ABSTRACT
Background: The primary objective of the study was to assess serum free testosterone and high sensitivity c-reactive protein concentrations and their correlation with hematocrit in patients of diabetes mellitus type 2. Hypogonadotropic hypogonadism is a common defect in type 2 diabetes, irrespective of the glycemic control, duration of disease, and the presence of complications of diabetes or obesity. It has been demonstrated that about one third of male patients with diabetes mellitus type 2 have low serum free Testosterone level. Methods: We have included 50 patients of diabetes mellitus type 2 presenting to the department of medicine SMS Hospital Jaipur. Both indoor and out door patients were selected who were free of microalbuminuria and diabetic nephropathy. Primary or secondary hypogonadism, other than diabetes mellitus and anemia of other causes were ruled out. Results: Diabetes mellitus type 2 patients with low serum free testosterone levels have significantly low hematocrit values ( n= 29) (p-value <0.001) and mild anemia compared to eugonadal men ( n= 21). Their correlation was highly significant. Patients with DM type 2 who have low serum free testosterone, also have high hs-CRP concentration. Though hematocrit values were low in patients with high hs-CRP concentration but it was not statistically significant. Conclusion: At the end of the study we concluded that both a low serum free testosterone level and high hs-CRP concentration may play an important role in the pathogenesis of mild anemia and low hematocrit values in DM type 2 patients.
ABSTRACT
BACKGROUND: Positive correlations between bone mass and androgen levels have been observed in premenopausal and postmenopausal women as well as in men. Androgen production was decreased in women with osteoporosis compared to that in age-matched controls. We hypothesized that androgen metabolism might be also deranged in osteoporosis. To clarify our hypothesis, we investigated the relationship between urinary metabolites of androgen and bone mineral density (BMD) in Korean postmenopausal osteoporotics. METHODS: We examined the anthropometry and bone turnover marker in 67 postmenopausal women. BMD was measured by dual energy X-ray absorptiometry (DEXA). Serurn levels of estrone, estradiol, free testosterone were measured by radioirnmunoassay and serum level of sex hormone binding globulin (SHBG) was measured by two site immunoradiometric assay. The urinary metabolites of androgen were determined by gas chromatography-mass spectrometry (GC-MS) at Korean Institute of Science and Technology Doping Control Center. RESULTS: 1. Spinal BMD had a positive correlation with height (r 0.3049, p<0.05), weight (r=0.4114, p<0.001) and body mass index (BMI, r=0.2638, p<0,05). 2. Spinal and femoral neck BMD had no correlation with serum levels of estrone, estradiol and ten major urinary metabolites of androgen, but serum free testosterone had positive correlation with spinal BMD (r=0.3622, p<0.01) and SHBG had negative correlation with femoral neck BMD (r=-0.2625, p< (0.05). 3. Serum free testosterone in osteoporotics was lower than non-osteoporotics with spinal BMD (p<0.05) and SHBG in patients with osteopenia was higher than non-osteopenic subjects with femoral neck BMD (p <0.05). 4. In multiple stepwise regression analysis, weight and serum free testosterone were statistically significant for spinal BMD (R =0.3072). As for femoral neck BMD, weight was the independent determinant (R 0.1307). 5. Serum level of osteo#ealcin and urinary deoxypyridinoline/creatinine had a positive correlation with urinary 11-ketoandrosterone (p<0.05). SHBG was positive correlation with osteocalcin (r=0.3190, p<0.05). 6. Serum free testosterone (r=-0.2740, p<0.05) decreased with aging. CONCLUSION: Our data suggest that androgen metabolism is not deranged in osteoporotics, but serum free testosterone is important than estrogen on postmenopausal osteoporosis after 5-10 years menopause.