Role of Serum Total Testosterone and High Sensitivity C-Reactive Protein Levels in Type 2 Diabetic Males

Abstract

Introduction: Diabetes Mellitus (DM) is a chronic metabolic disorder associated with low level of Total Testosterone (TT) and Hypogonadism. Estimation of High sensitivity C-Reactive Protein (Hs-CRP) is useful for assessing the cardiovascular risk. Aim: To estimate serum TT and Hs-CRP levels in Diabetic patients and hence, the association of Diabetes with Erectile Dysfunction (ED) and Cardiovascular risk. Materials and Methods: This was a case-control study with a case-control design, conducted at a tertiary care centre on 100 subjects,60 DM males as cases and 40 healthy male volunteers of same age, as controls, from June 2016 to May 2017. All the relevant demographic and clinical details i.e. age, height, weight, body mass index (BMI), Systolic and Diastolic Blood Pressure were noted for all subjects. All relevant tests i.e. serum TT by Electrochemiluminescence immunoassay analyser Enzyme Chemiluminescence Immunoassay (ECLIA) method, serum Hs-CRP by immunoturbidimetry method, fasting and post-prandial glucose measurements, HbA1c were all done and results were tabulated and analysed. Chi-square test was used to calculate p-value. Analysis of Variance (ANOVA) descriptive analysis was used to find out the mean, standard deviation, standard error and 95% confidence interval. Results: The mean of HbA1c among the case group was 8.185% and 5.004% among the controls. The mean value of TT among cases was 3.891 ng/dL, which was significantly reduced (p-value <0.005) as compared to healthy controls i.e. 5.339 ng/dL. Low level of TT (below 3.5 ng/dL) was seen in 45% of the cases among the diabetic study population which was statistically significant (p-value <0.0001). Seventy five percent of diabetics had erectile dysfunction. The mean value of Hs-CRP among diabetic population was 3.875 and controls were 1.457 mg/L (p-value 0.001). Based on Hs-CRP values, the subjects were sub-categorised into low, intermediate and high risk for CVD. A 31.7% of diabetics were in the intermediate group and 68.3% were in the high risk group for CVD. Conclusion: There was significant reduction in TT in Type 2 Diabetic men. Patients with low TT had increased Hs-CRP value among which 75% falling under high risk category and 25% under intermediate risk category. All the cases had serum Hs- CRP value of either intermediate or high risk category. Low level of TT was also associated with ED and PME.