Relationship between serum testosterone and sex hormone- binding globulin levels and some metabolic changes in Iraqi men with type 2 diabetes mellitus

Abstract

The present study aimed to assess the interrelationship between serum total testosterone (S.Tes) as well as sex hormone binding globulin (SHBG) and the main components of metabolic syndrome (MetS) in type 2 diabetic men. One hundred and sixty patients having T2DM were enrolled in this study. The following characteristics were reported: age, gender, duration of T2DM , Body mass index (BMI) and arterial blood pressure.. Serum hormonal profile analyses (S.Tes, SHBG and prolactin). Serum lipid analyses (T.ch TG, HDL-C, and LDL-C). The mean age of study subjects was 49.8 5.7 years and the mean duration of disease was 5.45.2 years. Body mass index (BMI) of study group was found to be within the range of either overweight or obese class . The means of HbA1c ratio and FSG levels were 9.4 %  2.1 and 200.9  75.2 mg/dl respectively which indicated that our patients were in a bad glycemic control. All components of S. lipid profile were within normal range . Serum Testosterone and SHBG levels were within normal range but in the low values( 4.49±2.11 ,28.88±18.12 ng/ml respectively) while serum prolactin level was within normal range but in the high values(11.22±9.42 ng/ml). When study analytes were compared according to the presence of one or more metabolic syndrome characteristic then there was a significant decrease in mean value of testosterone level between obese and non obese diabetics ( 3.89±1.87 vs. 4.79±2.17 ng/ ml, P < 0.001) . If hypertension was present in addition to obesity and diabetes then SHBG level was also significantly decreased in comparison with diabetics who were hypertensive but not obese (25.16±13.42 vs. 33.58±13.73 ng/ ml respectively , P <0.05 ). If hypertension and obesity were present as well as lower HDL-C then significant decreases in both S. SHBG and S. Tes were detected ( (30.63±14.93 vs. 40.7± 6.33 ng/ ml and 3.73±1.9 vs. 5.57±1.53 ng/ ml respectively , P<0.01). In conclusion; our T2DM patients have a bad glycemic state and are characterized by a significantly lower S. Tes mean level if they were obese. Still, the accumulation of other main characteristics of MetS which included hypertension and lower S. HDL- C results in a significantly lower mean levels of both S. Tes and S. SHBG. Obesity, among the other core characteristics of MetS, seems to have the main suppressor effect on serum testosterone and SHBG in T2DM.