Liu Shiyu,Cao Zhe,Yang Tongyue,et al.Study on serum free testosterone level and its relevant factors in adult male patients with type 2 diabetes mellitus[J].Journal of Chongqing Medical University,2022,47(11):1353-1358.
Liu Shiyu,Cao Zhe,Yang Tongyue,et al.Study on serum free testosterone level and its relevant factors in adult male patients with type 2 diabetes mellitus[J].Journal of Chongqing Medical University,2022,47(11):1353-1358. DOI: 10.13406/j.cnki.cyxb.003130.
Study on serum free testosterone level and its relevant factors in adult male patients with type 2 diabetes mellitus
To evaluate the level of serum free testosterone(FT) and to investigate the relevant factors of FT in male patients with type 2 diabetes mellitus(T2DM).
Methods
2
A retrospective study was conducted on 303 male patients with T2DM aged between 18-70 years and another age-matched 303 healthy individuals were selected as controls. We compared the difference of demographic and clinical indicators in different FT levels. According to the serum FT level,T2DM patients were divided into Q1 group,Q2 group
Q3 group and Q4 group by quartile method. Spearman rank correlation analysis and logistic regression analysis was conducted to analyze the revalent factors of the decrease of serum FT in T2DM patients.
Results
2
The level of serum FT in men with T2DM was significantly lower than that in control group,and decreased with age. Spearman rank correlation analysis showed that FT was negatively correlated with age(
r
=-0.402,
P
<
0.001),BMI(
r
=0.215,
P
=0.001),duration of diabetes(
r
=-0.121,
P
=0.035),and positively correlated with total cholesterol(TC)(
r
=0.115,
P
=0.049),25-(OH)D
3
(
r
=0.340,
P
<
0.001),and thyroid-stimulating hormone(TSH)(
r
=0.231,
P
=0.025). Multivariate logistic regression analysis showed that after adjustment for age,distribution,history of diabetes,smoking and alcohol consumption,high BMI(
OR
=1.101,95%CI=1.023-1.183,
P
=0.009),high HbA1c(
OR
=1.175,95%CI=1.060-1.302,
P
=0.002),low 25-(OH)D
3
(
OR
=0.937,95%CI=0.900-0.975,
P
=0.001),and low TSH(
OR
=0.838,95%CI=0.710-0.989,
P
=0.037) were closely related to low FT level.
Conclusion
2
T2DM patients have lower level of FT than healthy men and the low of serum FT level may be related to high BMI, high HbA1c,low 25-(OH) D
3
and low TSH.
关键词
Keywords
references
Dhindsa S , Ghanim H , Batra M , et al . Hypogonadotropic hypogonadism in men with diabesity [J ] . Diabetes Care , 2018 , 41 ( 7 ): 1516 - 1525 .
Zhou YX , Tian RN , Wang XN , et al . The occurrence of hypogonadotropic hypogonadism in Chinese men with type 2 diabetes [J ] . Clin Endocrinol(Oxf) , 2022 , 96 ( 6 ): 837 - 846 .
Bhasin S , Basaria S . Diagnosis and treatment of hypogonadism in men [J ] . Best Pract Res Clin Endocrinol Metab , 2011 , 25 ( 2 ): 251 - 270 .
Basaria S . Male hypogonadism [J ] . Lancet , 2014 , 383 ( 9924 ): 1250 - 1263 .
Grossmann M , Thomas MC , Panagiotopoulos S , et al . Low testosterone levels are common and associated with insulin resistance in men with diabetes [J ] . J Clin Endocrinol Metab , 2008 , 93 ( 5 ): 1834 - 1840 .
Farooq R , Bhat MH , Majid S , et al . Association between T2DM and the lowering of testosterone levels among Kashmiri males [J ] . Arch Endocrinol Metab , 2021 , 64 ( 5 ): 528 - 532 .
Zhang LY , He W , Wan JX , et al . Hypogonadism and the quality of life in male patients with type-2 diabetes mellitus [J ] . Natl J Androl , 2016 , 22 ( 12 ): 1088 - 1094 .
Zheng RD , Zhang HF , Liu KM , et al . Analysis of risk factors on hypogonadism in male patients with type 2 diabetes [J ] . Chin J Endocrinol Metab , 2017 , 33 ( 7 ): 556 - 561 .
Shigehara K , Izumi K , Kadono Y , et al . Testosterone and bone health in men:a narrative review [J ] . J Clin Med , 2021 , 10 ( 3 ): 530 .
Svartberg J , von Mühlen D , Sundsfjord J , et al . Waist circumference and testosterone levels in community dwelling men. the tromsø study [J ] . Eur J Epidemiol , 2004 , 19 ( 7 ): 657 - 663 .
Mancini M , Pecori Giraldi F , Andreassi A , et al . Obesity is strongly associated with low testosterone and reduced penis growth during development [J ] . J Clin Endocrinol Metab , 2021 , 106 ( 11 ): 3151 - 3159 .
Wei DD , Hou J , Liu X , et al . Interaction between testosterone and obesity on hypertension:a population-based cross-sectional study [J ] . Atherosclerosis , 2021 , 330 : 14 - 21 .
Mäkinen JI , Perheentupa A , Irjala K , et al . Endogenous testosterone and serum lipids in middle-aged men [J ] . Atherosclerosis , 2008 , 197 ( 2 ): 688 - 693 .
Li YM , Yao B . Influence of thyroid dysfunction on male sexual and reproductive functions and its mechanisms [J ] . Natl J Androl , 2016 , 22 ( 8 ): 741 - 745 .
Antonio L , Wu FCW , O'Neill TW , et al . Low free testosterone is associated with hypogonadal signs and symptoms in men with normal total testosterone [J ] . J Clin Endocrinol Metab , 2016 , 101 ( 7 ): 2647 - 2657 .
Rhoden EL , Ribeiro EP , Teloken C , et al . Diabetes mellitus is associated with subnormal serum levels of free testosterone in men [J ] . BJU Int , 2005 , 96 ( 6 ): 867 - 870 .
Huhtaniemi I . Late-onset hypogonadism:current concepts and controversies of pathogenesis,diagnosis and treatment [J ] . Asian J Androl , 2014 , 16 ( 2 ): 192 - 202 .
Lu YH , Li J , Cheng XL , et al . Testosterone level in aging male with different glucose tolerance state and its association with osteocalcin [J ] . Aging Male , 2019 , 22 ( 1 ): 68 - 73 .
Haffner SM , Valdez RA , Stern MP , et al . Obesity,body fat distribution and sex hormones in men [J ] . Int J Obes Relat Metab Disord , 1993 , 17 ( 11 ): 643 - 649 .
Giagulli VA , Castellana M , Murro I , et al . The role of diet and weight loss in improving secondary hypogonadism in men with obesity with or without type 2 diabetes mellitus [J ] . Nutrients , 2019 , 11 ( 12 ): 2975 .
Hill JW , Elmquist JK , Elias CF . Hypothalamic pathways linking energy balance and reproduction [J ] . Am J Physiol Endocrinol Metab , 2008 , 294 ( 5 ): E827 - E832 .
Wang NJ , Han B , Li Q , et al . Vitamin D is associated with testosterone and hypogonadism in Chinese men:results from a cross-sectional SPECT-China study [J ] . Reprod Biol Endocrinol , 2015 , 13 : 74 .
Lee DM , Tajar A , Pye SR , et al . Association of hypogonadism with vitamin D status:the European male ageing study [J ] . Eur J Endocrinol , 2012 , 166 ( 1 ): 77 - 85 .
Aboelnaga MM , Abdullah N . The correlation between 25-hydroxyvitamin D levels and testosterone levels in type 2 diabetic male patients [J ] . Endocr Metab Immune Disord Drug Targets , 2022 [ Epub ahead of print ] . DOI: 10.2174/1871530322666220524104929 http://dx.doi.org/10.2174/1871530322666220524104929 .
Hu X , Han X , Chen Y , et al . Factors defining the association between vitamin D and testosterone in males with type 2 diabetes and hypogonadism [J ] . Front Endocrinol(Lausanne) , 2022 , 13 : 842722 .
Liu Y , He YY , Wang QZ , et al . Vitamin D 3 supplementation improves testicular function in diabetic rats through peroxisome proliferator-activated receptor-γ/transforming growth factor-beta 1/nuclear factor-kappa B [J ] . J Diabetes Investig , 2019 , 10 ( 2 ): 261 - 271 .
Krassas GE , Tziomalos K , Papadopoulou F , et al . Erectile dysfunction in patients with hyper- and hypothyroidism:how common and should we treat? [J ] . J Clin Endocrinol Metab , 2008 , 93 ( 5 ): 1815 - 1819 .
Meikle AW . The interrelationships between thyroid dysfunction and hypogonadism in men and boys [J ] . Thyroid , 2004 , 14 ( Suppl 1 ): S17 - S25 .
Hamahara J , Honda H , Yamamoto K , et al . Clinical characteristics of low androgen status in males with type 2 diabetes mellitus [J ] . Acta Med Okayama , 2021 , 75 ( 1 ): 1 - 8 .
Herrero A , Marcos M , Galindo P , et al . Clinical and biochemical correlates of male hypogonadism in type 2 diabetes [J ] . Andrology , 2018 , 6 ( 1 ): 58 - 63 .