Endocrine Abstracts

Introduction: The interplay between type 2 diabetes (T2D), male hypogonadism (HG), and inflammation has emerged as a fascinating area of medical research. Understanding the complex relationship among these factors is crucial for advancing our knowledge.

Methods: The study focused on 250 adult male patients with T2D recruited from outpatient clinics at the National Institute of Nutrition and Food Technology. A thorough assessment of gonadal hormones, including Sex Hormone-Binding Globulin and albumin, was conducted to calculate Free Testosterone (FT) and Bioavailable Testosterone (BT) using the Vermeulen formula [1]. Diagnostic criteria for HG included specific thresholds: Total Testosterone (TT) below 231 ng/dl, FT below 6.5 ng/dl, or BT below 150 ng/dl. Additionally, various inflammatory markers, such as CRP, IL6, and TNF-alpha, were assessed for all patients.

Results: Mean levels of TT, FT, and BT were 438.8±172.1 ng/dl, 8.8±2.8 ng/dl, and 194.7±60.4 ng/dl, respectively. Median values (IQR) for inflammatory markers CRP, IL6, and TNF-alpha were 1.7 (0.9-3.3) mg/l, 2.5 (1.7-6.9) and 1.8 (1.0-2.5), respectively. A significant inverse correlation was found between TT and CRP (r= -0.192; P= 0.010), as well as FT (r= -0.165; P= 0.031). However, no such association was observed with BT (P= 0.056). The prevalence of HG was 27.2% (n=68), and variations in inflammatory marker levels based on gonadal status were not statistically significant. Comparison between HG vs non-HG groups revealed median (IQR) CRP values of (2.00 mg/l vs 1.46; P= 0.238); IL6 values of (2.73 pg/mL vs 2.38; P= 0.491) and TNF-alpha values of (1.78 pg/mL vs 1.78; P= 0.665).

Conclusion: In conclusion, this study sheds light on the intricate relationship between DT2, male HG, and inflammation. While significant correlations were observed between testosterone levels and CRP, further research is needed to unravel the complexities of this association. Understanding these dynamics is essential for developing targeted therapeutic strategies and improving the overall care of individuals with both DT2 and male HG.

Reference: 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