Details
Category: Volume 06 Issue 09 September 2018
Hits: 1088

Title: Evaluation of testosterone level in infertile Sudanese male with type 2 diabetic and its relation with lipid profile

Authors: Daralnaem S.  E. Adam, Abdelmula M. Abdalla

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i9.90

Abstract

Background:  Diabetes mellitus (DM) is increasing in men of reproductive age, and the number of diabetic men attending fertility clinics is largely increased. Testosterone is the male sex hormone, and plays a vital role in glucose homeostasis, lipid metabolism, and semen parameters.

Objectives: The aim of this study to assess serum total Testosterone levels among in infertile Sudanese males with type 2 diabetes mellitus and its relation to lipid profile and comparison with apparently healthy control.

Materials and Methods: A case-control study was conducted on 50 non-diabetic control group and 50 infertile diabetic men test group with age range (30-70 years). The analyzed variables age, BMI, serum levels of total Testosterone, HA1c,lipid profile ,and  semen parameters were  measured.

Results:  Serum Total Testosterone levels were significantly lower in infertile male with type diabetes when compared with control group (7.45 ± 1.07 versus 22.21 ± 3.1, p<0.000) .Where as serum HbA1c (%), triglyceride, and LDL were significantly increased (10.73±1.72 versus4.96±0.72, 102.4±12.5 versus 81.11±6.43 , 96.68±8.43 versus 84.39±6.65, p < 0.01 respectively). In addition the study observed  no significant difference in cholesrterol and HDL levels ( p > 0.05 ) in the test group when compared with their control .In comparing the results of patients with primary infertility with that with secondary infertility in the test group there is no significant difference in all measured variables (p > 0.05) . In addition serum testosterone level is significantly inversely correlated with age (r =- 0.31, p = 0.02), HbA1c (%) (r = -0.30. p = 0.02), total cholesterol (r = - 0.28. p = 0.03), and LDL (r = -0.26. P = 0.04), and insignificantly correlated with BMI, triglyceride, and HDL (p > 0.05). The testosterone level in the diabetic infertile test group illustrated significant inverse correlation with number of sperm with abnormal morphology (r= - 0.34, p= 0.01), and insignificantly correlated with  sperm count , motility and semen volume (P > 0.05) as in table 3.

Conclusion: It concluded that, type 2 diabetes mellitus significantly altered serum total testosterone level in infertile male, which is inversely correlated with dyslipidemia and semen quality.

Keywords: Glysemic control, type 2 diabetes, serum total testosterone, Lipid profile, HbA1c, semen quality.

References

  1. Power A. Diabetes Melitus. In: Fauci AS, Braun wald E, Kasper DS, Hauser SL, Lango DL, Jameson JL, et al., editors. Harrisons Internal Medicine 17nd edition. New York: McGrawHill Inc; 2008. p. 2275-7.:
  2. Kelly D, Jones T. Testosterone a metabolic hormone in health and disease. Journal of Endocrinology, 2013; 217: 25–45.
  3. Ding EL, Song Y, Malik VS, Liu S. Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta-analysis. JAMA., 2006; 295(11): 1288-99.
  4. Al Hayek AA, Khader YS, Jafal S, Khawaja N, Robert AA, Ajlouni K. Prevalence of low testosterone levels in men with type 2 diabetes mellitus: a cross-sectional study. J Fam Community Med., 2013; 20: 179-86.
  5. Kapoor D, Aldred H, Clark S, Channer KS & Jones TH. AClinical and biochemical assessment of hypogonadism in men with type 2 diabetes: correlations with bio-available testosterone and visceral adiposity. Diabetes Care. 2007; 30: 911–17.
  6. E. L, Ribeiro. E. P, Teloken. C, Souto. C. A.V. Diabetes mellitus is associated with subnormal serum levels of free testosterone in men. BJU International., 2005; 96(6): 867–70.
  7. Ari Kawe, A,p.,A. Daramola, A. Odofin, L, Obika, Alloxan-induced and insulin-resistant diabetes mellitus affect semen parameters and impair spermatogenesis in male rates. Afr. J.Reprod. Health.,10(3), 2006,106-113.
  8. Wang, Y.,Z.Zhang,w, G Guo, W.Sun, X.Miao, H.w u,L.Cai, Sulforaphane reduction of testicular apopotic cell death in diabetic mice is associated with the upregulation of Nrf2 expression and function. Am. J. physiol, Endocrinol. metab.307(1),2014,E 14-23.
  9. Aftab SA, Kumar S, Barber TM. The role of obesity and type 2 diabetes mellitus in the development of male obesity-associated secondary hypogonadism. Clin Endocrinol (Oxf)., 2013; 78:330-7.
  10. Shota Janjgava, et.al, Influence of testosterone replacement therapy on metabolic disorders in male patients with type 2 diabetes mellitus and androgen deficiency , European Journal of Medical Research., 2014, 19: 56.
  11. Kitty Kit Ting Cheung, et.al. Testosterone level in men with type 2 diabetes mellitus and related metabolic effects: A review of current evidence, J Diabetes Invest., 2015; 6: 112–123.
  12. Jihan Mohamed Mohiedin,Noon Babiker, Omer Mohamed Abdalla.Effect of type 2 Diabetes Mellitus on Sudanese male fertility. Sch. J. App.med.sci, 20016,4 (6E):2216-2223.
  13. Tajar A,Forti G,O Neill TW,Lee Dm,Silman Aj, Finn JD et al, characteristic of secondary, primary and compensated hypogonadism in ageing men,evidence from the European male ageing study.J clin Endocrinol metab.2010,05(4):1810-8
  14. Dhindsa S, Prabhakar S, Sethi M, Bandyopadhyay A, Chaudhuri A, Dandona P. Frequent occurrence of hypogonad-otropic hypogonadism in type 2 diabetes. J Clin Endocrinol Metab., 2004; 89: 5462–8.
  15. Al Hayek AA, Khader YS, Jafal S, Khawaja N, Robert AA, Ajlouni K. Prevalence of low testosterone levels in men with type 2 diabetes mellitus: a cross-sectional study. J Fam Community Med., 2013; 20: 179-86.
  16. Kapoor D, Aldred H, Clark S, Channer KS & Jones TH. AClinical and biochemical assessment of hypogonadism in men with type 2 diabetes: correlations with bioavailable testosterone and visceral adiposity. Diabetes Care., 2007; 30: 911–17.
  17. Rato,L.,M.Alves,T.Dias,,G.LOPES,J.Cavaco,S.Socorro,p.Oliveira.High energy diets may induce a pre-diabetic state altering testicular glycolytic metabolic profile and male reproductive parameters-Andrology. (3).2013,495-505
  18. Brand JS, Wareham NJ, Dowsett M, Folkerd E, van der Schouw YT, Luben RN, et al. Associations of endogenous testosterone and SHBG with glycated haemoglobin in middle-aged and older men. Clin Endocrinol (Oxf) 2011;74:572-8.  
  19. Saez JM. Leydig cells: Endocrine, paracrine, and autocrine regulation. Endocr Rev 1994;15:574-626. 
  20. Zhao J, Zhai L, Liu Z, Wu S, Xu L. Leptin level and oxidative stress contribute to obesity-induced low testosterone in murine testicular tissue. Oxid Med Cell Longev 2014; 2014: 190945
  21. Maggio M, Basaria S. Welcoming low testosterone as a cardiovascular risk factor. InternationalJournal of Impotence Research. 2009; 21: 261–64.
  22. Agbecha A, Usoro CA. Serum testosterone and insulin resistance in type 2 male diabetics attending University of Calabar teaching hospital, Nigeria. J Med Soc 2017;31:178-84.
  23. Dhindsa S, Miller MG, McWhirter CL, Mager DE, Ghanim H, Chaudhuri A, et al. Testosterone concentrations in diabetic and nondiabetic obese men. Diabetes Care 2010;33:1186-92.   .
  24. Andersson B, Mårin P, Lissner L, Vermeulen A, Björntorp P. Testosterone concentrations in women and men with NIDDM. Diabetes Care 1994;17:405-11.  
  25. Laaksonen DE, Niskanen L, Punnonen K, Nyyssönen K, Tuomainen TP, Valkonen VP, et al. The metabolic syndrome and smoking in relation to hypogonadism in middle-aged men: A prospective cohort study. J Clin Endocrinol Metab 2005;90:712-9. 
  26. Neagla F, Almilgs,Eman A,Eissa, Emain R,,Amer, Mohamed El-Assal. diabetes mellitus link with hypogonadism in male patients with type 2 diabetes mellitus age 40-50 years.Benha medical journal .2015,32:29-35.
  27. Nirmali mattack, Runi Deve, Tridiekutum, Dibyarata Patgiri. The evaluation of serum level of testosterone in type2 diabetic men and its relation with lipid profile .journal of clinical and diagnostic research .2015,vol-9(1);BC04-BC07
  28. Samathia P, Venkateswarla M, Slva prabodh V. Lipid profile levels in type 2 diabetes mellitus from the trbal population of Adlabad in Andhra Pradcesh , India, journal of clinical and diagnostic research . 2012;6(4):590.
  29. Magglo M, Basarla S. Welcoming low testosterone as a cardiovascular risk factor.International journal of impotence Research .2009;21:261-64
  30. Delfino M .Imbrogo N. Elia J, Capogreco E,M azzilli Prevalence of diabetes mellitus in male partners of   infertile couple, Minerva Urol Nefrol.2007;59:131-135
  31. Jing-zhen Zhu,Xing-You Dong,Lia-Lia Liang. Zi-Qian Zhang.Xiao Tan Hu.Long Kun Li.Effects of diabetes mellitus on semen quality in adult  men .systemic review and meta- analysis .Int J clin Exp Med 2017.10(8):11290-11303
  32. La Vignera S, Condovelli R, Vicaan E, D Agata Rand Calogero AE.Diabetus mellitus and sperm parameters. J androl 2012, 33:145-153
  33. Perrorrd .Sapori MH,Chatliain PC, Rogemand N and Saez JM. Modulation of  lydig cell functions by culture with sertoli cells or with sertoli cell-conditioned medium  ,effect of insulin  ,sematomedin C and FSH. Mol cell Endocrinol 1987,50:193-201.

Corresponding Author

Abdelmula M. Abdalla

Department of Clinical Chemistry, Faculty of Medical Laboratory Science, Al Neelain

University, Khartoum, Sudan