Testicular function during adolescence in boys with type 1 diabetes mellitus (T1D): absence of hypogonadism and differences in endocrine profile at the beginning and end of puberty

Rocha, Ana; Íñiguez, Germán; Godoy, Claudia; Gaete, Ximena; López, Patricia; Loreti, Nazareth; Campo, Stella; Rey, Rodolfo; Codner, Ethel

doi:10.1111/pedi.12078

Cited by 17 publications

(7 citation statements)

References 59 publications

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“…One mechanism that may explain this finding could be the higher testosterone levels present at the end of puberty in boys with T1D. Rocha et al showed that adolescents with T1D have elevated testosterone levels only at the final stages of puberty and not at the beginning of pubertal development, which agrees with the findings of our study …”

Section: Discussionsupporting

confidence: 93%

“…The fact that the final stages of puberty were observed in younger T1D than C adolescents, although they had similar ages at the initial stages of puberty, suggests that the duration of puberty may be shorter in the former group. A possible mechanism explaining the shorter duration of puberty in boys with T1D could be the higher testosterone levels observed at the final stages of puberty in T1D boys . T1D adolescents were shorter than C at the end of puberty, suggesting that they had a lower pubertal growth spurt.…”

Section: Discussionmentioning

confidence: 99%

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Earlier puberty in boys with type 1 diabetes mellitus compared to a simultaneously recruited group of control adolescents

et al. 2019

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Background: Recent studies have suggested that there is an earlier age of onset of puberty in healthy boys. However, no study has determined the age of pubertal development in boys with type 1 diabetes (T1D) and compared the results with a simultaneously recruited group of healthy children.Objective: The aim of this study was to evaluate the age of pubertal events in boys with TD1 and determine whether the duration of diabetes, metabolic control or insulin dose are associated with the age of puberty in boys with T1D.Methods: Boys aged 7 to 19 years with T1D (n = 148, age 12.9 ± 3.0 years) and healthy boys recruited from schools (n = 388 controls, age 12.8 ± 2.2 years) were studied. A pediatric endocrinologist evaluated pubertal development.Results: Boys at genital Tanner stage 2 and the final stages of puberty (genital Tanner 4 and 5)were younger than the control group (P = 0.005, P = 0.003, and P = 0.015, respectively). Both groups of boys had a similar age of pubic Tanner stage development. There were no cases of pubertal delay observed in the T1D cohort. There was no association observed between metabolic control with pubertal timing. T1D adolescents had lower height-SDS than the C group at the final stages of puberty.Conclusions: Boys with T1D who are treated with modern insulin therapy appear to have an earlier age of onset and an earlier age of final pubertal events than a simultaneously studied group of healthy children. These data suggest that pubertal delay is not a frequent problem for male T1D patients. K E Y W O R D Sadolescence, growth, height, puberty, testosterone, type 1 diabetes mellitus

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Earlier puberty in boys with type 1 diabetes mellitus compared to a simultaneously recruited group of control adolescents

et al. 2019

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“…AMH is potentially an important marker for congenital secondary hypogonadism among adults and delayed puberty in adolescents [54]. In fact, around the time of puberty, Sertoli cells mature, whereas AMH levels decline due to an increased level of intratesticular testosterone, which inhibits AMH production [55]. The relationship between insulin resistance and hypogonadism, as reflected by free testosterone levels, is shown to be bidirectional among men.…”

Section: Discussionmentioning

confidence: 99%

Anti-Müllerian Hormone Levels and Cardiometabolic Disturbances by Weight Status Among Men in the 1999 to 2004 National Health and Nutrition Examination Survey

Beydoun

Hossain

Beydoun

et al. 2019

Journal of the Endocrine Society

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Context Serum anti-Müllerian hormone level (AMH) and body mass index may be jointly associated with cardiometabolic risk. Objectives Examine the contribution of AMH to cardiometabolic disturbances by weight status among US adult men. Design Cross-sectional analysis using data from the 1999 to 2004 waves of the National Health and Nutrition Examination Survey. Setting Multistage probability sampling of the noninstitutionalized US population. Participants US men aged ≥18 years. Final analytic sample sizes ranged from 517 to 1063 participants. Main Outcome and Exposure Measures Cardiometabolic disturbances (metabolic syndrome and its components, insulin resistance, diabetes, and chronic inflammation) and AMH were obtained from trained staff and nurses in a mobile examination center or during in-home visits. Results AMH was directly associated with insulin resistance among obese men [OR 1.08 (95% CI 1.00, 1.15); P = 0.046; N = 146], whereas AMH was inversely associated with waist circumference (WC) among obese men [OR 0.95 (95% CI 0.91, 0.99); P = 0.049; N = 146]. An inverse relationship was also observed between categorical AMH and diabetes status [medium vs low AMH; OR 0.19 (95% CI 0.043, 0.84); P = 0.030; N = 145] among obese men, with a strong inverse relationship also detected among overweight men [high vs low AMH; OR 0.011 (95% CI 0.0004, 0.27); P = 0.007; N = 193]. An inverse relationship between continuous AMH and diabetes [OR 0.75 (95% CI: 0.59, 0.93); P = 0.011; N = 193] was also detected among overweight men. Conclusions AMH was associated with specific cardiometabolic risk factors, including WC, diabetes status, and insulin resistance, in overweight and obese US men.

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“…Adult and adolescent males with T1D are reported to have lower IS, independent of obesity‐status, than normal controls . Moreover, puberty is characterized by endocrine changes associated with deterioration in metabolic control and worsening IS .…”

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confidence: 99%

Testosterone concentration and insulin sensitivity in young men with type 1 and type 2 diabetes

et al. 2015

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Objective Reduced testosterone, a recognized comorbidity of reduced insulin sensitivity (IS) and type 2 diabetes (T2D), has also been reported in adult males with type 1 diabetes (T1D). However, there are limited data on how early reduced testosterone occurs, and whether it is related to the reduced IS in T1D. Leptin, a modulator of the HPG-axis, may also influence testosterone in T1D. We hypothesized that IS and leptin would be associated with total testosterone (TT), and free androgen index (FAI) in adolescent males with T1D. Methods T1D (n=35), T2D (n=13), lean (n=13) and obese (n=9) adolescent males had IS measured by hyperinsulinemic-euglycemic clamps (glucose infusion rate [GIR]), in addition to leptin, SHBG, TT, and FAI. The cohort was stratified into those with T1D (n=35) and those without (n=35). Results TT and SHBG were lower in T2D boys vs. lean controls, and GIR and leptin correlated with FAI and TT in non-T1D participants. However, despite being insulin resistant, adolescent males with T1D had normal TT and FAI, unrelated to GIR. In T1D, leptin was inversely associated with TT (p=0.005) and FAI (p=0.01), independent of puberty, HbA1c, diabetes duration, BMI z-score and GIR. Conclusion Leptin accounted for a significant proportion of the variability of testosterone in T1D. However, despite reduced IS, there was no association between IS and testosterone in T1D adolescents. These observations suggest that the mechanisms affecting testosterone may differ between adolescent males with and without T1D.

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Testicular function during adolescence in boys with type 1 diabetes mellitus (T1D): absence of hypogonadism and differences in endocrine profile at the beginning and end of puberty

Cited by 17 publications

References 59 publications

Earlier puberty in boys with type 1 diabetes mellitus compared to a simultaneously recruited group of control adolescents

Earlier puberty in boys with type 1 diabetes mellitus compared to a simultaneously recruited group of control adolescents

Anti-Müllerian Hormone Levels and Cardiometabolic Disturbances by Weight Status Among Men in the 1999 to 2004 National Health and Nutrition Examination Survey

Testosterone concentration and insulin sensitivity in young men with type 1 and type 2 diabetes

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