Low Testosterone Levels are Common and Associated with Insulin Resistance in Men with Diabetes

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Low Testosterone Levels are Common and Associated with Insulin

Resistance in Men with Diabetes

Testosterone and Insulin Resistance in Men with Diabetes

J Clin Endocrin Metab. First published ahead of print March 4, 2008 as

doi:10.1210/jc.2007-2177

Testosterone and Insulin Resistance in Men with Diabetes

Mathis Grossmann1,4 MD, PhD

Merlin C 1,2, MBChB, PhD

Sianna Panagiotopoulos1 PhD

Ken Sharpe3 PhD

J MacIsaac1 MBBS, PhD

Sophie e1 MBBS

D Zajac1 MBBS, PhD

Jerums1 MBBS, MD

1Department of Endocrinology and Medicine, University of Melbourne,

Austin Health, Australia

2Baker Heart Research Institute, Melbourne, Australia

3Department of Mathematics and Statistics, University of Melbourne,

Australia

Key words: diabetes, testosterone, insulin resistance

4To whom correspondence and reprint requests should be addressed:

Dr. Mathis Grossmann, FRACP, MD, PhD

Dept. of Medicine and Endocrinology, University of Melbourne, Austin Health

Level 7, Lance Townsend Building

Studley Road, Heidelberg, VIC 3084 Australia

Phone: 61-3-9496-5135 /5477

Mobile: 0404-822-123

Fax: 61-3-9457-5485

email: mathisg@...

J Clin Endocrin Metab. First published ahead of print March 4, 2008 as

doi:10.1210/jc.2007-2177

Abstract

Context: Low testosterone levels are common in men with type 2 diabetes

and may be

associated with insulin resistance.

Objective: We investigated prevalence of testosterone deficiency and the

relationship

between testosterone and insulin resistance in a large cohort of men

with type 2 and type

1 diabetes.

Design: Cross-sectional survey of 580 men with type 2 diabetes and 69

men with type 1

diabetes. A subgroup of 262 men with type 2 diabetes was then reassessed

after a median

of six months.

Results: Forty-three percent of men with type 2 diabetes had a reduced

total testosterone

(TT), and 57% had a reduced calculated free testosterone (cFT). Only 7%

of men with

type 1 diabetes had low TT. By contrast, 20.3% of men with type 1

diabetes had low cFT,

similar to that observed in type 2 diabetes (age-BMI adjusted odds ratio

1.4, 95% CI 0.7–

2.9). Low testosterone levels were independently associated with insulin

resistance in

men with type 1 diabetes, as well as type 2 diabetes. Serial

measurements also revealed

an inverse relationship between changes in testosterone levels and

insulin resistance.

Conclusions: Testosterone deficiency is common in men with diabetes,

regardless of the

type. Testosterone levels are partly influenced by insulin resistance,

which may represent

an important avenue for intervention, while the utility of testosterone

replacement

remains to be established in prospective trials.

http://jcem.endojournals.org/cgi/rapidpdf/jc.2007-2177v1.pdf

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