A Comparative study of Testosterone Levels in Male Diabetic Patients on Metformin Hydrochloride and Non-Diabetic Patients in Tertiary Care Hospital in Kancheepuram District, Tamilnadu

Navin, B (2020) A Comparative study of Testosterone Levels in Male Diabetic Patients on Metformin Hydrochloride and Non-Diabetic Patients in Tertiary Care Hospital in Kancheepuram District, Tamilnadu. Masters thesis, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Kanchipuram.

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Abstract

BACKGROUND: Diabetes is a public health issue, and there are over 0.4 billion people suffering from diabetes over the world and its prevalence is still increasing remarkably every year. Type 2 diabetes mellitus (T2DM) is the major type of diabetes, which is associated with numerous complications including cardiovascular disease, peripheral neuropathy, stroke, infection, chronic renal failure, retinopathy, and Erectile Dysfunction. An inverse relationship between serum free testosterone (FT) levels and plaque score has also been found in men with diabetes. However, it is not clear if there is any association of hypogonadism and increased CV risk in subjects with diabetes. The present study was therefore carried out to find out the prevalence of hypogonadism in Indian male diabetes subjects with CAD. OBJECTIVES: PRIMARY OBJECTIVE: 1. To compare testosterone levels in male diabetic patients with healthy controls. SECONDARY OBJECTIVES: 1. To study the effect of Metformin on the levels of testosterone in Male diabetic & Non Diabetic Patients 2. To investigate Hypogonadism using serum testosterone levels in male Type 2 diabetes mellitus (T2DM) subjects with and without coronary artery disease (CAD). METHODS: The study was carried out during the period of January 2018 to June 2019 (1 year 6 months). Totally 150 patients were included in the study. (Group 1)-50 controls (33.3%). (Group 2)-50 newly diagnosed diabetic male patients (33.3%) (Group 3)-50 known case of diabetic male patients for >1 year and less than 3 years (33.3%). After overnight fasting, 10 ml of blood was drawn from an antecubital vein under aseptic condition, then after centrifugation at 3000rpm, the serum was stored at -20°C for further analysis. Fasting Blood Glucose (FBG) mg/dL was determined by specific method (fasting capillary blood glucose). Total testosterone was analyzed by radioimmunoassay (RIA) using a commercial kit (Dia Sorin) with a sensitivity of 0.059 ng/ml (conversion factor to nmol/L=3.48). (Dia Sorin Incorporation 1990 Industrial). Free testosterone and 17-hydroxyprogesterone were analyzed by (RIA) using commercial kits from Diagnostic Products Corporation (DPC) with sensitivities of 0.15 pg/ml (conversion factor to pmol/L =3.48 and 0.2 nmol/l) (Diagnostic Products Corporation, 1999). Sex hormone binding globulin was measured by Immunoradiometric Assay (IRMA) using DPC kits from Diagnostic with a sensitivity of 0.04 nmol/l. (Diagnostic Products Corporation, September 2000) Dehydroepiandrosterone sulfate was analyzed by RIA using commercial kits from laboratories with a sensitivity of 0.046 mmol/l. Samples were analyzed for gonadotropins (LH and FSH) and insulin by microparticle enzyme immunoassay (MEIA). RESULTS AND CONCLUSION: Male sexual function declines with age. It is now clear that the age-associated decrease in testosterone levels has both a testicular and hypothalamic-pituitary origin, but Leydig cell function decrease does not always occur together with an increase of the pituitary hormone luteinizing hormone (LH). In Metformin-treated patients there was a significant reduction in the testosterone levels compared with healthy control since; Metformin leads to a significant diminution in the testosterone levels through inhibition of pituitary luteinizing hormone secretion and key enzymes in the synthesis of testosterone hormone. Compatible with another study that revealed significant elevation in the testosterone levels, low levels of testosterone in glyburide treated patients in the present study may be due to small sample size, severe metabolic alterations and age of patients herein most of the patients were not younger. Metformin in type 2 DM leads to a significant reduction in testosterone levels, sex drive and induction of low testosterone-induced erectile dysfunction, whereas; sulfonylurea in type 2 DM leads to a significant rise in testosterone levels, sex drive, and erectile function.

Item Type: Thesis (Masters)
Additional Information: 201711803
Uncontrolled Keywords: Testosterone, Metformin, Diabetes Mellitus.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 28 Jan 2021 19:59
Last Modified: 30 Jan 2021 01:36
URI: http://repository-tnmgrmu.ac.in/id/eprint/13390

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