Analysis of risk factors on hypogonadism in male patients with type 2 diabetes

Objective To investigate the risk factors of hypogonadism in male type 2 diabetic patients. Methods A total of 213 male patients with type 2 diabetes were enrolled and divided into low testosterone group (n=75) and normal testosterone group (n=138). Blood pressure, blood glucose, blood lipids, serum insulin and sex hormones including total testosterone (TT), sex hormone binding globulin (SHBG), progesterone, prolactin, estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone (DHEA) were measured in all patients. The correlations between the metabolic index and sex hormone levels were analyzed. Results Compared with normal testosterone group, body mass index (BMI), fasting insulin (FINS), and homeostasis model assessment insulin resistance (HOMA-IR) levels were significantly increased in low testosterone group(all P<0.05)while LH, FSH, and SHBG levels were significantly decreased(all P<0.05). Pearson correlation analysis showed that TT was negatively correlated with FINS and HOMA-IR(r=-0.142, -0.154, both P<0.05)while positively correlated with LH and FSH (r=0.157, 0.138, both P<0.05). TT level in patients with metabolic syndrome(MS) was significantly decreased (P<0.05). A multiple logistic regression analysis revealed that BMI, MS, HOMA-IR, and LH were significant independent risk factors for hypogonadism. Conclusions Hypogonadism often occurs in male patients with type 2 diabetes, especially in patients with MS. BMI, HOMA-IR, LH, and MS are risk factors for hypogonadism in male type 2 diabetic patients. (Chin J Endocrinol Metab, 2017, 33: 556-561) Key words: Diabetes; Male; Hypogonadism; Testosterone; Insulin resistance; Luteinizing hormone