Association between waist-to-hip ratio and testosterone in Chinese men with young-onset type 2 diabetes: a cross-sectional study.

Background: Low testosterone levels is associated with higher cardiovascular risk in men with diabetes. However, there are few studies on testosterone levels and the factors affecting them in patients with young-onset diabetes (YOD). The objective of this study was to investigate the correlation between waist-to-hip ratio (WHR) and testosterone levels in men diagnosed with YOD.

Research design and methods: This cross-sectional study involved 547 male patients with type 2 diabetes mellitus (T2DM) from the Endocrinology Department of the Affiliated Hospital of Jining Medical University. The participants were divided into two groups: a young-onset diabetes (YOD) group and a late-onset diabetes (LOD) group. Anthropometric measurements, including height, weight, waist circumference, and hip circumference, were recorded. Additionally, fasting blood samples were collected to assess various parameters, such as sex hormone levels and lipid profiles. The association between WHR and testosterone levels was analyzed by univariate linear regression and multivariable linear regression analysis.

Results: Five hundred forty-seven patients with type 2 diabetes and aged 50.3 ± 12.1 years were enrolled in the study. One hundred ninety-three patients were assigned to the YOD group based on a diagnosis age of 40 years or younger, while the remaining 354 patients were assigned to the LOD group. The testosterone was significantly lower in the YOD group compare to the LOD group (P = 0.049), and the WHR had an independent effect on testosterone in men with the YOD group (β=-4.67, P = 0.0251), but there was no evidence of such an association in the LOD group (β =-1.13, P = 0.4608).

Conclusions: According to our results, male patients with YOD exhibited lower testosterone levels compared to those with LOD. Furthermore, their testosterone levels were significantly negatively correlated with WHR. These findings indicate that it is more necessary to screen for testosterone in obese patients with YOD and that improving obesity, especially abdominal obesity, may help to interrupt the vicious cycle of low testosterone-obesity-insulin resistance-hyperglycemia-low testosterone.