The occurrence of hypogonadotropic hypogonadism in Chinese men with type 2 diabetes

Clin Endocrinol (Oxf). 2022 Jun;96(6):837-846. doi: 10.1111/cen.14680. Epub 2022 Jan 29.

Abstract

Context: The previous studies showed that hypogonadotropic hypogonadism (HH) occurred commonly in men with type 2 diabetes. However, since all the cohorts tested were from American and European studies, the occurrence of HH/nongonadal illness (NGI) in Chinese populations is unclear.

Objective: The study aimed to explore the occurrence of HH/NGI in Chinese men with type 2 diabetes. Furthermore, the correlative factors and predictors of hypogonadism were investigated.

Design: We conducted a cross-sectional study of 637 Chinese men with type 2 diabetes aged 20-75 years in our clinic. The prevalence of HH/NGI was investigated by measuring serum total testosterone (TT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in the enrolled subjects. Free testosterone (FT) was calculated by using SHBG and TT levels and hypogonadism was defined as TT lower than 10.4 nmol/L and calculated FT (cFT) lower than 0.225 nmol/L. The LH cut-off value for defining HH/NGI was 9.4 mIU/ml.

Results: The results suggested that 31.9% of male Chinese type 2 diabetes patients had hypogonadism and 26.5% of subjects in our cohort were determined as HH/NGI. The occurrence of hypogonadism was markedly correlated with body mass index (BMI). There was a significant association between TT, cFT and SHBG levels with BMI. TT levels are inversely correlated with BMI and homeostasis model assessment-estimated insulin resistance (HOMA-IR) while positively related with SHBG. The cFT levels were inversely correlated with age, LH, FSH, BMI and HOMA-IR. Multiple regression analysis suggested that SHBG, BMI and HOMA-IR were significant predictors of TT and cFT.

Conclusion: Our present study offered the first evidence that the occurrence of HH/NGI in Chinese male type 2 diabetes was 26.5%. TT and cFT were significantly correlated with BMI, SHBG and HOMA-IR in Chinese men with type 2 diabetes.

Keywords: hypogonadotropic hypogonadism; insulin resistance; luteinizing hormone; testosterone; type 2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • China / epidemiology
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2* / complications
  • Follicle Stimulating Hormone
  • Humans
  • Hypogonadism*
  • Insulin Resistance*
  • Klinefelter Syndrome*
  • Luteinizing Hormone
  • Male
  • Middle Aged
  • Sex Hormone-Binding Globulin / analysis
  • Testosterone
  • Young Adult

Substances

  • Sex Hormone-Binding Globulin
  • Testosterone
  • Luteinizing Hormone
  • Follicle Stimulating Hormone