Janjgava Shota, Zerekidze Tamar, Uchava Lasha, Giorgadze Elene, Asatiani Ketevan
National Institute of Endocrinology, 2/6 Ljubljana Street, Tbilisi, 0159, Georgia.
Department of Endocrinology, Tbilisi State University, Tbilisi, 0140, Georgia.
Eur J Med Res. 2014 Oct 23;19(1):56. doi: 10.1186/s40001-014-0056-6.
Multiple epidemiological studies have shown that low testosterone levels are associated with and predict the future development of type 2 diabetes mellitus and the metabolic syndrome. The aim of our study was to show the influence of testosterone replacement therapy on obesity, HbA1c level, hypertension and dyslipidemia in patients with diabetes mellitus and androgen deficiency.
One hundred and twenty-five male patients with diabetes mellitus were screened; 85 subjects aged 41 to 65 years, with BMI from 27.0 to 48.0 kg/m(2), were randomized in a placebo-controlled study. They also underwent a routine physical examination and selected by free testosterone examination. We divided patients into two groups: 1) treatment group, where we used diet, physical activity, patient's antidiabetic therapy and testosterone replacement therapy; 2) placebo group, where we used diet, physical activity, patient's antidiabetic therapy and placebo.
After 6 months of treatment we repeated the diagnostic assessments: lipid profile was improved in both groups but in first group it was clinically significant. Free testosterone level increased in all groups, but in group I was clinically significant. HbA1c decreased in both groups, but in group I we obtained the best result. Leptin level after treatment was approximately the same in both groups. Also, blood pressure was reduced in both groups but results were similar.
Our study demonstrated that it is possible to break this metabolic vicious circle by raising testosterone levels in diabetic men with androgen deficiency. Re-instituting physiological levels of testosterone, as the study has shown, has an important role in reducing the prevalence of diabetic complications.
多项流行病学研究表明，低睾酮水平与2型糖尿病和代谢综合征的未来发展相关，并可预测其发展。我们研究的目的是显示睾酮替代疗法对糖尿病和雄激素缺乏患者的肥胖、糖化血红蛋白水平、高血压和血脂异常的影响。
对125例男性糖尿病患者进行筛查；85名年龄在41至65岁之间、体重指数（BMI）为27.0至48.0kg/m²的受试者被随机纳入一项安慰剂对照研究。他们还接受了常规体格检查，并通过游离睾酮检查进行筛选。我们将患者分为两组：1）治疗组，采用饮食、体育活动、患者的抗糖尿病治疗和睾酮替代疗法；2）安慰剂组，采用饮食、体育活动、患者的抗糖尿病治疗和安慰剂。
治疗6个月后，我们重复了诊断评估：两组的血脂谱均有所改善，但第一组具有临床显著性。所有组的游离睾酮水平均升高，但第一组具有临床显著性。两组的糖化血红蛋白均下降，但第一组的结果最佳。治疗后两组的瘦素水平大致相同。此外，两组的血压均降低，但结果相似。
我们的研究表明，通过提高雄激素缺乏的糖尿病男性的睾酮水平，可以打破这种代谢恶性循环。正如研究所示，恢复睾酮的生理水平在降低糖尿病并发症的患病率方面具有重要作用。
