THE STATE OF THE HYPOPHYSIS-GONADAL SYSTEM IN YOUNG AND MIDDLE AGE MEN WITH TYPE 2 DIABETES MELLITUS

Abstract

Background. Age - related decrease in testosterone levels is a consequence of defects in the hypothalamic - pituitary - gonadal system at all levels. The consequence of androgen deficiency is a decrease in insulin secretion and impaired sensitivity to it, as well as a decrease in the vasoprotective effect of testosterone and a negative effect on lipid metabolism. These processes are characteristic of natural aging, but their appearance in young and middle age indicates premature aging. Materials and methods. 144 men aged 35-55 years were examined: the main group - men with type 2 diabetes mellitus, polymorbid cardiovascular pathology, anxiety and depressive disorders; the control group - practically healthy men. The levels of testosterone, thyroid - stimulating hormone, prolactin, luteinizing hormone, sex hormone - binding globulin in blood serum were determined. Free testosterone is calculated from the nomogram. The severity of androgen deficiency was assessed by the questionnaire method. Results. In patients with type 2 diabetes mellitus, primary laboratory and clinical androgen deficiency, differences in the ratio of luteinizing hormone and testosterone between men of the main and control groups, characteristic of the early onset of aging, were revealed. Correlations of testosterone with indicators of carbohydrate and lipid metabolism, subjective clinical signs of androgen deficiency have been established. Conclusion. A targeted search for androgen deficiency in the group of patients with type 2 diabetes mellitus and cardiovascular pathology is needed to prescribe treatment in the absence of contraindications to testosterone replacement therapy from the position of combating early aging.