Prevalence of Hypogonadism in Patients with Type 2 Diabetes Mellitus in an Asian Indian Study Group

Ganesh, Hosahithlu K; Sarathi, Vijaya; George, Joe; Shivane, Vyankatesh; Bandgar, Tushar; Menon, P. S. N.; Shah, Nalini

doi:10.4158/ep09035.orr

Cited by 35 publications

(43 citation statements)

References 22 publications

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“…Some studies reported decline with age while other deny this association. 8,17,32 A longer duration of DM not correlated with TT levels nor MHG prevalence as this result is inconsistent with other research. 8 while in agreement with other studies.…”

Section: Discussioncontrasting

confidence: 55%

“…8 while in agreement with other studies. 17,33 Different patients selection and study design may be responsible for this contrast.…”

Section: Discussionmentioning

confidence: 99%

“…28 By contrast these results are inconsistent with other study found nonsignificant association between microvascular complication and testosterone levels. 29 But up to our Knowledge it's the first study correlate the MHG with degree of albuminuria in type 2 DM. Microalbuminuria is a renal marker of generalized vascular endothelial damage and early atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and predictors for low total testosterone levels among male type 2 diabetic patients: an Egyptian experience

Aboelnaga

Elshahawy

2016

Int J Res Med Sci

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INTRODUCTIONDiabetes mellitus (DM) affects an estimated 285 million people worldwide. This number is expected to reach 438 million by the year 2030.1 On the other hand, Male hypogonadism (MHG) is a clinical syndrome that results from failure to produce physiological concentrations of testosterone. 2MHG is significantly associated with various comorbidities reduced libido, erectile dysfunction, increased adiposity, low energy and fatigue.3 Muscle weakness and low bone mass, Depression, anxiety loss of libido, and erectile dysfunction and decreased quality, abnormal lipid profile, CVS pathophysiologic change. [4][5][6][7] The association between low serum testosterone (LST) and diabetes (DM) has recently received substantial attention; studies have reported that male patients with ABSTRACT Background: Diabetes mellitus (DM) affects an estimated 285 million people worldwide. This number is expected to reach 438 million by the year 2030. The aim of this study was to determine the prevalence of male hypogonadism among Egyptian patients with type 2 diabetes and to identify the risk factors may be associated with low serum testosterone concentrations in men with type 2 diabetes. Methods: 140 male patients with type 2 diabetes were recruited in this cross-sectional study. This study WAS conducted from January 2012 to January 2016 in the endocrinology and metabolism unit, Mansoura University, Egypt. Results: We found 48 (34.2%) patients with hypogonadism (defined as TT ≤300 ng/dl) among 140 male patients with type 2 diabetes. 7 out of 48 (14.5%) patients with TT ≤300 ng/dl had high abnormal gondotrophins hormones levels while 41 patients out of 48 (85.5%) had normal gondotrophins hormones levels. We found BMI, WC, Hba1c, UACR, retinopathy ratio, nephropathy ratio, smoker ratio and patient on insulin therapy ratio were increased in the low TT group with statistically significance, but non statistically significant difference in age, diabetic duration, FSH, LH, Prolactin and lipid profile. In this study by using Pearson correlation, we found a statistically significant correlation between TT levels with BMI, WC, FSH, LH, Hba1c, and UACR (P value<0.05). Also by using stepwise multiple regression analysis, we found BMI, WC, LH, Hba1c, and UACR were statistically significant predictors of TT levels. In logistic regression analysis, we found Hba1c, UACR, and WC were statistically significant risk factors for MHG. Conclusions: Visceral obesity, higher Hba1c, and degree of albuminuria are independent risk factors for hypogonadism in Egyptian male patients with type 2 diabetes.

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Section: Discussioncontrasting

confidence: 55%

“…8 while in agreement with other studies. 17,33 Different patients selection and study design may be responsible for this contrast.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prevalence and predictors for low total testosterone levels among male type 2 diabetic patients: an Egyptian experience

Aboelnaga

Elshahawy

2016

Int J Res Med Sci

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“…[26] This study was the first study to determine the prevalence of hypogonadism in Indian population. This was done in one center and quoted a prevalence of 15% of hypogonadal patients.…”

Section: Discussionmentioning

confidence: 99%

A study to evaluate the prevalence of hypogonadism in Indian males with Type-2 diabetes mellitus

Agarwal

Singh

Chowdhury

et al. 2017

Indian J Endocr Metab

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Background:A high prevalence of hypogonadism in men with Type-2 diabetes mellitus (T2DM) has been reported worldwide.Objectives:To evaluate the prevalence of hypogonadism in Indian males with T2DM and assess the primary and secondary hypogonadism along with androgen deficiency.Materials and Methods:In this cross-sectional study, 900 men with T2DM were evaluated using androgen deficiency in aging male questionnaire. They were screened for demographic characteristics, gonadal hormone levels, lipid profile, and glycosylated hemoglobin.Results:The prevalence of hypogonadism in T2DM patients was found to be 20.7% (186 out of 900). Hypogonadism was of testicular origin (primary) in 48/186 (25.8%) patients, of pituitary or hypothalamic origin (secondary) in 14/186 (7.53%), and remaining 124/186 (66.67%) patients were found to have low testosterone with the inappropriate normal level of luteinizing hormone and Follicle-stimulating hormone. 451/900 (50.1%) patients were only symptomatic but had normal testosterone levels. Further 263 patients out 900 were asymptomatic, of which 51/900 (5.7%) patients had low levels of testosterone and 212/900 (23.5%) patients had normal testosterone level without symptoms. There were no deaths or other serious adverse events except mild pyrexia which was not related to the study.Conclusion:Hypogonadism diagnosis, at times, might not be validated with the help of androgen deficiency questionnaire or symptoms only. Given the large number of patients of T2DM in India, the incidence of hypogonadism is more in diabetic patients as compared to the general population. Hence, implementation of screening programs in diabetic patients is necessary to understand and detect individuals with low serum total testosterone at any early stage and to supplement testosterone accordingly.

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“…Попытки использовать заместительную андроген-ную терапию препаратами тестостерона у мужчин с СД и метаболическим синдромом обусловлены высокой распространенностью гипогонадизма при этих заболева-ниях [6][7][8][9]. В исследовании Mirzaei M.R.…”

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Aspects of androgen replacement therapy for the treatment of hypogonadism in men with diabetes and metabolic syndrome.

Викторович¹,

Николаевна²

2015

Obes. metabol.

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11 1'2015 О б з о р ы л и т е р а т у р ы А ндрогенная заместительная терапия проводится в случаях выявления у мужчин гипогонадизма -клинико-лабораторного синдрома, обуслов-ленного снижением секреции тестостерона яичками. Применение этой терапии во многих случаях является необходимым, так как развитие гипогонадизма у мужчин приводит к половой дисфункции, что значительно сни-жает качество жизни. Эффективность препаратов тесто-стерона в отношении гипогонадизма и обусловленных им нарушений мужской половой функции доказана в боль-шом числе исследований и сомнений не вызывает [1]. При этом существуют данные о высокой эффективно-сти этой терапии и в отношении устранения основных компонентов метаболического синдрома, в том числе ожирения и инсулинорезистентности, лежащей в основе развития сахарного диабета (СД) [2][3][4][5].Попытки использовать заместительную андроген-ную терапию препаратами тестостерона у мужчин с СД и метаболическим синдромом обусловлены высокой распространенностью гипогонадизма при этих заболева-ниях [6-9]. В исследовании Mirzaei M.R. и соавт. (2012), включившем 247 мужчин с СД 2 типа (СД2), распростра-ненность гипогонадизма оценивалась по уровню биодо-ступного тестостерона и составила 61,6% [7]. В другом, более крупном исследовании, включившем 1089 мужчин с СД2, низкий уровень тестостерона был выявлен у 36,5% пациентов [8]. В исследовании Dhindsa S. и соавт. (2010) у 1849 мужчин (1451 без СД и 398 с СД2) был определен уровень свободного тестостерона. Распространенность случаев выявления уровня свободного тестостерона в субнормальных (пограничных) значениях у худых муж-чин, с избыточным весом, и у мужчин с ожирением без СД составила 26% (n=275), 29% (n=687) и 40% (n=489) соответственно (p<0,001), а в аналогичных группах муж-чин, но с СД -4% (n=36), 44% (n=135) и 50% (n=227) соответственно (р<0,05). Средняя концентрация свобод-ного тестостерона у мужчин с диабетом была значительно ниже, чем у мужчин без диабета [9].При этом мета-анализ 26 исследований (проведенных в период с 1990 по 2007 гг.) продемонстрировал наличие связи между низким уровнем тестостерона у мужчин и развитием СД2. Основные результаты включенных The article presents the results of studies of efficacy and safety of androgen therapy for hypogonadism, metabolic syndrome and type 2 diabetes mellitus in men. In the study was used testosterone undecanoate therapy which causes reduction of obesity, a decrease in the severity of the other components of the metabolic syndrome, improving glycemic profile without significant side effects. Nevertheless, this therapy requires monitoring and management for risk factors.

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Prevalence of Hypogonadism in Patients with Type 2 Diabetes Mellitus in an Asian Indian Study Group

Cited by 35 publications

References 22 publications

Prevalence and predictors for low total testosterone levels among male type 2 diabetic patients: an Egyptian experience

Prevalence and predictors for low total testosterone levels among male type 2 diabetic patients: an Egyptian experience

A study to evaluate the prevalence of hypogonadism in Indian males with Type-2 diabetes mellitus

Aspects of androgen replacement therapy for the treatment of hypogonadism in men with diabetes and metabolic syndrome.

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