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Weight loss more than glycemic control may improve testosterone in obese type 2 diabetes mellitus men with hypogonadism.

التفاصيل البيبلوغرافية
العنوان: Weight loss more than glycemic control may improve testosterone in obese type 2 diabetes mellitus men with hypogonadism.
المؤلفون: Giagulli VA; Section of Internal Medicine, Geriatrics, Endocrinology and Rare Disease, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Bari, Italy.; Outpatients Clinic of Endocrinology and Metabolic Disease, Conversano Hospital, Bari, Italy., Castellana M; National Institute of Gastroenterology 'S. De Bellis', Castellana Grotte, Bari, Italy., Carbone MD; Institute of Clinical and Hormonal Research, Foggia, Italy., Pelusi C; 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., Ramunni MI; Outpatients Clinic of Endocrinology and Metabolic Disease, Conversano Hospital, Bari, Italy., De Pergola G; Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy., Guastamacchia E; Section of Internal Medicine, Geriatrics, Endocrinology and Rare Disease, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Bari, Italy., Triggiani V; Section of Internal Medicine, Geriatrics, Endocrinology and Rare Disease, Interdisciplinary Department of Medicine, School of Medicine, University of Bari, Bari, Italy.
المصدر: Andrology [Andrology] 2020 May; Vol. 8 (3), pp. 654-662. Date of Electronic Publication: 2020 Jan 22.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101585129 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-2927 (Electronic) Linking ISSN: 20472919 NLM ISO Abbreviation: Andrology Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Oxford : Wiley-Blackwell, 2013-
مواضيع طبية MeSH: Obesity*/complications , Obesity*/therapy , Weight Loss*, Diabetes Mellitus, Type 2/*complications , Glycemic Control/*methods , Hypogonadism/*etiology , Testosterone/*blood, Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/therapy ; Humans ; Hypoglycemic Agents/therapeutic use ; Hypogonadism/blood ; Male ; Middle Aged ; Retrospective Studies
مستخلص: 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.
(© 2020 American Society of Andrology and European Academy of Andrology.)
التعليقات: Comment in: J Urol. 2020 Aug;204(2):368. (PMID: 32401582)
References: Tajar A, Forti G, O'Neill TW, et al. Characteristics of secondary, primary, and compensated hypogonadism in aging men: evidence from the European Male Ageing Study. J Clin Endocrinol Metab. 2010;95:1810-1818.
Molina-Vega M, Asenjo-Plaza M, García-Ruiz MC, et al. Cross-sectional, primary care-based study of the prevalence of hypoandrogenemia in nondiabetic young men with obesity. Obesity (Silver Spring). 2019;27:1584-1590.
Young J, Xu C, Papadakis GE, et al. Clinical management of congenital hypogonadotropic hypogonadism. Endocr Rev. 2019;40:669-710.
Vermeulen A, Kaufman JM, Giagulli VA. Influence of some biological indexes on sex hormone-binding globulin and androgen levels in aging or obese males. J Clin Endocrinol Metab. 1996;81:1821-1826.
Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103:1715-1744.
Grossmann M, Matsumoto AM. A perspective on middle-aged and older men with functional hypogonadism: focus on holistic management. J Clin Endocrinol Metab. 2017;102:1067-1075.
Corona G, Giagulli VA, Maseroli E, et al. Therapy of endocrine disease: testosterone supplementation and body composition: results from a meta-analysis study. Eur J Endocrinol. 2016;174:R99-R116.
Kapoor D, Channer KS, Jones TH. Rosiglitazone increases bioactive testosterone and reduces waist circumference in hypogonadal men with type 2 diabetes. Diab Vasc Dis Res. 2008;5:135-137.
Pelusi C, Giagulli VA, Baccini M, et al. Clomiphene citrate effect in obese men with low serum testosterone treated with metformin due to dysmetabolic disorders: a randomized, double-blind, placebo-controlled study. PLoS One. 2017;12:e0183369.
Yassin A, Haider A, Haider KS, et al. Testosterone therapy in men with hypogonadism prevents progression from prediabetes to type 2 diabetes: eight-year data from a registry study. Diabetes Care. 2019;42:1104-1111.
American Diabetes Association. 9. Pharmacologic approaches to glycemic treatment: standards of medical care in diabetes-2019. Diabetes Care. 2019;42:S90-S102.
Associazione Medici Diabetologi (AMD), Società Italiana di Diabetologia (SID). Standard italiani per la cura del diabete mellito. 2018. http://www.siditalia.it/pdf/Standard%20di%20Cura%20AMD%20-%20SID%202018&#95;protetto.pdf. Accessed September 01, 2019.
Garber AJ, Abrahamson MJ, Barzilay JI, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm - 2018 executive summary. Endocr Pract. 2018;24:91-120.
Giagulli VA, Carbone MD, Ramunni MI, et al. Adding liraglutide to lifestyle changes, metformin and testosterone therapy boosts erectile function in diabetic obese men with overt hypogonadism. Andrology. 2015;3:1094-1103.
Jensterle M, Podbregar A, Goricar K, Gregoric N, Janez A. Effects of liraglutide on obesity-associated functional hypogonadism in men. Endocr Connect. 2019;8:195-202.
Shao N, Yu XY, Yu YM, et al. Short-term combined treatment with exenatide and metformin is superior to glimepiride combined metformin in improvement of serum testosterone levels in type 2 diabetic patients with obesity. Andrologia. 2018;50:e13039.
Shegem NS, Alsheek Nasir AM, Batieha AM, El-Shanti H, Ajlouni KM. Effects of short term metformin administration on androgens in diabetic men. Saudi Med J. 2004;25:75-78.
Cangiano B, Duminuco P, Vezzoli V, et al. Evidence for a common genetic origin of classic and milder adult-onset forms of isolated hypogonadotropic hypogonadism. J Clin Med 8. 2019;8(1):126.
Wang C, Nieschlag E, Swerdloff R, et al. Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations. Eur J Endocrinol. 2008;159:507-514.
Corona G, Rastrelli G, Morelli A, et al. Treatment of functional hypogonadism besides pharmacological substitution. World J Mens Health. 2019;37:e49. https://doi.org/10.5534/wjmh.190061.
Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999;11:319-326.
Vermeulen A, Verdonck L, Kaufman JM. A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab. 1999;84:3666-3672.
Sacks DB, Arnold M, Bakris GL, et al. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chem. 2011;57:e1-e47.
Rosen RC, Allen KR, Ni X, Araujo AB. Minimal clinically important differences in the erectile function domain of the International Index of Erectile Function scale. Eur Urol. 2011;60:1010-1016.
Dhindsa S, Ghanim H, Batra M, Dandona P. Hypogonadotropic hypogonadism in men with diabesity. Diabetes Care. 2018;41:1516-1525.
Giagulli VA, Kaufman JM, Vermeulen A. Pathogenesis of the decreased androgen levels in obese men. J Clin Endocrinol Metab. 1994;79:997-1000.
Caronia LM, Dwyer AA, Hayden D, Amati F, Pitteloud N, Hayes FJ. Abrupt decrease in serum testosterone levels after an oral glucose load in men: implications for screening for hypogonadism. Clin Endocrinol (Oxf). 2013;78:291-296.
Costanzo PR, Suárez SM, Scaglia HE, Zylbersztein C, Litwak LE, Knoblovits P. Evaluation of the hypothalamic-pituitary-gonadal axis in eugonadal men with type 2 diabetes mellitus. Andrology. 2014;2:117-124.
López-Alvarenga JC, Zariñán T, Olivares A, González-Barranco J, Veldhuis JD, Ulloa-Aguirre A. Poorly controlled type I diabetes mellitus in young men selectively suppresses luteinizing hormone secretory burst mass. J Clin Endocrinol Metab. 2002;87:5507-5515.
Gyawali P, Martin SA, Heilbronn LK, et al. Cross-sectional and longitudinal determinants of serum sex hormone binding globulin (SHBG) in a cohort of community-dwelling men. PLoS One. 2018;13(7):e0200078.
Gyawali P, Martin SA, Heilbronn LK, et al. The role of sex hormone-binding globulin (SHBG), testosterone, and other sex steroids, on the development of type 2 diabetes in a cohort of community-dwelling middle-aged to elderly men. Acta Diabetol. 2018;55(8):861-872.
Wang Q, Kangas AJ, Soininen P, et al. Sex hormone-binding globulin associations with circulating lipids and metabolites and the risk for type 2 diabetes: observational and causal effect estimates. Int J Epidemiol. 2015;44:623-637.
Morelli A, Comeglio P, Sarchielli E, et al. Negative effects of high glucose exposure in human gonadotropin-releasing hormone neurons. Int J Endocrinol. 2013;2013:684659.
Morelli A, Sarchielli E, Comeglio P, et al. Metabolic syndrome induces inflammation and impairs gonadotropin-releasing hormone neurons in the preoptic area of the hypothalamus in rabbits. Mol Cell Endocrinol. 2014;382:107-119.
Sarchielli E, Comeglio P, Squecco R, et al. Tumor necrosis factor-α impairs kisspeptin signaling in human gonadotropin-releasing hormone primary neurons. J Clin Endocrinol Metab. 2017;102:46-56.
Berkseth KE, Rubinow KB, Melhorn SJ, et al. Hypothalamic gliosis by MRI and visceral fat mass negatively correlate with plasma testosterone concentrations in healthy men. Obesity (Silver Spring). 2018;26:1898-1904.
Bonnet F, Scheen AJ. Effects of SGLT2 inhibitors on systemic and tissue low-grade inflammation: the potential contribution to diabetes complications and cardiovascular disease. Diabetes Metab. 2018;44:457-464.
Gejl M, Brock B, Egefjord L, Vang K, Rungby J, Gjedde A. Blood-brain glucose transfer in Alzheimer's disease: effect of GLP-1 analog treatment. Sci Rep. 2017;7:17490.
Lee YS, Jun HS. Anti-inflammatory effects of GLP-1-based therapies beyond glucose control. Mediators Inflamm. 2016;2016:3094642.
Gibb FW, Homer NZ, Faqehi AM, et al. Aromatase inhibition reduces insulin sensitivity in healthy men. J Clin Endocrinol Metab. 2016;101:2040-2046.
Lapauw B, Ouwens M, 't Hart LM, et al. Sex steroids affect triglyceride handling, glucose-dependent insulinotropic polypeptide, and insulin sensitivity: a 1-week randomized clinical trial in healthy young men. Diabetes Care. 2010;33:1831-1833.
Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet. 2019;394:121-130.
Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375:311-322.
Wiviott SD, Raz I, Bonaca MP, et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2019;380:347-357.
Hackett G. Type 2 diabetes and testosterone therapy. World J Mens Health. 2019;37:31-44.
Corona G, Rastrelli G, Morgentaler A, Sforza A, Mannucci E, Maggi M. Meta-analysis of results of testosterone therapy on sexual function based on international index of erectile function scores. Eur Urol. 2017;72:1000-1011.
Hatzimouratidis K, Giuliano F, Moncada I, Muneer A, Salonia A, Verze P. EAU guidelines on erectile dysfunction, premature ejaculation, penile curvature and priapism European Association of Urology 2016. https://uroweb.org/wp-content/uploads/EAU-Guidelines-Male-Sexual-Dysfunction-2016-3.pdf. Accessed December 20, 2019.
Cai X, Tian Y, Wu T, Cao CX, Bu SY, Wang KJ. The role of statins in erectile dysfunction: a systematic review and meta-analysis. Asian J Androl. 2014;16:461-466.
Schooling CM, Au Yeung SL, Freeman G, Cowling BJ. The effect of statins on testosterone in men and women, a systematic review and meta-analysis of randomized controlled trials. BMC Med. 2013;11:57.
Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and management of testosterone deficiency: AUA guideline. J Urol. 2018;200:423-432.
Travison TG, Vesper HW, Orwoll E, et al. Harmonized reference ranges for circulating testosterone levels in men of four cohort studies in the United States and Europe. J Clin Endocrinol Metab. 2017;102:1161-1173.
Giagulli VA, Castellana M, Murro I, et al. The role of diet and weight loss in improving secondary hypogonadism in men with obesity with or without type 2 diabetes mellitus. Nutrients. 2019;11(12):2975.
Ng Tang Fui M, Prendergast LA, Dupuis P, et al. Effects of testosterone treatment on body fat and lean mass in obese men on a hypocaloric diet: a randomized controlled trial. BMC Med. 2016;14:153.
Ng Tang Fui M, Hoermann R, Zajac JD, Grossmann M. The effects of testosterone on body composition in obese men are not sustained after cessation of testosterone treatment. Clin Endocrinol. 2017;87:336-343.
Yassin A, Almehmadi Y, Saad F, Doros G, Gooren L. Effects of intermission and resumption of long-term testosterone replacement therapy on body weight and metabolic parameters in hypogonadal in middle-aged and elderly men. Clin Endocrinol. 2016;84:107-114.
فهرسة مساهمة: Keywords: erectile dysfunction; functional hypogonadism; obesity; type 2 diabetes mellitus
المشرفين على المادة: 0 (Hypoglycemic Agents)
3XMK78S47O (Testosterone)
تواريخ الأحداث: Date Created: 20200111 Date Completed: 20210525 Latest Revision: 20210525
رمز التحديث: 20221213
DOI: 10.1111/andr.12754
PMID: 31919991
قاعدة البيانات: MEDLINE
الوصف
تدمد:2047-2927
DOI:10.1111/andr.12754