Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore.
Biomed Res Int. 2020 Jul 24;2020:6259437. doi: 10.1155/2020/6259437. eCollection 2020.
Type 2 diabetic (T2D) male patients with low total testosterone (TT) levels are at an increasing risk of all-cause mortality. However, the levels of TT in male patients with latent autoimmune diabetes in adults (LADA) remain largely unknown. . This was a single-center, open, observational study. The inclusion criteria were male patients who were diagnosed with LADA, and sex, body mass index, C-peptide, and glycated hemoglobin (HbA1c) levels matched with those of T2D patients. Islet function/sensitivity and sex hormone concentrations were determined at baseline and 1-year follow-up. The primary endpoint was the changes in androgen levels from baseline to 1-year follow-up in patients with LADA.
Our data showed that TT and Bio-T levels remained unchanged, while FT levels significantly decreased from baseline to 1-year follow-up in patients with T2D. However, TT, Bio-T, and FT concentrations dramatically increased in the LADA group from baseline to 1-year follow-up. Furthermore, a Spearman analysis showed that changes of TT, FT, and Bio-T levels from baseline to endpoint were significantly negatively correlated with homeostasis model assessment-2 IR (HOMA2-IR), respectively.
The FT change patterns in patients with LADA may differ from those in patients with T2D. Our data also indicated the significant negative correlation between insulin sensitivity and changes of TT, FT, and Bio-T levels along with the diabetic duration in patients with T2D and LADA.
患有 2 型糖尿病（T2D）且总睾酮（TT）水平较低的男性患者全因死亡率的风险不断增加。然而，成人隐匿性自身免疫糖尿病（LADA）男性患者的 TT 水平仍知之甚少。。这是一项单中心、开放、观察性研究。纳入标准为诊断为 LADA 的男性患者，其性别、体重指数、C 肽和糖化血红蛋白（HbA1c）水平与 T2D 患者相匹配。在基线和 1 年随访时测定胰岛功能/敏感性和性激素浓度。主要终点是 LADA 患者从基线到 1 年随访时雄激素水平的变化。
我们的数据显示，TT 和 Bio-T 水平保持不变，而 FT 水平在 T2D 患者中从基线到 1 年随访时显著下降。然而，在 LADA 组中，TT、Bio-T 和 FT 浓度从基线到 1 年随访时急剧增加。此外，Spearman 分析表明，从基线到终点时 TT、FT 和 Bio-T 水平的变化与稳态模型评估-2 胰岛素抵抗（HOMA2-IR）呈显著负相关。
LADA 患者的 FT 变化模式可能与 T2D 患者不同。我们的数据还表明，在 T2D 和 LADA 患者中，胰岛素敏感性与 TT、FT 和 Bio-T 水平的变化与糖尿病病程呈显著负相关。
