Cardiometabolic indices predict hypogonadism in male patients with type 2 diabetes

J Endocrinol Invest. 2023 Mar;46(3):599-608. doi: 10.1007/s40618-022-01941-0. Epub 2022 Oct 25.

Abstract

Purpose: To evaluate in men with type 2 diabetes the association of cardiometabolic indices [Visceral Adiposity Index (VAI), Triglyceride Glucose Index (TyG), and lipid accumulation product (LAP)] with total testosterone (TT) levels, and their predictive cut-off values in identifying hypogonadism.

Methods: 265 consecutive men aged 40-70 years with type 2 diabetes performed an andrological evaluation; metabolic parameters and TT were determined. Receiver operating characteristic (ROC) curves were used to identify cut-off values of cardiometabolic indices in predicting low testosterone (TT < 12 nmol/l).

Results: VAI, TyG, and LAP were negatively associated with TT levels. The prevalence of hypogonadism in men in the fourth quartiles of VAI, TyG, and LAP was ~ 70.0-75.0% compared to ~ 10.0-17.0% in men in the first quartiles (p < 0.001). The sensitivity and specificity of the three cardiometabolic indices in predicting TT < 12 nmol/l were significantly higher concerning BMI, waist circumference, lipid profile and HbA1c. Cut off values of VAI ≥ 3.985, TyG ≥ 4.925, and LAP ≥ 51.645 predict hypogonadism with good sensitivity and specificity.

Conclusion: This is the first study evaluating the association of VAI, TyG, and LAP with hypogonadism in men with type 2 diabetes. Alterations in these indices should direct the patients to andrological evaluation.

Keywords: Male hypogonadism; Metabolic syndrome; Testosterone; Type 2 diabetes.

MeSH terms

  • Adiposity
  • Body Mass Index
  • Cardiovascular Diseases* / complications
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / epidemiology
  • Glucose
  • Humans
  • Hypogonadism* / diagnosis
  • Hypogonadism* / epidemiology
  • Hypogonadism* / etiology
  • Male
  • Obesity, Abdominal / complications
  • Testosterone
  • Triglycerides / metabolism
  • Waist Circumference

Substances

  • Glucose
  • Triglycerides
  • Testosterone