Association between testosterone, estradiol and sex hormone binding globulin levels in men with type 1 diabetes with nephropathy.
Male sex is a risk factor for development and progression of diabetic nephropathy; however, the relationship between sex hormone levels and diabetic nephropathy in type 1 diabetic men is unknown. This was a prospective follow-up study as part of the nationwide Finnish Diabetic Nephropathy (FinnDiane) Study; 297 patients were followed for 5.9+/-1.5 years. Serum total testosterone (Tt) and estradiol (Te), calculated free testosterone (cFt) and estradiol (cFe) and sex hormone binding globulin were measured at baseline and correlated with urinary albumin excretion rate, estimated glomerular filtration rate and markers of metabolic syndrome. Diabetes without renal disease was associated with decreased Tt (p<0.001), Te (p<0.001) and cFt (p=0.001) levels compared with healthy non-diabetic men. With progression of renal disease from micro- to macroalbuminuria, this decrease in serum Tt was even more pronounced. Cox regression showed that cFt and cFe were independent predictors of the progression from macroalbuminuria to end-stage renal disease. Our study shows that men with type 1 diabetes exhibit dysregulated sex hormone levels, which is most pronounced in men with progressive renal disease, suggesting that sex hormones may play a role in the pathogenesis of diabetic nephropathy associated with type 1 diabetes.
Maric
Christine
C
Department of Physiology and Biophysics, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
Forsblom
Carol
C
Thorn
Lena
L
Wadén
Johan
J
Groop
Per-Henrik
PH
D000328:Adult; D000419:Albuminuria / Q000097:blood / Q000150:complications; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications*; D003928:Diabetic Nephropathies / Q000097:blood* / Q000150:complications*; D018450:Disease Progression; D004958:Estradiol / Q000097:blood*; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications; D008297:Male; D016016:Proportional Hazards Models; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D013739:Testosterone / Q000097:blood*
D012739:Gonadal Steroid Hormones; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D004958:Estradiol