[Features of steroidogenesis in men with hypogonadism and type 2 diabetes].

Q4 Medicine
R V Rozhivanov, M O Chernova, V A Ioutsi, G A Mel'nichenko, M V Shestakova, N G Mokrysheva
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引用次数: 0

Abstract

Background: Type 2 diabetes mellitus (DM2) in men is associated with a high incidence of hypogonadism. Testosterone is a steroid hormone and one of the final metabolites of steroidogenesis, which causes interest in assessing the content of key steroid hormones, their precursors and metabolites in hypogonadal and eugonadal men with T2DM.

Aims: Assessment of the features of steroidogenesis in men with hypogonadism in T2DM using tandem mass spectrometry.

Materials and methods: A full-design, cross-sectional, screening, single-center, non-interventional study included men with T2DM, who were he was treated in Endocrinology Research Centre, Moscow. The study was conducted from October 2021 to January 2022. Medical history assessment, physical examination with determination of body mass index (BMI), measurement of key steroid hormones, their precursors and metabolites by isotope dilution liquid chromatography/tandem mass spectrometry, glycated hemoglobin (HbA1c) were performed. The groups were compared using the Mann-Whitney U-test for quantitative indicators and χ² with Yates' correction for qualitative ones. Correlation analysis was performed by the Spearman correlation method. When determining the criterion of statistical significance, the Bonferroni correction was applied.

Results: Patients with hypogonadism had statistically significantly more pronounced obesity compared with eugonadal men. In a comparative analysis of patients, depending on the presence of hypogonadism, there were statistically significantly lower levels of androgen precursors 17-hydroxypregnenolone and 17-hydroxyprogesterone in hypogonadal men. At the same time, a positive statistically significant correlation was found between total testosterone and 17-hydroxyprogesterone. In addition, 17-hydroxyprogesterone, although to a lesser extent, but positively correlated with other androgens - androstenedione (r=0,328; p<0,001) and dehydroepiandrosterone (r=0,183; p=0,004). >< 0,001) and dehydroepiandrosterone (r=0,183; p=0,004).

Conclusions: In this investigation the prevalence of male hypogonadism in type 2 diabetes, determined by high-precision tandem mass spectrometry, was 69,5%. There was no effect of the disease on the mineralocorticoid and glucocorticoid links of adrenal steroidogenesis. Hypogonadism was associated with decreased levels of a number of testosterone precursors. The most significant of them was 17-hydroxyprogesterone, which can be considered as a marker of testicular steroidogenesis.

[男性性腺功能减退症和 2 型糖尿病患者的类固醇生成特征]。
背景:男性2型糖尿病(DM2)与性腺功能减退症的高发病率有关。睾酮是一种类固醇激素,也是类固醇生成的最终代谢产物之一,这引起了人们对评估T2DM男性性腺功能减退者和优生优育者体内关键类固醇激素、其前体和代谢产物含量的兴趣:这是一项全设计、横断面、筛查、单中心、非干预性研究,研究对象包括在莫斯科内分泌学研究中心接受治疗的T2DM男性患者。研究时间为 2021 年 10 月至 2022 年 1 月。研究人员进行了病史评估、体格检查和体重指数(BMI)测定,并通过同位素稀释液相色谱法/串联质谱法测量了主要类固醇激素及其前体和代谢物、糖化血红蛋白(HbA1c)。对定量指标采用 Mann-Whitney U 检验进行组间比较,对定性指标采用χ²加 Yates 校正进行组间比较。相关分析采用斯皮尔曼相关法。在确定统计学意义标准时,采用了Bonferroni校正法:结果:从统计学角度看,性腺功能减退症患者的肥胖程度明显高于性腺功能正常的男性。在对患者进行的比较分析中,根据是否存在性腺功能减退症,性腺功能减退男性的雄激素前体 17- 羟基孕烯醇酮和 17- 羟基孕酮的水平在统计学上明显较低。与此同时,总睾酮和 17- 羟孕酮之间在统计学上存在显著的正相关。此外,17-羟孕酮与其他雄激素--雄烯二酮(r=0,328;p<0,001)和脱氢表雄酮(r=0,183;p=0,004)也呈正相关,但程度较小:在这项调查中,通过高精度串联质谱测定,2 型糖尿病男性性腺功能减退症的发病率为 69.5%。该病对肾上腺类固醇生成的矿皮质激素和糖皮质激素环节没有影响。性腺功能减退与多种睾酮前体水平下降有关。其中最重要的是17-羟孕酮,它可被视为睾丸类固醇生成的标志物。
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来源期刊
Problemy endokrinologii
Problemy endokrinologii Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
1.40
自引率
0.00%
发文量
59
期刊介绍: Since 1955 the “Problems of Endocrinology” (or “Problemy Endocrinologii”) Journal publishes timely articles, balancing both clinical and experimental research, case reports, reviews and lectures on pressing problems of endocrinology. The Journal is aimed to the most topical issues of endocrinology: to chemical structure, biosynthesis and metabolism of hormones, the mechanism of their action at cellular and molecular level; pathogenesis and to clinic of the endocrine diseases, new methods of their diagnostics and treatment. The Journal: features original national and foreign research articles, reflecting world endocrinology development; issues thematic editions on specific areas; publishes chronicle of major international congress sessions and workshops on endocrinology, as well as state-of-the-art guidelines; is intended for scientists, endocrinologists diabetologists and specialists of allied trade, general practitioners, family physicians and pediatrics.
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