Hypogonadism and diabetes

Abstract

Clinicians have been aware of the increased prevalence of low testosterone levels in patients with type II diabetes for several years, but how these two conditions are associated is difficult to determine. Older age and obesity may be factors, as both are associated with type II diabetes and both decrease testosterone levels. Sex hormone-binding globulin (SHBG), the major serum carrier protein for testosterone, also may have an impact. SHBG levels fall with obesity and increase with aging. Some studies indicate lower SHBG levels in type II diabetes. Most of the differences in testosterone levels between diabetic and nondiabetic patients may be due to reduced SHBG, rather than reduced testosterone production. However, free testosterone levels fall with increasing age and obesity, rendering many type II diabetic patients testosterone deficient. Testosterone replacement may improve insulin sensitivity in hypogonadal, overweight men with type II diabetes by altering body composition, but studies are conflicting.

Association of hypogonadism and type II diabetes in men attending an outpatient erectile dysfunction clinic

“…All these differences were confirmed after adjustment for age (data not shown). Among diabetic patients, those with hypogonadism showed higher MHQ-D scores when compared to eugonadal patients (6 [4-8] versus 4 [2][3][4][5][6][7], respectively; Po0.005). No significant differences were observed between diabetic and nondiabetic individuals and between hypogonadal and eugonadal diabetic patients in other MHQ parameters (data not shown).…”

“…*Po0.005. [3][4][5][6][7][8] for MHQ-A and MHQ-D respectively; Po0.05). All these differences were confirmed after adjustment for age (data not shown).…”

“…2 However, the possibility that hypogonadism might contribute to DM-related sexual dysfunction has been reconsidered recently, due to a higher prevalence of a low testosterone in diabetic than in nondiabetic individuals. [3][4][5][6] Several longitudinal studies reported that a lower androgen milieu increased the risk for developing diabetes, [7][8][9][10] although 6 months of androgen supplementation in a small cohort of symptomatic hypogonadal DM type II patients did not ameliorate glycemic control. 6 Recently, it has been reported that androgen deficiency in type II diabetes is commonly associated with a gonadotropin deficiency leading to hypogonadotropic hypogonadism.…”

The ratio of insulin, sex hormones, sex hormone-binding β-globulin, parameters of lipid metabolism and glucose in the male population of the Arctic

“…Имеются данные о том, что значительное повы-шение показателей глюкозы и инсулина или их сни-жение также может приводить к ослаблению репро-дуктивных функций, вызывая изменения в содержа-нии гормонов гипоталамо-гипофизарно-гонадной системы -от секретирующих ЛГРФ гипоталамиче-ских нейронов (рилизинг-фактор лютеинизирую-щего гормона) до гонад, где осуществляются стерои-догенез и созревание половых клеток [10][11][12][13][14][15][16].…”

The Effects of Vasectomy on Epididymal Morphology and Sperm Parameters in Adult Male Balb/c mice

“…After vasectomy, epididymal epithelium function may change with time, resulting in poor sperm quality after vasovasostomy (Doiron et al, 2003). After vasectomy in adult rats, sperm content was significantly decreased in caput, corpus, and caudal segments, resulting oligozoospermia (Betancourt-Albrecht & Cunningham, 2003). Histological studies on testis after vasectomy in men and animals demonstrate a spermatogenic detention at the level of primary spermatocytes, desquamation of immature germ cells, deformity of elongated spermatids and loss of germ cells (Soudamani et al).…”