The prevalence of hypogonadism in male patients with type 2 diabetes mellitus and clinically relevant factors

Abstract

Aims: Hypogonadism has been reported at high rates in male patients with type 2 diabetes mellitus (T2DM). However, the origin of male hypogonadism in patients with T2DM is poorly known. The aim of this study was to determine the prevalence of hypogonadism and to investigate the potential impact of certain clinical and biochemical variables on hypogonadism in patients with T2DM. Methods: The study included a total of 513 consecutive males (aged 30 - 60 years) with T2DM who presented at the endocrinology outpatient clinic. The demographic and clinical characteristics of the patients were recorded. Biochemical parameters, total testosterone (TT), gonadotrophins, prolactin, serum lipids, and hemoglobin A1c (HbA1c) were measured. Correlations between metabolic and clinical conditions and T levels were analyzed. Results: The mean age of the study population was 45.5±12.6 years. Hypogonadism was present in 122 (23.7%) patients, of which 24 (23.3%) were determined with primary hypogonadism. Compared with participants with normal testosterone, those with hypogonadism had lower estimated glomerular filtration rate (eGFR), and the liver function test results, HbA1c and triglycerides levels, and duration of diabetes were higher. Correlation analyses showed that TT was negatively correlated with body mass index (BMI), waist circumference, age, fasting blood glucose, HbA1c, uric acid and triglycerides, and positively correlated with eGFR and high density lipoprotein cholesterol (HDL-C). Multivariate logistic regression analysis revealed that BMI, age, diabetes course, hypertrglyceridemia, hyperuricemia and eGFR <60 ml/min/1.73 m2 are independent risk factors for hypogonadism in male patients with type 2 diabetes. Conclusion: The current study results demonstrated that the prevalence of hypogonadism is higher in men with type 2 diabetes than in the general population and age, diabetes duration, BMI, triglycerides and uric elevation are independent risk factors.