open access

Vol 10, No 1 (2021)
Research paper
Published online: 2021-02-08
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Hypergonadotropic hypogonadism in Nigerian men with type 2 diabetes mellitus

Ezekiel Musa, Jibril Mohammed El-Bashir, Fatima Sani-Bello, Adamu Girei Bakari
DOI: 10.5603/DK.a2021.0002
·
Clinical Diabetology 2021;10(1):129-137.

open access

Vol 10, No 1 (2021)
ORIGINAL ARTICLES
Published online: 2021-02-08

Abstract

Background. Studies have reported a higher preva-lence of hypogonadism in men with type 2 diabetes mellitus (T2DM) than non-diabetic men. The pattern of hypogonadism in men with T2DM using gonado-tropin-releasing hormone (GnRH) stimulation test in Sub-Saharan Africa is unknown.
Objective. This study was conducted to determine the prevalence and pattern of hypogonadism in Nigerian men with T2DM.
Methods. A cross-sectional study involving 358 men with T2DM and 179 non-diabetic men as controls. Androgen Deficiency in the Ageing Male (ADAM) questionnaire was administered. Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) both at 0 hours and 4 hours after subcutaneous buserelin injec-tion, fasting total testosterone (TT), fasting plasma glucose and glycated haemoglobin were measured. Ninety-nine men with T2DM selected by randomiza-tion using a computer underwent GnRH stimulation test, with subcutaneous injection of 100 micrograms of buserelin.
Results. The mean TT of T2DM men was significantly lower compared to the controls (8.79 ± 3.35 nmol/L vs 15.41 ± 3.79 nmol/L, p < 0.001). The prevalence of hypogonadism in T2DM men was 80.4%, comprising 38.5% of severe hypogonadism and 41.9% mild hypogonadism. The mean LH and FSH levels were significantly higher in T2DM men than the controls (9.62 ± 6.82 IU/L vs 8.24 ± 5.91 IU/L, p = 0.022 and 8.50 ± 8.17 IU/L vs 5.17 ± 3.89 IU/L, p < 0.001 respectively). There was a statistically significant exaggerated response in mean (±SD) LH and FSH levels at 4 hours after buserelin in-jection compared to the 0-hour levels (58.58 ± 40.72 IU/L vs 8.38 ± 6.10 IU/L, p < 0.001 and 23.03 ± 18.02 IU/L vs 8.41 ± 7.45 IU/L, p < 0.001 respectively) in men with T2DM who had GnRH stimulation tests.
Conclusion. This study shows that the prevalence of hypogonadism in men with T2DM is significantly higher than in non-diabetic men with mild hypogonadism accounting for most cases. Hypergonadotropic hypo-gonadism occurs more frequently in men with T2DM in Nigeria. 

Abstract

Background. Studies have reported a higher preva-lence of hypogonadism in men with type 2 diabetes mellitus (T2DM) than non-diabetic men. The pattern of hypogonadism in men with T2DM using gonado-tropin-releasing hormone (GnRH) stimulation test in Sub-Saharan Africa is unknown.
Objective. This study was conducted to determine the prevalence and pattern of hypogonadism in Nigerian men with T2DM.
Methods. A cross-sectional study involving 358 men with T2DM and 179 non-diabetic men as controls. Androgen Deficiency in the Ageing Male (ADAM) questionnaire was administered. Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) both at 0 hours and 4 hours after subcutaneous buserelin injec-tion, fasting total testosterone (TT), fasting plasma glucose and glycated haemoglobin were measured. Ninety-nine men with T2DM selected by randomiza-tion using a computer underwent GnRH stimulation test, with subcutaneous injection of 100 micrograms of buserelin.
Results. The mean TT of T2DM men was significantly lower compared to the controls (8.79 ± 3.35 nmol/L vs 15.41 ± 3.79 nmol/L, p < 0.001). The prevalence of hypogonadism in T2DM men was 80.4%, comprising 38.5% of severe hypogonadism and 41.9% mild hypogonadism. The mean LH and FSH levels were significantly higher in T2DM men than the controls (9.62 ± 6.82 IU/L vs 8.24 ± 5.91 IU/L, p = 0.022 and 8.50 ± 8.17 IU/L vs 5.17 ± 3.89 IU/L, p < 0.001 respectively). There was a statistically significant exaggerated response in mean (±SD) LH and FSH levels at 4 hours after buserelin in-jection compared to the 0-hour levels (58.58 ± 40.72 IU/L vs 8.38 ± 6.10 IU/L, p < 0.001 and 23.03 ± 18.02 IU/L vs 8.41 ± 7.45 IU/L, p < 0.001 respectively) in men with T2DM who had GnRH stimulation tests.
Conclusion. This study shows that the prevalence of hypogonadism in men with T2DM is significantly higher than in non-diabetic men with mild hypogonadism accounting for most cases. Hypergonadotropic hypo-gonadism occurs more frequently in men with T2DM in Nigeria. 

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Keywords

hypergonadotropic hypogonadism; hypogonadism; type 2 diabetes mellitus; GnRH stimulation; total testosterone

About this article
Title

Hypergonadotropic hypogonadism in Nigerian men with type 2 diabetes mellitus

Journal

Clinical Diabetology

Issue

Vol 10, No 1 (2021)

Article type

Research paper

Pages

129-137

Published online

2021-02-08

DOI

10.5603/DK.a2021.0002

Bibliographic record

Clinical Diabetology 2021;10(1):129-137.

Keywords

hypergonadotropic hypogonadism
hypogonadism
type 2 diabetes mellitus
GnRH stimulation
total testosterone

Authors

Ezekiel Musa
Jibril Mohammed El-Bashir
Fatima Sani-Bello
Adamu Girei Bakari

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