title: Prevalence of subnormal testosterone concentrations in men with type 2 diabetes and chronic kidney disease.
abstract: BACKGROUND
  One-third of men with type 2 diabetes have subnormal testosterone concentrations along with inappropriately normal LH and FSH concentrations. It is not known if the presence of renal insufficiency affects free testosterone concentrations in men with type 2 diabetes.
  
  
  OBJECTIVE
  We hypothesized that type 2 diabetic men with chronic renal disease (CKD; estimated glomerular filtration rate (eGFR) < 60 ml/min per 1.73 m(2)) have lower free testosterone concentrations than men with normal renal function (eGFR ≥ 60 ml/min per 1.73 m(2)).
  
  
  METHODS
  This is a retrospective chart review of patients attending diabetes and nephrology clinics. Men with type 2 diabetes who had the following information available were included in the study: testosterone (total and free) done by LC/MS-MS followed by equilibrium dialysis, sex hormone binding globulin, LH, FSH and prolactin concentrations.
  
  
  METHODS
  We present data on T and gonadotropin concentrations in 111 men with type 2 diabetes and CKD (stages 3-5) and 182 type 2 diabetic men without CKD.
  
  
  RESULTS
  The prevalence of subnormal free testosterone concentrations was higher in men with type 2 diabetes and CKD as compared to those without CKD (66% vs 37%, P < 0.001). Men with CKD had a higher prevalence of hypergonadotropic hypogonadism (26% vs 5%, P < 0.001) but not of hypogonadotropic hypogonadism (HH; 40% vs 32%, P = 0.22). There was an increase in the prevalence of hypergonadotropic hypogonadism with decreasing eGFR. Fifty-two percent of men with renal failure (CKD stage 5) had hypergonadotropic hypogonadism and 25% had HH. In men with CKD, the hemoglobin concentrations were lower in those with subnormal free T concentrations as compared to men with normal free T concentrations (119 ± 19 vs 128 ± 19 g/l, P = 0.04).
  
  
  CONCLUSIONS
  Two-thirds of men with type 2 diabetes and CKD have subnormal free T concentrations. The hypogonadism associated with CKD is predominantly hypergonadotropic.
authors.affiliation: Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA sandeep.dhindsa@ttuhsc.edu.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Dhindsa
authors.affiliation: Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA.
authors.forename: Anand
authors.initials: A
authors.lastname: Reddy
authors.affiliation: Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA.
authors.forename: Jyotheen Sukhmoy
authors.initials: JS
authors.lastname: Karam
authors.affiliation: Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA.
authors.forename: Sayeeda
authors.initials: S
authors.lastname: Bilkis
authors.affiliation: Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA.
authors.forename: Archana
authors.initials: A
authors.lastname: Chaurasia
authors.affiliation: Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA.
authors.forename: Aditya
authors.initials: A
authors.lastname: Mehta
authors.affiliation: Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA.
authors.forename: Keerthi P
authors.initials: KP
authors.lastname: Raja
authors.affiliation: Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA.
authors.forename: Manav
authors.initials: M
authors.lastname: Batra
authors.affiliation: Department of MedicineDivision of Endocrinology and Metabolism, Texas Tech University Health Sciences Center, Permian Basin Campus, 701 W 5th Street, Odessa, 79763 Texas, USAPermian Basin Kidney CenterOdessa, Texas, USANephrology AssociatesMurfreesboro, Tennessee, USADepartment of MedicineDivision of Endocrinology and Metabolism and the Diabetes and Endocrinology Center of Western New York, State University of New York at Buffalo, Buffalo, New York, USA.
authors.forename: Paresh
authors.initials: P
authors.lastname: Dandona
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002853:Chromatography, Liquid; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005640:Follicle Stimulating Hormone / Q000097:blood; D005919:Glomerular Filtration Rate; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000453:epidemiology*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011388:Prolactin / Q000097:blood; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000378:metabolism; D012189:Retrospective Studies; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D053719:Tandem Mass Spectrometry; D013739:Testosterone / Q000097:blood*
chemical_list: D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone