Distinct patterns of hypogonadism in a cross-sectional study of Malaysian men with type 2 diabetes mellitus: The role of insulin resistance, visceral adiposity, and aging

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation Pub Date : 2025-08-08 DOI:10.1111/jdi.70127

Waye-Hann Kang, Norlela Sukor, Nor Azmi Kamaruddin

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Abstract

Introduction

Hypogonadism is common among male patients living with type 2 diabetes mellitus and can be divided into hypergonadotropic hypogonadism (hyper-H) and hypogonadotropic hypogonadism (hypo-H). Hypo-H is strongly linked to insulin resistance and visceral adiposity, while hyper-H in type 2 diabetes mellitus males has not been extensively studied. We aimed to study factors associated with the two subtypes of hypogonadal type 2 diabetes mellitus males in Malaysia, where obesity and poorly controlled diabetes are highly prevalent.

Patients and Methods

We screened 360 type 2 diabetes mellitus males for hypogonadism (H), defined by total testosterone <12 nmol/L, repeated calculated free testosterone <0.255 nmol/L, and Aging Male Symptoms (AMS) scale >26. Subjects were classified into hypogonadotropic hypogonadism (hypo-H) and hypergonadotropic hypogonadism (hyper-H) based on luteinizing hormone (LH) levels. We further analyzed their sociodemographic and clinical parameters in comparison to the control group of eugonadal males.

Results

55.6% of the 63 hypogonadal subjects have hypo-H. Significant differences in weight (P = 0.001), BMI (P < 0.001), waist circumference (P < 0.001), serum HDL-C (P < 0.001), serum triglycerides (P = 0.001) and TyG index (P < 0.001) were observed between hypo-H and eugonadal males. For hyper-H males, only age differed significantly from eugonadal males (P = 0.034).

Conclusions

Age is significantly associated with hyper-H, while insulin resistance and visceral adiposity are strongly linked to hypo-H. Older and obese Malaysian type 2 diabetes mellitus males, particularly those with coronary artery disease and lower HDL-C levels, are at a higher risk of developing hypogonadism. Diabetic treatments aimed at improving insulin resistance and reducing visceral adiposity could be highly effective for hypogonadal type 2 diabetes mellitus males in Malaysia.

Abstract Image

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在马来西亚2型糖尿病男性的横断面研究中，性腺功能减退的不同模式：胰岛素抵抗、内脏脂肪和衰老的作用。

性腺功能减退症在男性2型糖尿病患者中较为常见，可分为促性腺功能亢进症（hyper-H）和促性腺功能减退症（hypogonadotropic Hypogonadism, hypoh）。低h与胰岛素抵抗和内脏脂肪密切相关，而高h在2型糖尿病男性中尚未得到广泛研究。我们的目的是研究与马来西亚男性性腺功能低下2型糖尿病的两种亚型相关的因素，在马来西亚，肥胖和控制不良的糖尿病非常普遍。患者和方法：我们筛选了360例2型糖尿病男性性腺功能减退(H)，由总睾酮26定义。根据黄体生成素（LH）水平将受试者分为促性腺功能减退症（hypoh）和促性腺功能亢进症（hyper-H）。我们进一步分析了他们的社会人口学和临床参数，并与性腺正常的男性对照组进行了比较。结果：63例性腺功能低下者中有55.6%存在低h。结论：年龄与高h显著相关，而胰岛素抵抗和内脏肥胖与低h密切相关。老年和肥胖的马来西亚2型糖尿病男性，特别是那些患有冠状动脉疾病和低HDL-C水平的男性，患性腺功能减退的风险更高。在马来西亚，旨在改善胰岛素抵抗和减少内脏脂肪的糖尿病治疗可能对性腺功能低下的2型糖尿病男性非常有效。

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来源期刊

Journal of Diabetes Investigation ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

9.40%

发文量

218

审稿时长

6-12 weeks

期刊介绍： Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).