Эндокринология и метаболический синдром
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Relationship between Testosterone and Sex Hormone Binding Globulin Concentrations with Cardiometabolic Parameters and Macrovascular Disease in Afro-Caribbean Men with Type 2 Diabetes

Fritz-Line Vélayoudom-Céphise, Lydia Foucan, Laurent Larifla, Vanéva Chingan, Jacqueline Bangou, Catherine Massard, Christophe Armand, Jacqueline Deloumeaux and Fabrice Bonnet

Introduction: Low testosterone concentrations have been reported in type 2 diabetes (T2D) and Coronary Artery Disease (CAD). Contrary to diabetes, the prevalence of CAD is lower in Afro-Caribbean (AC) from French West Indies islands than in people from mainland France. However, CAD is a frequent complication of T2D. To evaluate this paradoxical situation, we investigated the prevalence of sex steroids deficiency that might be associated with CAD in AC men with T2D and the relationships with metabolic parameters.

Methods: We performed a cross-sectional study in the Department of Diabetology of the University Hospital of Guadeloupe. Clinical and biological data were collected from men with T2D. Total Testosterone (TT) and Sex Hormone Binding Globulin (SHBG) concentrations were measured using electrochemiluminescence and immunoradiometric assays. Results are expressed as mean ± SD or percentages. The data were analyzed using the Mann–Whitney and chi-squared tests, Pearson correlations and logistic regression. P values<0.05 were considered significant. Results: One hundred thirty-three AC men with T2D were included. Prevalence of testosterone deficiency was 43.5%. The mean TT and SHBG concentrations were 12.06 ± 6.24 and 35.9 ± 17.54 nmol/l respectively. Low TT concentrations were more frequently found in obese subjects compared to subjects with normal weight and low SHBG concentrations were high rather in subjects with overweight. Both sex steroids levels were higher in subjects with dyslipidemia than subjects without dyslipidemia. TT deficiency was more frequent in subjects with macrovascular disease including CAD, peripheral artery disease or stroke than subjects without macrovascular disease.

Conclusion: Testosterone deficiency and low SHBG concentrations occur frequently in AC men with T2D and are associated with metabolic profile that may promote the development of macrovascular disease. In this population, it may be necessary to systematically apply a testosterone replacement in case of deficiency, to improve cardiometabolic profiles without forget the risk of prostate cancer.