Endocrine Abstracts

Background: Men with type 2 diabetes mellitus (T2DM) have significantly lower levels of testosterone (T) than nondiabetic controls. But androgen deficit symptoms may be detected in males with normal T levels.

Aim: To analyze parameters of lipid, carbohydrate metabolism and endothelial function in diabetic males with low normal and middle-to-high normative T levels.

Patients and methods: We examined 86 men with T2DM and serum T levels higher than 12.1 nmol/l. Parameters of total T, lipid metabolism, HbA1c, biochemical markers of endothelial function – NO, endothelial NO synthase type 3 (NOS3) were analyzed. The patients were divided into two groups: 1–23 men with T levels 12.1–14.9 nmol/l, 2–63 patients with T levels ≧15.0 nmol/l. Statistic analysis was performed using Mann-Whitney U-test and Spearmen rank correlation method.

Results: The HbA1c value was 8.7% (6.7; 9.8) in 1st group and 7.7% (6.4; 9.2) in 2nd group (P>0.39), but the proportion of patients with HbA1c level>7% was higher in group 1 (71% vs 58.6%) as compared to group 2 (P=0.002). In patients with T levels lower than 15.0 nmol/l, higher levels of serum cholesterol (38.1% vs 27.6%), triglycerides (40.0% vs 24.1%) and low density lipoproteins (26.3% vs 17.2%) as compared to the 2nd group were found (P<0.01). There was a significant correlation in the T concentrations with NOS3 levels |r|=0.350 in 1st and |r|=0.266, (P<0.05) in 2nd group. Vascular endothelial dysfunction as assessed by ultrasonographic measurement of the dilatation of the brachial artery was more frequent in patients of group 1 compared to group 2 (55.6% vs 23.8%, P=0.02).

Conclusion: Males with T2DM and low-normal T level are at higher risks of dyslipidemia, endothelial dysfunction and progression of T2DM as compared to men with serum T higher than>15 nmol/l.

Acknowledgments: Supported by RSF, grant No. 14-25-00052.