Low Total Testosterone Levels in Men with Newly Diagnosed Early-Onset Type 2 Diabetes: A Cross-Sectional Study in China

Abstract

Objective. There is a bidirectional interaction between circulating testosterone and blood glucose levels. We aim to investigate the testosterone levels in men with early-onset type 2 diabetes (T2DM). Methods. A total of 153 drug naive men with T2DM were enrolled in the study. Early- ( $n=63$ ) and late-onset ( $n=90$ ) T2DM was classified according to age 40 years old. Clinical characteristics and plasma for biochemical criterions were collected. Gonadal hormones were measured using chemiluminescent immunometric assay. The concentrations of 3β- and 17β-HSD were determined using ELISA. Results. Compared with men with late-onset T2DM, those with early-onset T2DM had lower serum total testosterone (TT), sex hormone-binding globulin (SHBG), and FSH, but higher dehydroepiandrosterone sulfate (DHEA-S) level ( $p<0.05$ ). The mediating effect analysis showed that the decreased TT levels in patients with early-onset T2DM were associated with the higher HbA1c, BMI, and triglyceride in these patients (both $p<0.05$ ). The early-onset of T2DM directly correlated with increased DHEA-S (both $p<0.01$ ). The 3β-HSD concentration in the early-onset T2DM group was lower than that in the late-onset T2DM group ( $11.07\pm 3.05$ vs. $12.40\pm 2.72$  pg/mL, $p=0.048$ ) and was positively correlated with fasting C-peptide, while negatively correlated with HbA1c and fasting glucagon ( $p$ all < 0.05). Conclusions. Patients with early-onset T2DM showed inhibition of conversion from DHEA to testosterone, which may attribute to the low level of 3β-HSD and high blood glucose in these patients.