Testosterone deficiency in non-obese type 2 diabetic male patients.

BACKGROUND AND AIMS: it is unclear whether male hypogonadism is ascribable to the diabetic state per se, or because of other factors, such as obesity or age. We aimed to investigate the prevalence and identify the predictors for testosterone deficiency among non-obese type 2 diabetic males. METHODS: This cross-sectional study was conducted on 95 nonobese type 2 diabetic males with BMI below 30. We evaluated the total testosterone (TT) levels to determine prevalence and risk factors of testosterone deficiency. Serum TT ≤ 300 ng/dl defined testosterone deficiency. RESULTS: The prevalence of testosterone deficiency was 29.1%. Testosterone deficient patients had statistically significantly higher visceral adiposity index (VAI), waist, and triglyceride in comparison with normal testosterone patients. TT level correlated with VAI, waist, BMI, LH, and age. VAI was the only significant predictor of TT levels even after adjustment for age and BMI in regression analysis. Furthermore, VAI was a statistically significant risk factor for testosterone deficiency in binary logistic analysis. CONCLUSIONS: testosterone deficient non-obese type 2 diabetic male patients had elevated VAI, waist, and triglyceride. Moreover, elevated VAI was a risk factor for testosterone deficiency. VAI could be an easily applicable and reliable index for the evaluation and prediction in type 2 non-obese diabetic males.

The Correlation between 25-Hydroxyvitamin D Levels and Testosterone Levels in Type 2 Diabetic Male Patients.

BACKGROUND: Hypovitaminosis D and low testosterone levels are common in men with T2DM, and vitamin D has been proposed to regulate pituitary-testicular function. OBJECTIVE: We investigated the association between testosterone levels and the circulating vitamin D among type 2 diabetic males. METHODOLOGY: We recruited 95 type 2 diabetic males in this cross-sectional study, and investigated the circulating form of vitamin D which is 25-hydroxyvitamin D (25(OH) D). 25(OH) D level <30 ng/mL was used to define vitamin D insufficiency and 25(OH) D level <20 ng/ml defined deficiency. Testosterone deficiency was defined as a total testosterone level less than300 ng/dl. RESULT: Testosterone deficiency prevalence in type 2 diabetic males was 46.3%. Testosterone deficient diabetics had significantly lower 25(OH) D levels than patients with normal testosterone. We observed a higher prevalence of vitamin D deficiency in testosterone deficient diabetics compared with testosterone sufficient patients. Furthermore, significantly lower total testosterone but not LH levels were observed in diabetic males with vitamin D deficiency in comparison to non-deficient patients. We observed that 25(OH) D significantly predicted total testosterone levels in diabetic males evaluated by linear regression analysis. However this association was no longer statistically significant after exclusion of macro-albuminuric patients. Moreover, Vitamin D deficiency was a significant risk factor for testosterone deficiency in logistic regression analysis. CONCLUSION: Testosterone deficient diabetic males had significantly lower 25(OH)D levels and a higher prevalence of vitamin D deficiency in comparison with normal testosterone diabetic males. Likewise, vitamin D deficient patients had lower testosterone levels. Overall, 25(OH) D significantly predicted total testosterone levels. The vitamin D deficiency was thus a significant risk factor for testosterone deficiency in diabetic males.

Metformin addition to androgen deprivation therapy effect on cancer prostate patients with type 2 diabetes.

AIMS: Patients with prostate cancer (PC) have a higher rate of non-cancer mortality than cancer-related, which could be partially attributed to the treatment they receive. We aimed to evaluate the effect of metformin addition to androgen deprivation therapy (ADT) among cancer prostate patients with type 2 DM. METHODOLOGY: This prospective, two-arm study included 95 PC patients with type 2 DM who had ADT. The patients were divided into 2 groups: the Metformin group includes 48 patients and the non-metformin group includes 47 patients. We compared the anthropometric, diabetic status; tumour status, survival rate, and biochemical relapse between metformin and non-metformin groups. RESULTS: We observed significant differences in fold changes of anthropometric parameters including weight, BMI, and waist circumference between both groups. We found significant differences in fold change of PSA levels in metformin groups in comparison with non-metformin groups. Overall survival comparison between metformin users and non-users showed better statistically insignificant survival in the metformin users group. We observed a significantly lower relapse rate in the metformin group in comparison with the non-metformin. CONCLUSION: Metformin could decrease some of the unfavourable metabolic consequences of ADT. Moreover, Metformin could enhance the tumour-suppressive effect of ADT and decrease the PSA relapse rate.

Urinary cystatin C as a biomarker of early renal dysfunction in type 2 diabetic patients.

AIMS: We aimed to evaluate urinary CysC (cystanin c) as an early marker of diabetic nephropathy in patients with type 2 diabetes and investigate the correlation of urinary CysC with albuminuria and GFR. METHODOLOGY: This case-controlled study was conducted on 66 type 2 diabetic patients who were classified according to albuminuria into 3 groups and consisting of 20 healthy subjects as the control group. We assessed urinary CysC, urinary albumin excretion rate (UACR). RESULTS: Urinary CysC levels were significantly higher in normoalbuminuric diabetic compared with healthy control and there was a progressive linear increase in urinary CysC levels with increasing albuminuria in the diabetic patients. Despite insignificant deference in creatinine between participants groups, we observed significant differences between these groups as regard eGFR, urinary CysC, and UACR. Urinary CysC did not have significant correlations with any clinical or biochemical parameters. Moreover, urinary CysC had a statistically significant association with albuminuria and eGFR. CONCLUSION: Urinary CysC levels correlated with UACR and GFR. It is linked to subclinical tubular injury and can be an earlier marker of kidney involvement, even before albuminuria and it is less influenced by non-renal factors. Therefore, Urinary CysC is useful biomarker for early diagnosis of diabetic nephropathy.

Different Cabergoline Effect on Metabolic and Anthropometric Parameters in Female Prolactinoma Patients Versus Idiopathic Hyperprolactinemia Patients.

BACKGROUND: Hyperprolactinemia can lead to weight gain, insulin resistance, abnormal glucose homeostasis and dyslipidemia. Reversibility of these changes after normalization of prolactin with dopamine agonists is still controversial and needs more clarification. OBJECTIVE: We aimed to: 1) evaluate and compare metabolic and anthropometric profile in female with newly diagnosed prolactin-secreting adenoma versus female idiopathic hyperprolactinemic patients; 2) compare the effects of one year cabergoline therapy on the metabolic profile and anthropometric parameters (by using visceral adiposity index as index for evaluation of adipose tissue dysfunction) in females with prolactinoma to female idiopathic hyperprolactinemic patients. PATIENTS AND METHODS: We enrolled 40 female patients with newly diagnosed prolactinoma and 40 female patients with idiopathic hyperprolactinemia, who were matched according to: age; weight; BMI; waist; and prolactin levels. We enrolled the participants in this study at the time of diagnosis before therapy and they were followed up for 12 months. RESULTS: Cabergoline therapy had significant favorable effects on metabolic and anthropometric parameters, visceral adiposity index and in all patients (apart from HDLc in prolactinoma patients). Cabergoline therapy was significantly more effective in patient with idiopathic hyperprolactinemia than prolactinoma patients with regard to BMI, waist circumference, HDLc and visceral adiposity index despite normalization of prolactin levels in both groups. CONCLUSION: 12 months of Cabergoline treatment improved most of the anthropometric and metabolic parameters, and visceral adiposity index as a marker for adipose tissue dysfunction in both idiopathic hyperprolactinemia and prolactinoma patients. However, Cabergoline treatment was more effective in idiopathic hyperprolactinemic than prolactinoma patients.

25-hydroxyvitamin D Correlation with Prolactin Levels and Adenoma Size in Female Patients with Newly Diagnosed Prolactin Secreting Adenoma.

OBJECTIVE: The present research explored the relationship of vitamin D status with prolactin levels and adenoma size in female patients with newly diagnosed prolactinoma and determination of hypovitaminosis D prevalence among female patients with prolactinoma. PATIENTS AND METHODS: We enrolled 67 female patients with newly diagnosed prolactinoma (41 with micro adenoma and 26 with macro adenoma) in this case-control study at the time of presentation. We selected 45 female subjects as a control group who were matched according to age, weight, height, body mass index and waist circumference. We investigated 25-hydroxyvitamin D, the major circulating form of vitamin D. RESULTS: Prolactinoma patients had significantly lower 25-hydroxyvitamin D levels in comparison with control subjects. Also, macroadenoma patients showed significantly lower 25-hydroxyvitamin D levels as compared to microadenomoa patients. By contrast, microadenoma patients had nonsignificant lower 25-hydroxyvitamin D levels in comparison with control subjects. Furthermore, we found prolactinoma patients with 25-hydroxyvitamin D >20.00 ng/ml showing significant differences in the prolactin levels and adenoma size when compared with those who had 25- hydroxyvitamin D <20.00 ng/ml. In regression analysis, 25-hydroxyvitamin D level was a significant predictor of adenoma size in patients diagnosed with prolactinoma. CONCLUSION: Female patients with prolactinoma have lower vitamin D levels and have higher prevalence of vitamin D insufficiency and deficiency among prolactinoma patients when compared with normal subjects. Also vitamin D deficiency in prolactinoma patients associated with larger adenoma size and higher prolactin level. Finally, 25-hydroxyvitamin D level was a statistically significant predictor of prolactinoma size but not prolactin levels.

Vitamin D status in Egyptian euthyroid multinodular non-toxic goiter patients and its correlation with TSH levels / Estado de vitamina D en pacientes egipcios con BMN eutiroideo y su correlación con las concentraciones de TSH

Background and aim: Although the prevalence of MNG is widespread throughout the world, its pathogenesis is poorly understood, and the complex interactions of both genetic predisposition and the individuals’ environment are likely. However, to the best of our knowledge, it remains unknown whether there is a relationship between vitamin D status and prevalence or pathogenesis of euthyroid MNG. Therefore, the goal of the present study was determination of vitamin D status in euthyroid MNG as well as exploration of the correlation between vitamin D status & TSH levels. Methods: A total of 77 patients diagnosed with euthyroid MNG and 50 subjects without goiter were matched according to age, weight and BMI as control group in this case control study. Results: We found that patients with euthyroid MNG had statistically significant lower mean of [25(OH)D] (24.21±8.68ng/mL) in comparison with its mean in control subjects (28.37±10.91ng/mL, P value=0.019). The 28 sufficient vitamin D MNG patients had statistically significant lower level of TSH than 49 insufficient vitamin D MNG patients. Vitamin D and TSH levels correlate with vitamin D levels in MNG patients in Pearson correlation. Also 25 OH vitamin D was a significant independent predictor for TSH levels among euthyroid MNG patients in regression analysis. Conclusions: Patients with euthyroid MNG have lower levels of vitamin D and TSH levels correlate with vitamin D levels in euthyroid MNG patients. In addition, 25 OH vitamin D was a significant independent predictor for TSH levels among euthyroid MNG patients. We recommend hypovitaminosis D evaluation and correction in patients with MNG (AU)

Antecedentes y objetivo: A pesar de su amplia prevalencia en todo el mundo, se sabe poco de la patogénesis del BMN. Es probable que existan interacciones complejas de la predisposición genética y el entorno de los sujetos. No obstante, sigue sin saberse si existe una relación entre el estado de vitamina D y la prevalencia o la patogénesis del BMN eutiroideo. Por ello, el objetivo de este estudio era determinar el estado de vitamina D en el BMN eutiroideo, y explorar la correlación entre las concentraciones de vitamina D y TSH. Métodos: En este estudio de casos y controles se emparejó por edad, peso e IMC a 77 pacientes diagnosticados BMN eutiroideo y a 50 sujetos sin bocio como grupo de control. Resultados: Los pacientes con BMN eutiroideo tenían una concentración media de (25[OH]D) (24,21±8,68ng/ml) significativamente inferior a la hallada en los sujetos de control (28,37±10,91ng/ml, valor de p=0,019). Los 28 pacientes con BMN y vitamina D suficiente tenían valores de TSH estadísticamente inferiores a los 49 pacientes con BMN y vitamina D insuficiente. Las concentraciones de vitamina D y de TSH se correlacionan con los valores de vitamina D en los pacientes con BMN en la correlación de Pearson, y la 25 OH vitamina D era un factor predictivo independiente de los valores de TSH en los pacientes con BMN eutiroideo en un análisis de regresión. Conclusiones: Los pacientes con BMN eutiroideo tienen concentraciones más bajas de vitamina D y los valores de TSH se correlacionan con los de vitamina D en esos pacientes. Además, la 25 OH vitamina D era un factor predictivo independiente importante de la concentración de TSH en los pacientes con BMN eutiroideo. Se recomienda la evaluación de la hipovitaminosis D y su corrección en los pacientes con BMN (AU)

Vitamin D status in Egyptian euthyroid multinodular non-toxic goiter patients and its correlation with TSH levels.

BACKGROUND AND AIM: Although the prevalence of MNG is widespread throughout the world, its pathogenesis is poorly understood, and the complex interactions of both genetic predisposition and the individuals' environment are likely. However, to the best of our knowledge, it remains unknown whether there is a relationship between vitamin D status and prevalence or pathogenesis of euthyroid MNG. Therefore, the goal of the present study was determination of vitamin D status in euthyroid MNG as well as exploration of the correlation between vitamin D status & TSH levels. METHODS: A total of 77 patients diagnosed with euthyroid MNG and 50 subjects without goiter were matched according to age, weight and BMI as control group in this case control study. RESULTS: We found that patients with euthyroid MNG had statistically significant lower mean of [25(OH)D] (24.21±8.68ng/mL) in comparison with its mean in control subjects (28.37±10.91ng/mL, P value=0.019). The 28 sufficient vitamin D MNG patients had statistically significant lower level of TSH than 49 insufficient vitamin D MNG patients. Vitamin D and TSH levels correlate with vitamin D levels in MNG patients in Pearson correlation. Also 25 OH vitamin D was a significant independent predictor for TSH levels among euthyroid MNG patients in regression analysis. CONCLUSIONS: Patients with euthyroid MNG have lower levels of vitamin D and TSH levels correlate with vitamin D levels in euthyroid MNG patients. In addition, 25 OH vitamin D was a significant independent predictor for TSH levels among euthyroid MNG patients. We recommend hypovitaminosis D evaluation and correction in patients with MNG.

Early parathyroid hormone laboratory abnormalities related to therapeutic radiation of neck: an Egyptian experience.

The effect of neck radiation on parathyroid hormone (PTH) is studied on concern as late effect of radiotherapy for benign or malignant diseases. However, the early effect on PTH is still in debate and need further evaluations. We aimed, in our study, to assess early effect of neck radiation on PTH, and related calcium and phosphorus levels. Patients diagnosed with breast or head and neck cancer who planned to received radiotherapy to neck as a definite or a part of their treatment enrolled in this prospective single-arm study from June 2012 to June 2013. Laboratory assessment of PTH, serum calcium, phosphorus and albumin was obtained before starting radiotherapy, 3 weeks and 3 months after radiation. Fifty-two patients included 24 (46.2 %) males and 28(53.8 %) females. Median age of diagnosis was 55 years. Thirty-six patients had head and neck cancer, while 16 patients were diagnosed as breast cancer. The difference in PTH and calcium levels before and after radiotherapy was statistically significant (P = 0.014 and P = 0.001 for 3 weeks and P = 0.015 and P = 0.004 for 3 months, respectively); even after correction of calcium level according to albumin level, the same results were obtained, while there was no significant difference in their levels after 3 weeks in comparison with 3 months after radiotherapy. The variation of level of phosphorus was not significant. PTH and calcium can be affected early with neck radiation, so follow-up of calcium and PTH level is mandatory for cases that will receive neck radiotherapy.