The occurrence of hypogonadotropic hypogonadism in Chinese men with type 2 diabetes

Abstract

Context The previous studies showed that hypogonadotropic hypogonadism (HH) occurred commonly in men with type 2 diabetes. However, since all the cohorts tested were from American and European studies, the occurrence of HH/nongonadal illness (NGI) in Chinese populations is unclear. Objective The study aimed to explore the occurrence of HH/NGI in Chinese men with type 2 diabetes. Furthermore, the correlative factors and predictors of hypogonadism were investigated. Design We conducted a cross‐sectional study of 637 Chinese men with type 2 diabetes aged 20–75 years in our clinic. The prevalence of HH/NGI was investigated by measuring serum total testosterone (TT), sex hormone‐binding globulin (SHBG), luteinizing hormone (LH) and follicle‐stimulating hormone (FSH) in the enrolled subjects. Free testosterone (FT) was calculated by using SHBG and TT levels and hypogonadism was defined as TT lower than 10.4 nmol/L and calculated FT (cFT) lower than 0.225 nmol/L. The LH cut‐off value for defining HH/NGI was 9.4 mIU/ml. Results The results suggested that 31.9% of male Chinese type 2 diabetes patients had hypogonadism and 26.5% of subjects in our cohort were determined as HH/NGI. The occurrence of hypogonadism was markedly correlated with body mass index (BMI). There was a significant association between TT, cFT and SHBG levels with BMI. TT levels are inversely correlated with BMI and homeostasis model assessment‐estimated insulin resistance (HOMA‐IR) while positively related with SHBG. The cFT levels were inversely correlated with age, LH, FSH, BMI and HOMA‐IR. Multiple regression analysis suggested that SHBG, BMI and HOMA‐IR were significant predictors of TT and cFT. Conclusion Our present study offered the first evidence that the occurrence of HH/NGI in Chinese male type 2 diabetes was 26.5%. TT and cFT were significantly correlated with BMI, SHBG and HOMA‐IR in Chinese men with type 2 diabetes.

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“…Pre-testicular mechanisms involve central as well as peripheral hypogonadism, leading to decreased serum levels of gonadotropins, including follicle-stimulating hormone (FSH) and luteinizing hormone (LH), and testosterone (T) [14,15]. Indeed, high incidence of hypogonadism has been previously reported among type 2 diabetic men [16][17][18][19]. Moreover, a large amount of pre-clinical and clinical evidence supports substantial association between DM-related metabolic derangements and reduced serum testosterone levels [20,21].…”