Testosterone levels and risk of newly diagnosed type 2 diabetes mellitus in adult men: systematic review and meta-analysis

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2024-09-09 DOI:10.1007/s12020-024-04019-4

Gustavo Adolfo Vásquez- Tirado, Juan Diego Guarniz-Salavarria, Claudia Vanessa Quispe-Castañeda, Jhuliana M. Contreras-Cabrera, María del Carmen Cuadra-Campos, Edinson Dante Meregildo-Rodriguez, Niler Manuel Segura-Plasencia, Yesenia Katherin Arbayza-Ávalos

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Abstract

Introduction

Testosterone is a metabolically active hormone in males for metabolic homeostasis. Although the coexistence of low testosterone levels and type 2 diabetes mellitus (T2DM) have been associated, there are no reports that evaluate alterations in total testosterone (TT) levels and the risk of newly diagnosed T2DM. This review evaluates this question in adult men with high or low levels of total testosterone (TT), as well as the role played by other hormones such as free testosterone (FT), sex hormone binding globulin (SHBG), dihydrotestosterone (DHT), estrogens and testosterone bioavailable (bT).

Methods

We searched for studies published up to July 30, 2023, in five databases, following a PECO strategy. We found twenty-two studies for quantitative analysis and meta-analyzed the same quantity of studies.

Results

This first meta-analysis incorporates the assessment of the risk of low TT and T2DM in longitudinal studies. 43,038 adult men are included. Our meta-analysis shows that there is an association between low TT levels and the risk of newly diagnosed T2DM (OR 1.52; 95% CI 1.10–2.10; p < 0.05; I²: 79%). It is also evident that SHBG in low TT studies behaves as a risk factor for T2DM in the same way as FT, although without statistical significance. bT behaves as a protective factor. There is no association between estrogen, DHT and T2DM.

Conclusions

In adult men with low TT values, there is a greater risk of developing a newly diagnosed of T2DM. SHBG values in low TT patients also present a higher risk of T2DM as the same FT but without statistical significance. bT behaves as a protective factor We have not found an association between risk of T2DM and the levels of estrogen, DHT although there are very few studies that report these hormones.

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睾酮水平与成年男性新诊断 2 型糖尿病的风险：系统回顾和荟萃分析

导言睾酮是男性体内一种代谢活跃的激素，可促进新陈代谢平衡。虽然低睾酮水平与 2 型糖尿病（T2DM）并存有关联，但目前还没有报告评估总睾酮（TT）水平的变化与新诊断 T2DM 的风险。本综述评估了总睾酮（TT）水平过高或过低的成年男性的这一问题，以及游离睾酮（FT）、性激素结合球蛋白（SHBG）、双氢睾酮（DHT）、雌激素和生物可用睾酮（bT）等其他激素的作用。我们找到了 22 项进行定量分析的研究，并对相同数量的研究进行了荟萃分析。结果这是首次在纵向研究中对低 TT 和 T2DM 风险进行评估的荟萃分析。共纳入 43038 名成年男性。我们的荟萃分析表明，低 TT 水平与新诊断的 T2DM 风险之间存在关联（OR 1.52; 95% CI 1.10-2.10; p < 0.05; I²: 79%）。同样明显的是，低 TT 研究中的 SHBG 与 FT 一样，都是 T2DM 的危险因素，尽管没有统计学意义。结论在 TT 值偏低的成年男性中，新诊断出 T2DM 的风险更大。低 TT 值患者的 SHBG 值也与相同的 FT 值一样，具有更高的 T2DM 风险，但无统计学意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.