Hypogonadotropic hypogonadism in men with type 2 diabetes.
It has recently been demonstrated that > or = one-third of men with type 2 diabetes mellitus have low testosterone concentrations associated with inappropriately low luteinizing hormone and follicle-stimulating hormone concentrations. Hypogonadotropic hypogonadism in men with type 2 diabetes is associated with obesity but not duration of diabetes, elevated glycosylated hemoglobin, or the presence of microvascular complications of diabetes. Recent data show that hypogonadotropic hypogonadism is also observed frequently in nondiabetics with the metabolic syndrome or obesity, but it is not associated with type 1 diabetes. Low testosterone concentrations in men with type 2 diabetes have also been related to a higher C-reactive protein concentrations, lower hematocrit, increased total and regional adiposity, lower bone mineral density, and erectile dysfunction. This article discusses the pathophysiology of hypogonadotropic hypogonadism in men with type 2 diabetes and its signs and symptoms. Clinical trials are required to determine whether testosterone replacement therapy alleviates insulin resistance, inflammation, and symptoms related to sexual dysfunction care.
Dandona
Paresh
P
Diabetes-Endocrinology Center of Western New York, State University of New York at Buffalo, 3 Gates Circle, Buffalo, NY 14209, USA. pdandona@kaleidahealth.org
Dhindsa
Sandeep
S
Chandel
Anil
A
Chaudhuri
Ajay
A
D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D007986:Luteinizing Hormone / Q000097:blood*; D008297:Male; D015995:Prevalence; D011863:Radioimmunoassay; D012307:Risk Factors; D013739:Testosterone / Q000097:blood*; D014481:United States / Q000453:epidemiology
D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone