Vito Angelo Giagulli1,2, Marco Castellana3, Matteo Domenico Carbone4, Carla Pelusi5, Maria Isabella Ramunni2, Giovanni De Pergola6, Edoardo Guastamacchia1, Vincenzo Triggiani1. 1. Section of Internal Medicine, Geriatrics, Endocrinology and Rare Disease, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Bari, Italy. 2. Outpatients Clinic of Endocrinology and Metabolic Disease, Conversano Hospital, Bari, Italy. 3. National Institute of Gastroenterology "S. De Bellis", Castellana Grotte, Bari, Italy. 4. Institute of Clinical and Hormonal Research, Foggia, Italy. 5. Division of Endocrinology and Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, Alma Mater Studiorum, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. 6. Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy.
Abstract
BACKGROUND: Functional hypogonadism is a common disorder among patients with obesity and type 2 diabetes mellitus and could be managed by first treating the underlying causes. OBJECTIVE: The present study was undertaken to investigate the contribution of body weight and glycemic control to the reversibility of hypogonadism to eugonadism in a real-life setting. MATERIALS AND METHODS: Adult obese male patients with uncontrolled type 2 diabetes mellitus, complaining of mild to moderate erectile dysfunction and suspected of functional hypogonadism evaluated at our institution from 2015 to 2017, were retrospectively included. The gonadal status 3 and 12 months after the glucose-lowering medication prescription was assessed. RESULTS: Seventy-one consecutive patients were enrolled, with 24 (34%) of them achieving total testosterone ≥300 ng/dL (10.4 nM/L) at the end of the study. When they were stratified according to HbA1c and body weight loss, a direct correlation was found for the latter only. Particularly, 94% of patients achieving a body weight loss >10% presented with total testosterone ≥300 ng/dL. An inverse correlation was found for HbA1c, with no higher prevalence of total testosterone ≥300 ng/dL in patients with HbA1c <6.5%. DISCUSSION: The findings are strengthened by the rigorous study design. However, a limited number of patients and glucose-lowering medications could be included. CONCLUSIONS: The present study supports the hypothesis that in obese patients with uncontrolled type 2 diabetes mellitus losing weight may have a greater impact on androgens compared to improving glycemic control. Further prospective studies are needed to corroborate this finding.
BACKGROUND:Functional hypogonadism is a common disorder among patients with obesity and type 2 diabetes mellitus and could be managed by first treating the underlying causes. OBJECTIVE: The present study was undertaken to investigate the contribution of body weight and glycemic control to the reversibility of hypogonadism to eugonadism in a real-life setting. MATERIALS AND METHODS: Adult obese male patients with uncontrolled type 2 diabetes mellitus, complaining of mild to moderate erectile dysfunction and suspected of functional hypogonadism evaluated at our institution from 2015 to 2017, were retrospectively included. The gonadal status 3 and 12 months after the glucose-lowering medication prescription was assessed. RESULTS: Seventy-one consecutive patients were enrolled, with 24 (34%) of them achieving total testosterone ≥300 ng/dL (10.4 nM/L) at the end of the study. When they were stratified according to HbA1c and body weight loss, a direct correlation was found for the latter only. Particularly, 94% of patients achieving a body weight loss >10% presented with total testosterone ≥300 ng/dL. An inverse correlation was found for HbA1c, with no higher prevalence of total testosterone ≥300 ng/dL in patients with HbA1c <6.5%. DISCUSSION: The findings are strengthened by the rigorous study design. However, a limited number of patients and glucose-lowering medications could be included. CONCLUSIONS: The present study supports the hypothesis that in obesepatients with uncontrolled type 2 diabetes mellitus losing weight may have a greater impact on androgens compared to improving glycemic control. Further prospective studies are needed to corroborate this finding.
Authors: Giuseppe Defeudis; Rossella Mazzilli; Marta Tenuta; Giovanni Rossini; Virginia Zamponi; Soraya Olana; Antongiulio Faggiano; Paolo Pozzilli; Andrea M Isidori; Daniele Gianfrilli Journal: Diabetes Metab Res Rev Date: 2021-09-21 Impact factor: 8.128
Authors: Sandro La Vignera; Rossella Cannarella; Fabio Galvano; Agata Grillo; Antonio Aversa; Laura Cimino; Cristina M Magagnini; Laura M Mongioì; Rosita A Condorelli; Aldo E Calogero Journal: Endocrine Date: 2020-10-15 Impact factor: 3.633