Endocrine Abstracts

Introduction: Obesity and hypogonadism (HG) are two conditions frequently observed in people with type 2 diabetes (T2D). The complex relationship between obesity and hormonal imbalances, particularly hypogonadism, remains a key area of interest in understanding the overall health profile of men with T2D.

Methods: In this cross-sectional study involving 250 men with T2D undergoing diabetes consultations, comprehensive clinical examinations were carried out, including measurements of weight, height, and waist circumference(Wc). Testosterone levels, specifically Free Testosterone (FT) and Bioavailable Testosterone (BT), were determined using the Vermeulen formula¹. Hypogonadism was defined by meeting one of the following criteria: Total Testosterone (TT) below 231 ng/dl, FT below 6.5 ng/dl, or BT below 150 ng/dl. We defined two groups: (HG) hypogonadic patient and (non-HG) for non hypogonadic patients. Antropometric indices were compared in the two groups.

Results: The median age (IQR) of men with HG was 59 years [56-64], with a prevalence of 27.2% (n=68). In comparison to the non-HG group, patients with HG had a higher average weight (84.9±14.3 vs 82.7±11.7 kg; P=0.192), as well as a higher BMI (28.3±4.5 vs 27.9±3.8; P 0.492). The mean WC was also higher in the HG group (98.3±10.3 cm vs 97.3±8.9; P 0.481), as well as android fat distribution (65.7% vs 67.0%; P 0.471). Although obesity was higher in the HG patients (35.8% vs 26.7%), this difference was not significant (P=0.162). A significant inverse correlation was found between weight and the levels of TT (r: -0.313, P<10^-3), FT (r: -0.141, P=0.030, and BT (r: -0.134, P=0.036). In a multivariate analysis, considering age, glycemic control, and inflammatory status, weight emerged as an independent risk factor for HG in men with T2D. Indeed, each kilogram of weight was associated with a 1.05 times increased risk of HG (adjusted Odds Ratio = 1.05; 95% confidence interval = [1.01-1.08]; P=0.006).

Conclusion: These findings underscore the significant role of weight as an independent risk factor for HG in men with T2D, even after adjusting for other relevant variables. Further research and interventions targeting weight control may contribute to improved hormonal health outcomes in this patient population.

References: 1. Vermeulen A, Verdonck L, Kaufman JM. A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab. 1999;84(10):3666-3672. doi:10.1210/jcem.84.10.6079