Endocrine Abstracts

Introduction: The issue of the impact of disturbances of functional status of gonads in men on the development of type 2 diabetes mellitus (T2DM) has been studied for a long time. However, the results obtained appear to be ambiguous. A number of studies conclude that blood levels of testosterone (T) in men with DM are within the normal range of fluctuations and do not play a pathogenetic role. At the same time, recent epidemiological studies demonstrate a high prevalence of low T levels in the blood of men with T2DM.

Material and methods: Androgen’s levels and functional status of hypophyseal–gonadal system has been assessed in147 men aged from 35 to 65 years with T2DM and 82 practically healthy men. Using an immunoenzymic method, blood concentrations of the following hormones were tested: FSH, LH, total testosterone (tT), free testosterone (fT), bioavailable testosterone (bT), dihydrotestosterone (DHT), and sex-steroid-binding globulin (SSBG).

Results: The average blood level of tT in study patients was significantly decreased. Marked fluctuations of hormone concentrations from 2.3 to 29.9 nmol/l were noted. An analysis of individual indices in certain patients showed a decreased hormone level (≤11.7 nmol/l) in 43.5% men with T2DM. It has been established that in 19.0% patients with T2DM tT level was below 8.0 nmol/l, and in 34.0% men was within the range 8.0–12.0 nmol/l. Blood concentration of fT was below the lower limit of normal hormone range in 59.1% of study subjects. The average level of bT was significantly decreased, as well, in 69.6% of males with T2DM (7.7±0.7 nmol/l in T2DM patients vs 13.4±1.1 nmol/l in controles, P<0.001). SSBG blood levels were decreased or within the lower limit of normal range in 2/3 T2DM male patients group: 36.3±1.3 vs 43.1±2.3 nmol/l in control group (P<0.01). No differences were observed in LH and FSH levels among both groups. Study of DHT blood concentrations in patients with T2DM suggested decreased levels irrespective of severity, compensation of metabolic disturbances, diabetes course and duration.

Conclusion: Men with type 2 diabetes mellitus are at risk group for development androgendeficasy. For the estimation of the state of the androgen supplementation its necessary to determine total and bioavailable T levels, as well.