title: Testicular function during adolescence in boys with type 1 diabetes mellitus (T1D): absence of hypogonadism and differences in endocrine profile at the beginning and end of puberty.
abstract: OBJECTIVE
  Conflicting results regarding testicular function in adults with type 1 diabetes (T1D) have been reported, but little is known about Leydig and Sertoli cell function during puberty in boys treated with multiple daily insulin doses. Our aim was to assess testicular function in boys with T1D.
  
  
  METHODS
  Pubertal boys with T1D (n = 71) and healthy control boys (Control group; n = 104) who were 10-18 years were studied. Both groups were matched by pubertal stage, age, and BMI. Total testosterone (TT), calculated free testosterone (cfT), SHBG, inhibin B, AMH, and gonadotropin levels were determined.
  
  
  RESULTS
  At the beginning of puberty, the T1D group had higher levels of SHBG (p = 0.003) and similar androgen levels than the Control group. At the end of puberty, higher TT, and cfT were observed in T1D compared to the Control group (p < 0.01 and p < 0.001, respectively). Gonadotropins and AMH were similar in both groups. Regression analysis showed that T1D was a significant factor, even after adjusting for Tanner stage and BMI-SDS, affecting TT, cFT, and SHBG levels. BMI-SDS was a significant factor affecting TT and SHBG levels. Higher HbA1c had a negative effect on total testosterone and cFT and a positive effect on SHBG levels in T1D boys.
  
  
  CONCLUSIONS
  Adolescents with T1D do not exhibit hypogonadism, as shown by normal gonadotropin, testosterone, inhibin B, and AMH levels. However, in T1D boys, HbA1c and BMI-SDS had a negative association with testosterone levels. Elevated testosterone levels are observed during late puberty, which were not present earlier.
authors.affiliation: Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile.
authors.forename: Ana
authors.initials: A
authors.lastname: Rocha
authors.forename: German
authors.initials: G
authors.lastname: Iñiguez
authors.forename: Claudia
authors.initials: C
authors.lastname: Godoy
authors.forename: Ximena
authors.initials: X
authors.lastname: Gaete
authors.forename: Patricia
authors.initials: P
authors.lastname: López
authors.forename: Nazareth
authors.initials: N
authors.lastname: Loreti
authors.forename: Stella
authors.initials: S
authors.lastname: Campo
authors.forename: Rodolfo A
authors.initials: RA
authors.lastname: Rey
authors.forename: Ethel
authors.initials: E
authors.lastname: Codner
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002677:Chile; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D004702:Endocrine Glands / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology*; D004700:Endocrine System Diseases / Q000139:chemically induced / Q000150:complications* / Q000517:prevention & control; D006442:Glycated Hemoglobin / Q000032:analysis; D006779:Hospitals, Public; D006786:Hospitals, Urban; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007006:Hypogonadism / Q000139:chemically induced / Q000150:complications* / Q000517:prevention & control; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008954:Models, Biological; D011627:Puberty / Q000187:drug effects; D012044:Regression Analysis; D013737:Testis / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology*; D013739:Testosterone / Q000032:analysis / Q000378:metabolism
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D013739:Testosterone; C517652:hemoglobin A1c protein, human
keywords: complication; diabetes mellitus type 1; puberty; testes; testosterone