabolic syndrome, sex hormone binding globulin (SHBG), treatment protocols and complication status of diabetes. Objective To determine the prevalence of hypogonadism in T2DM men and to evaluate the association between hypogonadism and clinical, biochemical parameters of diabetes. To look for an independent association between hypogonadism and insulin resistance. Methods This was a cross sectional study of 353 consecutive men aged 20 to 70 years with T2DM. Hypogonadism was defined on the symptoms as defined in the androgen deficiency in aging male questionnaire (ADAM) along with low calculated testosterone levels (calculated by Vermeulen's equation taking total testosterone, albumin and SHBG). Insulin resistance was measured by homeostasis model assessment for insulin resistance [HOMA-IR] and Quantitative insulin sensitivity check index [QUICKI]. Results The prevalence of hypogonadism in our cohort was 17%. We found a significant correlation between calculated free testosterone and BMI (r=-0.149, p value =0. 005), HbA1c (r = -0.145, p value = 0. 006), Triglycerides (r= -0.217, p value =<0. 001), HOMA IR (r=-0.207, p value =<0. 001), QUIKI (r=0.148, p value=0. 005). On applying multiple linear regression, HOMA IR was significantly inversely correlated with calculated free testosterone levels independent of age, duration of diabetes, BMI and glycaemic status of diabetes. Similarly, total testosterone was significantly associated with insulin resistance independent of age, BMI, SHBG, complication status and other potential confounding variables. There was no statistically significant association between hypogonadism and diabetes complications. Conclusions Hypogonadism is a common finding in T2DM men. Hypogonadism is significantly associated with insulin resistance even after adjusting for age, BMI, duration of diabetes, diabetic complications, treatment regimens and other potentially confounding variables. Presentation: No date and time listed