Sandeep Dhindsa, MD, and Paresh Dandona, MD: Obesity and Diabetes Lower Testosterone Levels in Men
By: Almas Eftekhari
Reduced production of testosterone is common in men with obesity and diabetes – one in three men with type 2 diabetes will experience this complication. Clinically known as hypogonadism, men may experience symptoms such as lowered muscle mass, greater fat gain, decreased libido, reduced fertility, and generalized inflammation. Moreover, the condition leads to an increase in insulin resistance and increases risk for cardiovascular complications such as heart disease and stroke.
Two American Diabetes Association-funded researchers from the State University of New York at Buffalo, Sandeep Dhindsa, MD, and Paresh Dandona, MD, have determined that 40% of obese men will suffer from low testosterone levels. The percentage rises to 50% among obese men with diabetes. The researchers also observed that diabetes decreases testosterone levels independently – men with type 2 diabetes have lower levels of the hormone than men who don't have diabetes, regardless of weight.
“The effect of diabetes on lowering testosterone levels was similar to that of a weight gain of approximately 20 pounds,” says Dr. Dhindsa, the first author of the study published in the June 2010 issue of Diabetes Care. The study shows that testosterone levels decline dramatically as weight-to-height ratio, or body-mass-index (BMI), increases.
To-date, Drs. Dhindsa and Dandona provide the largest analysis of testosterone levels in male obesity. The two researchers are also the first to assess the prevalence of hypogonadism in men with both diabetes and obesity, in addition to comparing them separately. They used data from 1,849 selected men from the Hypogonadism in Males (HIM) study, which was conducted in 95 primary health care clinics from 2003 to 2004 and funded by Solvay Pharmaceuticals.
The researchers recommend that men with either obesity or diabetes should have their testosterone levels tested regularly. Dr. Dhindsa is currently developing treatment methods for men who suffer from diabetes and hypogonadism. Dr. Dandona, who is also affiliated with Kaleida Health, is the senior author on the study. He hopes to conduct further studies focusing on younger male populations in their peak reproductive years.
(Dhindsa S, Miller MG, McWhirter CL, Mager DE, Ghanim H, Chaudhuri A, Dandona P. Testosterone concentrations in diabetic and nondiabetic obese men. Diabetes Care. 2010 Jun; 33(6):1186-92.)
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