Hormonal regulation of carbohydrate metabolism in men with type 2 diabetes mellitus and hypogonadism

The aim. Study of the features of hormonal regulation of carbohydrate metabolism in men with type 2 diabetes mellitus (T2DM) and hypogonadism by assessing beta and alpha cell function, as well as the degree of insulin resistance (IR).

Material and methods. The study included 271 men with T2DM. Group 1 consisted of patients with T2DM and confirmed hypogonadism (n=126), group 2 consisted of men with T2DM without hypogonadism (n=145). Body mass index, waist circumference, hip circumference, fasting plasma glucose, glycated hemoglobin, triglycerides (TG), insulin, C-peptide, glucagon, HOMA-IR, HOMA-β, TYG indices were evaluated.

Results. In patients with hypogonadism, IR tended to be higher according to the HOMA-IR index (Δ0.41, p=0.07), and significantly higher according to the TYG index (Δ0.14, p <0.05). Also, in group 1, the TG level was higher (Δ0.33, p <0.05), higher values of C-peptide (Δ0.4 ng/ml, p <0.05), insulin (Δ3.3 mIU/ml, p <0.05) and HOMA-β index (Δ15.7 or higher by 84%, p <0.001). A moderate negative correlation was observed between the total testosterone level and the TYG index (r=-0.364, p <0.001). In group 1, the median glucagon was significantly lower – 46 versus 98.6 pg/ml (p <0.05). All men from group 1 who had their basal glucagon levels assessed had values of less than 150 pg/ml.

Conclusion: The presence of functional hypogonadism in men with T2DM is associated with a more pronounced IR. The significant difference between the values of the TYG index and TG level, as well as the inverse correlation between total testosterone level and the TYG index, confirm that hypogonadism in T2DM in men can be considered as an independent cardiovascular risk factor. T2DM in men with functional hypogonadism is characterized by the absence of basal hyperglucagonemia.

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