Influence of Testosterone Replacement Therapy on Metabolic Disorders in Male Patient with Type 2 Diabetes Mellitus and Androgen Deficiency
DOI:
https://doi.org/10.3889/oamjms.2014.107Keywords:
Free testosterone, HbA1c, Lipid Profile, BMI, LeptinAbstract
INTRODUCTION: Multiple epidemiological studies have shown that low testosterone levels are associated with and predict the future development of T2DM.
AIM: The aim of study was to show the influence of testosterone replacement therapy on anthropometric characteristics, glycosylated hemoglobinlevel level, blood pressure and dyslipidemia in patients with T2DM and Androgen deficiency.
MATERIALS AND METHODS: From 125 male patients with T2DM were randomized 85 subjects with age 49.8 ± 6.74 and BMI from 35.83 ± 3.65 kg/m2 in placebo-controlled study. We divided patients into two groups: 1) Treatment group, where was used testosterone replacement therapy. 2) Placebo group, where was used placebo. In both groups was added Life style modification, but Antidiabetic therapy was unchanged.
RESULTS: After six months of treatment we repeated the diagnostic assessments: lipid profile was improved in both groups but in group I it was statistically significant. Free testosterone level increased in all groups but in group I it was statistically significant. HbA1c decreased in both group but in group I we had the best result. Blood pressure was reduced in both groups, results were similar.
CONCLUSION: Our study demonstrated that it is possible to regulate blood pressure, lipid profile, HbA1c, BMI - by raising testosterone in diabetic men with androgen deficiency.Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Ogden CL, Yanovski SZ, Carroll MD, Flegal KM. The epidemiology of obesity. Gastroenterology. 2007; 132: 2087–2102. DOI: https://doi.org/10.1053/j.gastro.2007.03.052
Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004; 27: 1047–1053. DOI: https://doi.org/10.2337/diacare.27.5.1047
Alberti KG, Zimmet P, Shaw J. IDF Epidemiology Task Force Consensus Group. The metabolic syndrome – a new worldwide definition. Lancet. 2005; 366: 1059–1062. DOI: https://doi.org/10.1016/S0140-6736(05)67402-8
Wang C, Jackson G, Jones TH, Matsumoto AM, Nehra A, Perelman MA, Swerdloff RS, Traish A, Zitzmann M, Cunningham G. Low testosterone associated with obesity and the metabolic syndrome contributes to sexual dysfunction and cardiovascular disease risk in men with type 2 diabetes. Diabetes Care. 2011;34(7):1669-75. DOI: https://doi.org/10.2337/dc10-2339
Oh JY, Barrett CE, Wedick NM, Wingard DL. Endogenous sex hormones and the development of type 2 diabetes in older men and women: the Rancho Bernardo Study. Diabetes Care. 2002; 25: 55-60. DOI: https://doi.org/10.2337/diacare.25.1.55
Kapoor D, Malkin CJ, Channer KS, Jones TH. Androgens, insulin resistance and vascular disease in men. Clin Endocrinol. 2005; 63: 239-250. DOI: https://doi.org/10.1111/j.1365-2265.2005.02299.x
Simon D, Charles MA, Nahoul K, Orssaud G, Kremski J, Hully V, Joubert E, Papoz L, Eschwege E. Association between plasma total testosterone and car diovascular risk factors in healthy adult men: The Tele com Study. J Clin Endocrinol Metab. 1997; 82: 682–685. DOI: https://doi.org/10.1210/jcem.82.2.3766
Haffner SM, Karhapaa P, Mykkanen L, Laakso M. Insulin resistance, body fat distribution and sex hormones in men. Diabetes. 1994; 43: 12–19. DOI: https://doi.org/10.2337/diabetes.43.2.212
Stellato RK, Feldman HA, Hamdy O, Horton ES, McKinlay JB. Testosterone, sex hormone-binding globlin, and the development of type 2 diabetes in middle-aged men. Diabetes Care. 2004; 23: 490–494. DOI: https://doi.org/10.2337/diacare.23.4.490
Keating NL, O’Malley AJ, Smith MR. Diabetes and cardiovascular disease during androgen depriva tion therapy for prostate cancer. J Clin Oncol. 2006; 24: 4448–4456. DOI: https://doi.org/10.1200/JCO.2006.06.2497
Jackson FL, Hutson JC. Altered responses to androgen in diabetic male rats. Diabetes. 2004; 33: 819–824. DOI: https://doi.org/10.2337/diabetes.33.9.819
Dhindsa S, Prabhakar S, Sethi M, Bandyopadhyay A, Chaudhuri A, Dandona P. Frequent occurrence of hypogonadotropic hypogonadism in type 2 diabetes. J Clin Endocrinol Metab. 2004; 89:5462–5468.
Woodhouse LJ, Gupta N, Bhasin M, Singh AB, Ross R, Phillips J, Bhasin S. Dose-dependent effects of testosterone on regional adipose tissue distribution in healthy young men. J Clin Endocrinol Metab. 2004; 89: 718–726. DOI: https://doi.org/10.1210/jc.2003-031492
Pitteloud N, Mootha VK, Dwyer AA, Hardin M, Lee H, Eriksson KF, Tripathy D, Yialamas M, Groop L, Elahi D, Hayes FJ. Relationship between testosterone levels, insulin sensitivity, and mitochondrial function in men. Diabetes Care. 2005; 28:1636–1642. DOI: https://doi.org/10.2337/diacare.28.7.1636
Wu FC, Tajar A, Beynon JM, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med. 2010; 363:123–135 DOI: https://doi.org/10.1056/NEJMoa0911101
Kapoor D, AldredH, Clark S, Channer KS, Jones TH. Clinical and biochemical assessment of hypogonadism in men with type 2 diabetes. correlations with bioavailable testosterone and visceral adiposity. Diabetes Care. 2007; 30:911–917.
Kapoor D, Clarke S, Channer KS, Jones TH. Erectile dysfunction is associated with low bioactive testosterone levels and visceral adiposity in men with type 2 diabetes. Int J Androl. 2007; 30:500–507. DOI: https://doi.org/10.1111/j.1365-2605.2007.00744.x
Corona G, Mannucci E, Petrone L, et al.:Association of hypogonadism and type II diabetes in men attending an outpatient erectile dysfunction clinic. Int J Impot Res. 2006; 18:190–197. DOI: https://doi.org/10.1038/sj.ijir.3901391
Grossmann M, Gianatti EJ, Zajac JD. Testosterone and type 2 diabetes. Current Opinion in Endocrinology, Diabetes and Obesity. 2010; 17(3): 247-256. DOI: https://doi.org/10.1097/MED.0b013e32833919cf
Ding EL, Song Y, Malik VS, Liu S. Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta-analysis. JAMA. 2006; 295:1288–1299. DOI: https://doi.org/10.1001/jama.295.11.1288
Corona G, Monami M, Rastrelli G, Aversa A, Sforza A, Lenzi A, Forti G, Mannucci E, Maggi M. Type 2 diabetes mellitus and testosterone: a meta-analysis study. Int J Androl. 2011;34(6 Pt 1):528-40. DOI: https://doi.org/10.1111/j.1365-2605.2010.01117.x
Selvin E, Feinleib M, Zhang L, Rohrmann S, Rifai N, Nelson WG, Dobs A, Basaria S, Golden SH, Platz EA. Androgens and diabetes in men: results from the Third National Health and Nutrition Examination Survey (NHANESIII). Diabetes Care. 2007; 30:234-238. DOI: https://doi.org/10.2337/dc06-1579
Brand JS, Wareham NJ, Dowsett M, Folkerd E, van der Schouw YT, Luben RN, Khaw KT. Associations of endogenous testosterone and SHBG with glycated haemoglobin in middle-aged and older men. Clin Endocrinol (Oxf). 2011;74(5):572-8. DOI: https://doi.org/10.1111/j.1365-2265.2010.03951.x
Grossmann M, Thomas MC, Panagiotopoulos S, Sharpe K, Macisaac RJ, Clarke S, Zajac JD, Jerums G. Low testosterone levels are common and associated with insulin resistance in men with diabetes. J Clin Endocrinol Metab. 2008; 93:1834–1840. DOI: https://doi.org/10.1210/jc.2007-2177
Kapoor D, Aldred H, Clark S, Channer KS, JonesTH. Clinical and biochemical assessment of hypogonadism in men with type 2 diabetes: correlations with bioavailable testosterone and visceral adiposity. Diabetes Care. 2007; 30:911–917. DOI: https://doi.org/10.2337/dc06-1426
Dhindsa S, Prabhakar S, SethiM,Bandyopadhyay A, Chaudhuri A, Dandona P. Frequent occurrence of hypogonadotropic hypogonadism in type 2 diabetes. J Clin Endocrinol Metab. 2004; 89:5462–5468. DOI: https://doi.org/10.1210/jc.2004-0804
Wang C, Cunningham G, Dobs A, et al. Long-term testosterone gel (AndroGel) treatment maintains beneficial effects on sexual function and mood, lean and fat mass, and bone mineral density in hypogonadal men. J Clin Endocrinol Metab. 2004; 89:2085–2098. DOI: https://doi.org/10.1210/jc.2003-032006
Whitsel EA, Boyko EJ, Matsumoto AM, Anawalt BD, Siscovick DS. Intramuscular testosterone esters and plasma lipids in hypogonadal men: a meta-analysis. Am J Med. 2001; 111: 261-269. DOI: https://doi.org/10.1016/S0002-9343(01)00833-6
Simon D, Preziosi P, Barrett-Connor E, Roger M, Sait-21. Brignardello E, Beltramo E, Molinatti PA, Aragno M, Paul M, Nahoul K, Papoz L. The influence of ageing on plasma sex hormones in men. The Telecom Study. Am J Epidemiol. 1992; 135: 783–791. DOI: https://doi.org/10.1093/oxfordjournals.aje.a116365
Laaksonen DE, Niskanen L, Punnonen K et al. Testosterone and sex hormone binding globulin predict the metabolic syndrome and diabetes in middle-aged men. Diabetes Care. 2004; 27: 1036–41. DOI: https://doi.org/10.2337/diacare.27.5.1036
Marin P, Holmang S, Gustafsson C, Jonsson L, Kvist H, Elander A, et al. Androgen treatment of abdominally obese men. Obes Res. 1993; 1(4):245-51. DOI: https://doi.org/10.1002/j.1550-8528.1993.tb00618.x
Yassin AA, Saad F. Improvement of sexual function in men with late-onset hypogonadism treated with testosterone only. J Sex Med. 2007; 4(2):497-501. DOI: https://doi.org/10.1111/j.1743-6109.2007.00442.x
Isidori AM, Caprio M, Strollo F, Moretti C, Frajese G, Isidori A & Fabbri A. Leptin and androgens in male obesity: evidence for leptin contribution to reduced androgen levels. Journal of Clinical Endocrinology and Metabolism. 1999; 84: 3673–3680. DOI: https://doi.org/10.1210/jcem.84.10.6082
Asatiani K, Giorgadze E, Tsagareli M, Zerekidze T, Janjgava Sh. Androgen deficiency and insulin resistance in obese male patients. Diabetes, Obesity and Metabolism. 2010;47-48.
Downloads
Published
How to Cite
Issue
Section
License
http://creativecommons.org/licenses/by-nc/4.0
