Weight loss more than glycemic control may improve testosterone in obese type 2 diabetes mellitus men with hypogonadism.

BACKGROUND

Functional hypogonadism is a common disorder among patients with obesity and type 2 diabetes mellitus and could be managed by first treating the underlying causes.

OBJECTIVE

The present study was undertaken to investigate the contribution of body weight and glycemic control to the reversibility of hypogonadism to eugonadism in a real-life setting.

MATERIALS AND

METHODS

Adult obese male patients with uncontrolled type 2 diabetes mellitus, complaining of mild to moderate erectile dysfunction and suspected of functional hypogonadism evaluated at our institution from 2015 to 2017, were retrospectively included. The gonadal status 3 and 12 months after the glucose-lowering medication prescription was assessed.

RESULTS

Seventy-one consecutive patients were enrolled, with 24 (34%) of them achieving total testosterone ≥300 ng/dL (10.4 nM/L) at the end of the study. When they were stratified according to HbA1c and body weight loss, a direct correlation was found for the latter only. Particularly, 94% of patients achieving a body weight loss >10% presented with total testosterone ≥300 ng/dL. An inverse correlation was found for HbA1c, with no higher prevalence of total testosterone ≥300 ng/dL in patients with HbA1c <6.5%.

DISCUSSION: The findings are strengthened by the rigorous study design. However, a limited number of patients and glucose-lowering medications could be included.

CONCLUSIONS

The present study supports the hypothesis that in obese patients with uncontrolled type 2 diabetes mellitus losing weight may have a greater impact on androgens compared to improving glycemic control. Further prospective studies are needed to corroborate this finding.