Incidence and Risk Factors of Hypogonadism in Male Patients With Latent Autoimmune Diabetes and Classic Type 2 Diabetes

Abstract

ObjectivesThis study aimed to compare the prevalence of hypogonadism between male patients with latent autoimmune diabetes (LADA) and type 2 diabetes (T2DM) and investigate the risk factors for hypogonadism in these patients.MethodsThis cross-sectional study evaluated 367 male patients with LADA (n=73) and T2DM (n=294) who visited the endocrinology department of Shanghai Tenth People’s Hospital between January 2016 and October 2019 for diabetes management. Sex hormones, lipid profiles, sex hormone-binding globulin (SHBG), glycosylated hemoglobin A1c, beta-cell function, uric acid, and osteocalcin were determined in serum samples. Hypogonadism was defined as calculated free testosterone (cFT) less than 220 pmol/L along with the presence of symptoms (positive ADAM score).ResultsThe rate of hypogonadism in the LADA and T2DM group were 8.2, and 21.7%, respectively (p=0.017). After adjusting possible confounders, the rate of hypogonadism in the LADA group was comparable to those of the T2DM group. Univariate logistic regressions demonstrated that age, BMI, fasting C-peptide, triglycerides, total cholesterol and uric acid were associated with hypogonadism in men with diabetes, BMI, triglycerides and estradiol were independent risk for hypogonadism in men with diabetes.ConclusionThis is the first evidence to explore the rate of hypogonadism in male patients with latent autoimmune diabetes (LADA). In the population requiring admission to a large urban hospital in China, the rate of hypogonadism was comparable to those of the T2DM group after adjusting for possible confounders. BMI, triglycerides and estradiol were independently associated with the presence of HH in male diabetic patients.

Latent autoimmune diabetes in adults in China

“…In addition, a Chinese study showed that the rate of hypogonadism in the LADA and T2D groups were 8.2%, and 21.7%, respectively (p = 0.017). After adjusting for possible confounders, the rate of hypogonadism in the LADA group was comparable to those of the T2D group ( 64 ).…”

Nồng Độ Testosterone Máu Và Một Số Yếu Tố Liên Quan Ở Nam Giới Mắc Suy Sinh Dục Đến Khám Tại Bệnh Viện Trường Đại Học Y Dược Cần Thơ

“…Tương đồng với nghiên cứu Meili Cai (2021) nồng độ testosterone trung bình ở BN nguy cơ mắc đái tháo đường là 6,1± 2,2 nmol/l, nhóm BN mắc đái tháo đường 4,0 ± 1,9 nmol/l. Thấp hơn nghiên cứu M. Huijben (2023) trên 153 BN nồng độ testosterone trung bình là 8,8 ± 3,2 mmol/l [7]. Nghiên cứu chúng tôi ghi nhận nhóm BN có mức độ rối loạn cương dương (RLCD) nặng, trung bình, nhẹ, không có nồng độ testosterone lần lượt là 7,82; 7,19; 6,23; 5,71 nmol/L, nhóm BN có nồng độ testosterone càng thấp thì mức độ RLCD càng nặng sự khác biệt chưa có ý nghĩa thống kê p< 0,05.…”

Testosterone and Glucose Homeostasis in Adult Males: Current Insights and Future Prospects

“…A body of evidence from studies in human male subjects [1][2][3] and animal models [4] suggests that low blood testosterone levels may induce insulin resistance and type 2 diabetes mellitus. Possible causality may also go in the opposite direction, since research data also indicate that hyperglycemia may lead to hypogonadism in males [5,6]. From a physiological perspective, this bidirectional relationship between testosterone insufficiency and dysglycemia is complex and largely unknown.…”