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Low estradiol concentrations in men with subnormal testosterone concentrations and type 2 diabetes
Sandeep Dhindsa1, Richard Furlanetto, Mehul Vora
1State University of New York at Buffalo,Buffalo, NY, USA.
Diabetes Care
|July 1, 2011
Summary
In men with type 2 diabetes, low free testosterone is not linked to higher estradiol levels. Further research is needed to understand the causes of low testosterone in these patients.
Area of Science:
- Endocrinology
- Metabolic Disorders
Background:
- Type 2 diabetes is associated with a high prevalence of subnormal free testosterone concentrations.
- Low or inappropriately normal gonadotropins in men with type 2 diabetes may be linked to increased aromatase activity, leading to elevated estradiol and suppressed hypothalamo-hypophyseal-gonadal axis.
Purpose of the Study:
- To investigate the hypothesis that increased plasma estradiol concentrations contribute to suppressed hypothalamo-hypophyseal-gonadal axis in men with type 2 diabetes.
Main Methods:
- Measured plasma estradiol, testosterone, luteinizing hormone, follicle-stimulating hormone, and sex hormone-binding globulin (SHBG) in 240 men with type 2 diabetes.
- Free estradiol concentrations were calculated or directly measured using liquid chromatography tandem mass spectrometry (LC-MS/MS) and equilibrium dialysis.
Main Results:
- Calculated free estradiol concentrations were lower in men with subnormal free testosterone (median 0.047 ng/dL) compared to those with normal free testosterone (median 0.063 ng/dL).
- Directly measured free estradiol concentrations were also lower in men with subnormal free testosterone (median 0.025 ng/dL) versus normal free testosterone (median 0.045 ng/dL).
- Free estradiol concentrations showed a direct relationship with free testosterone but not with BMI or age.
Conclusions:
- The suppression of the hypothalamo-hypophyseal-gonadal axis in type 2 diabetes patients with subnormal free testosterone is not associated with increased estradiol concentrations.
- The exact pathogenesis of subnormal free testosterone concentrations in type 2 diabetes requires further investigation.
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