Session: OR22-Male Reproductive Hormones: Effects on Fertility and Beyond
Room 104 (Moscone Center)
50 men with T2D were recruited into the study. HH was defined as free T concentrations <5 ng/dl with normal or low LH and FSH. 26 men had HH(mean total T 247±82ng/dl; free T 4.2±1.1ng/dl) and 24 men had normal total and free T concentrations(means 527±205 and 7.3±2.0ng/dl). Insulin sensitivity was calculated from the glucose infusion rate(GIR) during the last 30 min of a 4 hour hyperinsulinemic-euglycemic clamp(80mU/m2/min) and expressed as mg/kg body weight/min. Lean mass and fat mass were measured by DEXA. Men with HH were randomized to receive intramuscular T(250 mg) or placebo(1ml saline) every 2 weeks for 6 months(n=13 in each group). Clamps and DEXA were repeated at 6 months.
Men with HH had similar age(54±8 vs. 53±10years, p=0.56) but higher BMI(40±9 vs. 34±7kg/m2, p=0.02) than eugonadal men. Men with HH had higher fat mass(45±15 vs. 34±15kg, p=0.02) but similar lean mass(73±21 vs. 66±9kg, p=0.12) than eugonadal men. Mean GIR was lower in men with HH than in eugonadal men(4.1±2.4 vs. 6.9±3.6 mg/kg/min, p=0.003) even after adjustment for fat mass, lean mass and age(4.6±2.7 vs. 6.4±2.7 mg/kg/min, p=0.05). Total and free T increased after 6 months of T therapy(273±96 vs 561±249 ng/dl, p=0.01; 4.2±1.1 vs. 11.8±7.1 ng/dl, p=0.007; blood sample drawn 1 week after the final T injection) but did not change in placebo group(271±40 vs 349±215 ng/dl, p=0.23; 4.0±0.8 vs. 4.8±2.1 ng/dl, p=0.3). There was no change in weight(123±23 vs 122±24kg, p=0.37) or fat mass(46±15 vs 43±13kg, p=0.24) but lean mass(71±9 vs 72±10kg, p=0.03) increased slightly but significantly after 6 months of T therapy. There was no change in weight(111±38 vs 112±38kg, p=0.85), fat mass(37±16 vs 36±14kg, p=0.19) or lean mass(67±14 vs 67±13kg, p=0.57) in placebo group. GIR increased by 30% after 6 months (4.1±2.0 vs 5.3±2.3 mg/kg/min, p=0.005) of T therapy but did not change in placebo group(3.4±1.5 vs 3.5±1.8 mg/kg/min, p=0.88). Change in GIR did not relate to increase in free T(r=-0.16, p=0.68) or to change in lean mass(r=-0.13, p=0.73) in T group.
Our data show for the first time that 1) men with T2D and HH are more insulin resistant than those with normal T; 2) insulin resistance is reversed following T replacement.
Sources of support: NIH
Nothing to Disclose: SSD, MB, NDK, SS, AC, AM, HG, PD
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