Biochemical Correlation of Sex Hormone Profile with Diabetes Mellitus Type 2 In Indian Men- A Case-Control Study
DOI:
https://doi.org/10.33086/mhsj.v7i01.3532Keywords:
Type 2 Diabetes, testosterone level, hypogonadism, dyslipidemiaAbstract
Introduction: India, the country with the highest prevalence of diabetes, has between 62,4 and 77,2 million diabetics and pre-diabetics. The purpose of this study was to investigate the biological correlation between sex hormone profile and type 2 diabetes in Indian men.
Methodology: In this case-control study, total of 181 diabetic cases and 181 healthy controls were enrolled as per WHO norms. Along with clinic-demographical data, fasting blood glucose, Postprandial blood glucose, HBA1c, insulin, lipid profile and Testosterone, LH, FSH were measured and compared.
Results: A non-significant difference was observed [p=0.7831] between different ages among the study population's case and control groups. The FPG, HbA1c, total cholesterol, LDL, triglycerides were significantly elevated in cases as compared to controls, except HDL and SHBG, showing non-significant differences. The spearman correlation between Testosterone and different parameters, and all the correlations showed a significant negative correlation. However, Testosterone Vs. Testicular Volume (ml) [r=0.2981], Testosterone Vs. HDL cholesterol(mmol/l) [r=0.04884] and Testosterone Vs. Calculated Free Testosterone (mmol/L) [r=0.007494] respectively shows significant positive correlation.
Conclusion: Type 2 Diabetes male patients had lower testosterone levels. As a biomarker for Type 2 Diabetes, it is possible to measure changes in serum testosterone levels.
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References
International Diabetes Federation. IDF Diabetes Atlas. 9th ed. Brussels: IDF; 2019.
Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research- India DIABetes (ICMR-INDIAB) study. Diabetologia. 2011;54:3022-7.
Brand JS, Wareham NJ, Dowsett M, Folkerd E, van der Schouw YT, Luben RN, et al. Associations of endogenous Testosterone and SHBG with glycated haemoglobin in middle-aged and older men. Clin Endocrinol (Oxf). 2011;74:572-8.
Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research- India Diabetes (ICMR-INDIAB) study. Diabetologia. 2011;54:3022-7.
Stellato RK, Feldman HA, Hamdy O, Horton ES, McKinlay JB. Testosterone, sex hormone-binding globulin, and the development of type 2 diabetes in middleaged men: prospective results from the Massachusetts male aging study. Diabetes Care. 2000;23:490-4.
Dhindsa S, Miller MG, McWhirter CL, Mager DE, Ghanim H, Chaudhuri A, et al. Testosterone concentrations in diabetic and nondiabetic obese men. Diabetes Care. 2010;33:1186-92.
Laaksonen DE, Niskanen L, Punnonen K, Nyyssonen K, Tuomainen TP, Salonen R, et al. Sex hormones, inflammation and the metabolic syndrome: a population-based study. Eur J Endocrinol. 2003;149:601-8.
Kapoor D, Clarke S, Channer KS, Jones TH. Erectile dysfunction is associated
with low bioactive testosterone levels and visceral adiposity in men with type 2 diabetes. Int J Androl. 2007;30:500-7.
Kapoor D, Aldred H, Clark S, Channer KS, Jones TH. Clinical and biochemical assessment of hypogonadism in men with type 2 diabetes: Correlations with bioavailable Testosterone and visceral adiposity. Diabetes Care. 2007;30:911-7.
Dhindsa S, Miller MG, McWhirter CL, Mager DE, Ghanim H, Chaudhuri A, et al. Testosterone concentrations in diabetic and nondiabetic obese men. Diabetes Care. 2010;33:1186-92.
Kapoor D, Goodwin E, Channer KS, Jones TH. Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes. Eur J Endocrinol. 2006;154:899-906.
Lee CH, Kuo SW, Hung YJ, Hsieh CH, He CT, Yang TC, et al. The effect of testosterone supplement on insulin sensitivity, glucose effectiveness, and acute insulin response after glucose load in male type 2 diabetics. Endocr Res. 2005;31:139-48.
Basu R, Dalla Man C, Campioni M, Basu A, Nair KS, Jensen MD, et al. Effect of 2 years of testosterone replacement on insulin secretion, insulin action, glucose effectiveness, hepatic insulin clearance, and postprandial glucose turnover in elderly men. Diabetes Care. 2007;30:1972-8.
Ezekiel Musa et al. Clinical and biochemical correlates of hypogonadism in men with type 2 diabetes mellitus. Pan African Medical Journal. 2021;38(292). 10.11604/pamj.2021.38.292.25719
Asare-Anane H, Ofori E, Yeboah F, Tagoe E, Bani S, Bawah A et al. Primary hypogonadism in Ghanaian men with type 2 diabetes mellitus. IJSTR. 2013;2(5): 310-5.
Onung S, Young E, Ugwu T, Fasanmade O. Hypogonadism in Nigerian men with type 2 diabetes mellitus. Int J Diabetes Dev Ctries. 2017;37(3): 254-61.
Paruk IM, Pirie FJ, Nkwanyana NM, Motala AA. Prevalence of low serum testosterone levels among men with type 2 diabetes mellitus attending two outpatient diabetes clinics in KwaZulu-Natal Province, South Africa. S Afr Med J. 2019 Nov 27;109(12): 963-970.
Ding EL, Song Y, Malik VS, Liu S. Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta-analysis. Jama. 2006 Mar 15;295(11): 1288-99.
Corona G, Monami M, Rastrelli G, Aversa A, Sforza A, Lenzi A et al. Type 2 diabetes mellitus and testosterone: A meta-analysis study. Int J Androl. 2011 Dec;34(6 Pt 1): 528-40.
Lakshman KM, Bhasin S, Araujo AB. Sex hormone-binding globulin as an independent predictor of incident type 2 diabetes mellitus in men. J Gerontol A Biol Sci Med Sci. 2010 May;65(5): 503-9.
Farooq R, Bhat MH, Majid S, Mir MM. Association between T2DM and the lowering of testosterone levels among Kashmiri males. Archives of endocrinology and metabolism. 2020 Aug 28;64:528-32.
Ogbera OA, Sonny C, Olufemi F, Wale A. Hypogonadism and subnormal total testosterone levels in men with type 2 diabetes mellitus. J Coll Physicians Surg Pak. 2011 Sep;21(9): 517-21.
Kapoor D, Aldred H, Clark S, Channer KS, Jones TH. Clinical and biochemical assessment of hypogonadism in men with type 2 diabetes: correlations with bioavailable Testosterone and visceral adiposity. Diabetes care. 2007 Apr;30(4): 911-7.
Mirzaei MR, Amini M, Aminorroaya A. The prevalence of hypogonadism in diabetic men in Isfahan Endocrine and Metabolism Research Center, Isfahan, Iran. J Res Med Sci. 2012 Jul;17(7): 602-6.
Wickramatilake CM, Mohideen MR, Pathirana C. Association of serum testosterone with lipid abnormalities in patients with angiographically proven coronary artery disease. Indian J Endocrinol Metab. 2013 Nov;17(6): 1061-5.
Hackett GI, Cole NS, Deshpande AA, Popple MD, Kennedy D, Wilkinson P. Biochemical hypogonadism in men with type 2 diabetes in primary care practice. Br J Diabetes Vasc Dis. 2009;9(5): 226-31.
Alhayek AA, Khader YS, Jafal S, Khawaja N, Ajlouni K. Hypogonadism among Jordanian men with type 2 diabetes: Prevalence and associated factor. Int J Diabetes Mellit. 2015;3(1): 31-6.
Phillips GB, Jing T, Heymsfield SB. Relationships in men of sex hormones, insulin, adiposity, and risk factors for myocardial infarction. Metabolism. 2003 Jun;52(6): 784-90.
Zheng R, Cao L, Cao W, Chu X, Hu Y, Zhang H et al. Risk Factors for Hypogonadism in Male Patients with Type 2 Diabetes. J Diabetes Res. 2016;2016: 5162167.
Laaksonen DE, Niskanen L, Punnonen K, Nyyssonen K, Tuomainen TP, Salonen R et al. Sex hormones, inflammation and the metabolic syndrome: a population-based study. Eur J Endocrinol. 2003 Dec;149(6): 601-8.
Musa E, El-Bashir JM, Sani-Bello F, Bakari AG. Hypergonadotropic hypogonadism in Nigerian men with type 2 diabetes mellitus. Clin Diabetol. 2021;10(1):
Tripathy D, Dhindsa S, Garg R, Khaishagi A, Syed T, Dandona P. Hypogonadotropic hypogonadism in erectile dysfunction associated with type 2 diabetes mellitus: a common defect? Metab Syndr Relat Disord. 2003 Mar;1(1): 75-80.
Kemp T, Rheeder P. The prevalence and association of low testosterone levels in a South African male, diabetic, urban population. JEMDSA. 2015;20(2): 92-7.
Diaz-Arjonilla M, Schwarcz M, Swerdloff RS, Wang C. Obesity, low testosterone levels and erectile dysfunction. Int J Impot Res. Mar-Apr 2009;21(2): 89-98.
Chang TC, Tung CC, Hsiao YL. Hormonal changes in elderly men with non-insulin-dependent diabetes mellitus and the hormonal relationships to abdominal adiposity. Gerontology. 1994;40(5): 260-7.
Wang C, Jackson G, Jones TH, Matsumoto AM, Nehra A, Perelman MA et al. Low testosterone associated with obesity and the metabolic syndrome contributes to sexual dysfunction and cardiovascular disease risk in men with type 2 diabetes. Diabetes care. 2011 Jul;34(7): 1669-75.
Morley JE, Charlton E, Patrick P, Kaiser FE, Cadeau P, McCready D et al. Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism. 2000 Sep;49(9): 1239-42.
Mahmoud AM, Goemaere S, El-Garem Y, Van Pottelbergh I, Comhaire FH, Kaufman JM. Testicular volume in relation to hormonal indices of gonadal function in community-dwelling elderly men. J Clin Endocrinol Metab. 2003 Jan;88(1): 179-84.
Travison TG, Araujo AB, Kupelian V, O'Donnell AB, McKinlay JB. The relative contributions of aging, health, and lifestyle factors to serum testosterone decline in men. J Clin Endocrinol Metab. 2007 Feb;92(2): 549-55.
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