scholarly journals The effect of testosterone replacement therapy on adipocytokines and C-reactive protein in hypogonadal men with type 2 diabetes

2007 ◽  
Vol 156 (5) ◽  
pp. 595-602 ◽  
Author(s):  
D Kapoor ◽  
S Clarke ◽  
R Stanworth ◽  
K S Channer ◽  
T H Jones

Objective: Serum testosterone levels are known to inversely correlate with insulin sensitivity and obesity in men. Furthermore, there is evidence to suggest that testosterone replacement therapy reduces insulin resistance and visceral adiposity in type 2 diabetic men. Adipocytokines are hormones secreted by adipose tissue and contribute to insulin resistance. We examined the effects of testosterone replacement treatment on various adipocytokines and C-reactive protein (CRP) in type 2 diabetic men. Design: Double-blinded placebo-controlled crossover study in 20 hypogonadal type 2 diabetic men. Patients were treated with testosterone (sustanon 200 mg) or placebo intramuscularly every 2 weeks for 3 months in random order followed by a washout period of 1 month before the alternate treatment phase. Methods: Leptin, adiponectin, resistin, tumour necrosis factor-α (TNF-α), interleukin (IL)-6 and CRP levels were measured before and after each treatment phase. Body mass index (BMI) and waist circumference were also recorded. Results: At baseline, leptin levels significantly correlated with BMI and waist circumference. There was a significant inverse correlation between baseline IL-6 and total testosterone (r=−0.68; P=0.002) and bioavailable testosterone levels (r=−0.73; P=0.007). CRP levels also correlated significantly with total testosterone levels (r=−0.59; P=0.01). Testosterone treatment reduced leptin (−7141.9 ± 1461.8 pg/ml; P=0.0001) and adiponectin levels (−2075.8 ± 852.3 ng/ml; P=0.02). There was a significant reduction in waist circumference. No significant effects of testosterone therapy on resistin, TNF-α, IL-6 or CRP levels were observed. Conclusion: Testosterone replacement treatment decreases leptin and adiponectin levels in type 2 diabetic men. Moreover, low levels of testosterone in men are associated with pro-inflammatory profile, though testosterone treatment over 3 months had no effect on inflammatory markers.

Author(s):  
Volodymyr Pankiv ◽  
Tetyana Yuzvenko ◽  
Nazarii Kobyliak ◽  
Ivan Pankiv

Background: In men with low levels of testosterone in the blood, it is believed that the symptoms can be regarded as an association between testosterone deficiency syndrome and related comorbidities. Aim: to investigate the effectiveness of testosterone therapy in patients with type 2 diabetes (T2D) and androgen deficiency. Materials and methods: Testosterone replacement therapy was carried out in 26 men with T2D and clinically or laboratory-confirmed androgen deficiency. The age of the subjects ranged from 35 to 69 years old. Laboratory studies included determinations of the concentration of the hormones estradiol, luteinizing hormone (LH), and prostate-specific antigen (PSA). The observation period was 9 months. Results: The average level of total blood testosterone in the subjects before treatment was 9.4 mol/l and was likely lower than that of the control group (19.3 ± 1.6 nmol/l). The levels of total testosterone in the subjects ranged from 3.9 nmol/l to 10.7 nmol/l, and hormone levels measuring less than 8.0 nmol/l were observed in only 11 patients. After a course of testosterone replacement therapy, a stabilization in total testosterone levels at the level of reference values (as compared to the start of treatment) was observed in the blood of men with T2D after 9 months of observation and the administration of the fourth injection (16.83 ± 0.75 nmol/l). Conclusion: The use of long-acting injectable testosterone undecanoate leads to normalization of total testosterone levels in the blood of men with T2D and androgen deficiency, and LH levels in these patients are unlikely to change.


2012 ◽  
Vol 1 (1) ◽  
pp. 3-9
Author(s):  
SK Talukder ◽  
F Afsana ◽  
ZA Latif ◽  
F Pathan ◽  
SM Ashrafuzzaman ◽  
...  

doiAim: The aim of the study was to assess the prevalence of clinical hypogonadism in type 2 diabetic men based on clinical features and available biochemical measures. Materials and Methods: In this study carried out in a tertiary level hospital, serum concentration of total testosterone was measured in 170 type 2 diabetic (mean age 44.9±7.9 years) subjects who have erectile dysfunction or other features of hypogonadism. Results: The mean total testosterone concentration in type 2 diabetic men was 14.4±5.6 nmol/l. Fifty nine of 170 (34.7%) type 2 diabetic subjects had low serum testosterone levels (d”12 nmol/L). Luteinizing hormone (LH) and follicle stimulating hormone (FSH) concentrations in type 2 diabetic men were inappropriately low with a very high prevalence of hypogonadotropic hypogonadism. BMI and waist circumference were both negatively correlated with testosterone levels, with the association being stronger for waist circumference. HbA1C level also reveal a negative association with sexual dysfunction and hypogonadotropic hypogonadism among type 2 diabetic men. Metabolic syndrome is also associated with the low serum testosterone levels in the study subjects. Conclusions: This study reveals that serum total testosterone levels are lower in diabetic men with signs/symptoms of hypogonadism. Hypogonadotropic hypogonadism is frequent in diabetic hypogondal population. There is an association between poor glycaemic control and hypogonadism in male diabetic persons. DOI: http://dx.doi.org/10.3329/birdem.v1i1.12378 Birdem Med J 2011; 1(1): 3-9


2020 ◽  
Vol 27 (12) ◽  
pp. 1186-1191
Author(s):  
Giuseppe Grande ◽  
Domenico Milardi ◽  
Silvia Baroni ◽  
Andrea Urbani ◽  
Alfredo Pontecorvi

Male hypogonadism is “a clinical syndrome that results from failure of the testis to produce physiological concentrations of testosterone and/or a normal number of spermatozoa due to pathology at one or more levels of the hypothalamic– pituitary–testicular axis”. The diagnostic protocol of male hypogonadism includes accurate medical history, physical exam, as well as hormone assays and instrumental evaluation. Basal hormonal evaluation of serum testosterone, LH, and FSH is important in the evaluation of diseases of the hypothalamus-pituitary-testis axis. Total testosterone levels < 8 nmol/l profoundly suggest the diagnosis of hypogonadism. An inadequate androgen status is moreover possible if the total testosterone levels are 8-12 nmol/L. In this “grey zone” the diagnosis of hypogonadism is debated and the appropriateness for treating these patients with testosterone should be fostered by symptoms, although often non-specific. Up to now, no markers of androgen tissue action can be used in clinical practice. The identification of markers of androgens action might be useful in supporting diagnosis, Testosterone Replacement Treatment (TRT) and clinical follow-up. The aim of this review is to analyze the main findings of recent studies in the field of discovering putative diagnostic markers of male hypogonadism in seminal plasma by proteomic techniques. The identified proteins might represent a “molecular androtest” useful as a seminal fingerprint of male hypogonadism, for the diagnosis of patients with moderate grades of testosterone reduction and in the follow-up of testosterone replacement treatment.


2018 ◽  
Vol 13 (1) ◽  
pp. 155798831880704
Author(s):  
Moustafa A. Elsaied ◽  
Doaa Masallat ◽  
Ibrahim A. Abdel-Hamid

The aim of this study was to evaluate the levels of adiponectin in diabetic patients with and without erectile dysfunction (ED). In addition, the correlations of adiponectin with the scores of international index of erectile function (IIEF) and total testosterone levels were explored in diabetic and nondiabetic patients with ED. The study included three groups: Type 2 Diabetic patients (T2DM) with and without ED and a third nondiabetics with ED group, each of 29 patients. Fasting blood glucose (FBG), fasting insulin (FI), homeostasis model assessments of insulin resistance (HOMA-IR index), testosterone and adiponectin levels were evaluated. IIEF was applied to diabetic and nondiabetic patients with ED. The results showed that adiponectin was lower in diabetic patients with ED than in both nondiabetics with ED and diabetics without ED groups (5.23 ± 1.05 vs. 11.38 ± 10.08 and 6.5 ± 2.13; p = .003 and .006 respectively). Testosterone was lower in diabetic patients with ED than in diabetics without ED group (2.52 ± 1.15 vs. 4.1 ± 1.46; p = .024). Testosterone had a direct correlation with adiponectin ( r = .371; p = .001). Both adiponectin and testosterone levels did not correlate with IIEF. In conclusion, the decreased adiponectin and testosterone are associated with ED in T2DM. Testosterone has a direct correlation with circulating adiponectin while both have no correlation with IIEF.


2020 ◽  
Vol 7 (2) ◽  
pp. 226
Author(s):  
Satya Bhushan Nayyar ◽  
Karamvir Singh ◽  
Neha .

Background: A high incidence of hypogonadism in men with Type 2 Diabetes Mellitus has been globally reported. The present study was aimed at determining the frequency of hypogonadism in T2DM males. Screening and management of hypogonadism in Diabetic males should be done.Methods: In this case control study conducted from January 2018 to August 2019 at SGRDIMSR Sri Amritsar 100 Type 2 Diabetic males were taken as cases. 50 age matched nondiabetic males were taken as controls. Apart from BMI and waist hip ratio routine investigations, HbA1C, serum total and free testosterone levels were done. All the subjects were subjected to ADAM questionnaire to evaluate for hypogonadism.Results: Majority of subjects were in the age of 40-50 years. Mean Serum Total Testosterone levels in Study and Control Groups were 4.94±5.32 nmol/L and 6.63±4.54 nmol/L respectively (p=0.045). Mean Serum Free Testosterone levels in Study and Control Groups were 4.12±3.43 pg/ml and 6.05±3.24 pg/ml respectively (p=0.001). A statistically highly significant negative correlation was found between BMI and Serum Testosterone levels in both groups. Prevalence of hypogonadism (Total Testosterone <4.56 nmol/L) in Study and Control Groups was 73% and 58% respectively. Sensitivity and specificity of ADAM questionnaire was found to be 78.46% and 94.29 % respectively.Conclusions: Prevalence of hypogonadism among T2DM males is high. So, screening for hypogonadism should be done. ADAM questionnaire can be used as a screening tool, results must be confirmed with Serum Total Testosterone levels.


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