| Abstrakt: |
Diabetes mellitus as a chronic metabolic disease is well known for its systemic effects as a result of affecting the metabolism of carbohydrates, proteins and fats. The relationship between type 2 diabetes mellitus (DM2), insulin resistance and metabolic syndrome, as well as related reproductive disorders in men, and changes in androgen levels and the development of hypogonadism have been documented and studied in detail. Type 1 diabetes mellitus (DM1) with leading insulinopenia and hyperglycaemia has also been linked to the influence of the hypothalamic-pituitary-gonadal axis (HPG axis) and fertility where hormonal parameters in men, and the exact mechanisms of damage are the subject of widespread scientific debate. The aim of the study was to compare serum androgen levels in men with DM1 and age- and BMI-matched clinically healthy men of active reproductive age. Materials and methods: The study included 71 individuals – 30 men with DM1 and 41 clinically healthy men serving as a control group. A detailed medical history related to disease duration, insulin administered, total daily insulin dose (TDI) was taken. Anthropometric measurements of weight, height, waist (W) and hip circumference (H) were performed on all participants, body mass index (BMI) and W/H were calculated. Basal levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), testosterone (T), sex hormone binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEA-S), thyroid stimulating hormone (TSH), serum prolactin (Prl), adrenocorticotropic hormone (ACTH), morning cortisol (corisol 8h) were studied. Free androgen index (FAI), calculated free testosterone (cFT) and bioavailable testosterone (BioT) were calculated. Fasting blood glucose (FBG), glycated hemoglobin (HbA1C) and microalbuminuria (U-ALB) were assessed. Biochemical studies had been expanded to include levels of total protein (TPROT), albumin (ALB) and creatinine (CREA).). Results: The mean age of the studied men was 31,72± 6,05 years, and no statistically significant difference was found in this indicator between the persons with DM1 and the controls (p = 0,944). The mean BMI was 24,87± 6,03 kg/m2, again without significant difference between the two study groups (p=0,537). Men with DM1 had been found to have a larger waist circumference (p<0,05) and increased W/H ratio (p = 0,000), but a smaller hip circumference (p<0,05). HbA1C and FBG levels were statistically significantly higher in men with DM1 compared to healthy controls (p=0,000, respectively). All participants had normal levels of total protein and albumin in the absence of statistically significant differences in these indicators between the two groups (p=0,188, p=0,600, respectively). The participants in the present study had euthyroid function, normoprolactinaemia, normal morning cortisol and ACTH levels. Men with DM1 had statistically significantly higher SHBG levels (p=0,000) and lower FAI levels compared to controls (p=0,004). No statistically significant difference was found in terms of T and cFT levels (p=0,101, p=0,465, respectively). Lower levels of BioT compared to the control group were noticeable in the DM1 group, but without reaching a statistically significant difference (p=0,071). There were no significant differences in the levels of LH, FSH, LH / FSH and E2 in the two groups of men (p=0,126, p=0,553, p=0,284, p=0,900, respectively). Conclusion: Men with DM1 with mean disease duration of 10 years and no diabetic macroangiopathy and diabetic nephropathy had no evidence of androgen deficiency and were comparable to healthy men in active reproductive age respective of sex hormone levels. [ABSTRACT FROM AUTHOR] |
