diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM12913diaendo-12913Research ArticleОригинальные исследованияOriginal StudiesЧастота встречаемости и отягощающие факторы синдрома гипогонадизма у мужчин с сахарным диабетом типа 2The incidence and aggravating factors of male hypogonadism in type 2 diabeteshttps://orcid.org/0000-0002-5386-4289РоживановР. В.RozhivanovR. V.

Роживанов Роман Викторович, доктор медицинских наук

117036, Москва, ул. Дм. Ульянова, д. 11

eLibrary SPIN: 8052-3310

Roman V. Rozhivanov, MD, PhD

11 Dm. Ulyanova street, 117036 Moscow

eLibrary SPIN: 8052-3310

rrozhivanov@mail.ruhttps://orcid.org/0000-0002-7250-4588ЧерноваМ. О.ChernovaM. O.

Чернова Мария Олеговна, аспирант

Москва

eLibrary SPIN: 7765-3872

Mariia O. Chernova, MD, PhD-student

Moscow

eLibrary SPIN: 7765-3872

maryblack22@mail.ruhttps://orcid.org/0000-0002-5634-7877МельниченкоГ. А.Mel’nichenkoG. A.

Мельниченко Галина Афанасьевна, доктор медицинских наук, профессор, академик РАН

Москва

eLibrary SPIN: 8615-0038

Galina A. Mel’nichenko, MD, PhD, Professor

Moscow

eLibrary SPIN: 8615-0038

teofrast2000@mail.ruhttps://orcid.org/0000-0003-3893-9972ШестаковаМ. В.ShestakovaM. V.

Шестакова Марина Владимировна, доктор медицинских наук, профессор, академик РАН

Москва

eLibrary SPIN: 7584-7015

Marina V. Shestakova, MD, PhD, Professor

Moscow

eLibrary SPIN: 7584-7015

nephro@endocrincentr.ruhttps://orcid.org/0000-0002-9717-9742МокрышеваН. Г.MokryshevaN. G.

Мокрышева Наталья Георгиевна, доктор медицинских наук, профессор, член-корреспондент РАН

Москва

eLibrary SPIN: 5624-3875

Natalya G. Mokrysheva, MD, PhD, Professor

Moscow

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nm70@mail.ruНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian Federation202229082022254338346Copyright © Роживанов Р.В., Чернова М.О., Мельниченко Г.А., Шестакова М.В., Мокрышева Н.Г., 20222022Роживанов Р.В., Чернова М.О., Мельниченко Г.А., Шестакова М.В., Мокрышева Н.Г.Rozhivanov R.V., Chernova M.O., Mel’nichenko G.A., Shestakova M.V., Mokrysheva N.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/12913ОБОСНОВАНИЕ

ОБОСНОВАНИЕ. Мужской гипогонадизм ассоциирован с сахарным диабетом 2 типа (СД2), в связи с этим представляет интерес исследование частоты его встречаемости. Клинические симптомы гипогонадизма являются неспецифическими, и в основе его выявления лежит лабораторная диагностика. Оптимальным методом этой диагностики является тандемная масс-спектрометрия, которая и применена в нашем исследовании.

 ЦЕЛЬ

 ЦЕЛЬ. Оценка частоты встречаемости и отягощающих факторов синдрома гипогонадизма у мужчин с СД2, обратившихся за медицинской помощью в связи с основным заболеванием.

МЕТОДЫ

МЕТОДЫ. В сплошное одномоментное скрининговое одноцентровое неинтервенционное исследование были включены мужчины с СД2, обратившиеся за медицинской помощью в ФГБУ «НМИЦ эндокринологии» МЗ РФ в период с октября 2021 г. по январь 2022 г. Проводились изучение анамнеза, физикальный осмотр с определением индекса массы тела, измерение общего тестостерона методом тандемной масс-спектрометрии, гликированного гемоглобина и липидного спектра крови. Сравнение групп проведено с помощью U-критерия Манна–Уитни и χ² с поправкой Йейтса. Статистически значимыми считались различия при p<0,05.

 РЕЗУЛЬТАТЫ

 РЕЗУЛЬТАТЫ. Синдром гипогонадизма был выявлен у 355 (70,3%) мужчин. Пациенты с гипогонадизмом имели статистически значимо более выраженное ожирение по сравнению с мужчинами без гипогонадизма, худшие показатели контроля углеводного обмена, более низкие уровни липопротеинов высокой плотности (ЛПВП) и высокие — триглицеридов. Дополнительный сравнительный анализ среди лиц без ожирения показал наличие статистически значимых различий в уровне гликированного гемоглобина (выше у мужчин с гипогонадизмом) и ЛПВП (ниже у мужчин с гипогонадизмом). Анализ пациентов с гипогонадизмом в зависимости от наличия ожирения продемонстрировал статистически значимые различия между группами в уровне общего тестостерона (ниже у мужчин с ожирением) и триглицеридов (выше у мужчин с ожирением).

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. У 70,3% пациентов с СД2 выявлен синдром гипогонадизма. Его развитие ассоциировано с ожирением, а также неудовлетворительным контролем углеводного обмена.

BACKGROUND

BACKGROUND: Male hypogonadism is associated with type 2 diabetes mellitus (T2DM), therefore, it is of interest to study its frequency. The clinical symptoms of hypogonadism are not specific, and laboratory diagnostics is the basis for its detection. The optimal method for this diagnostics is isotope dilution liquid chromatography/tandem mass spectrometry, which was used in our study.

 AIMS

 AIMS: Assessment of the incidence and aggravating factors of male hypogonadism in type 2 diabetes

MATERIALS AND METHODS

MATERIALS AND METHODS: A full-design, cross-sectional, screening, single-center, non-interventional study included men with T2DM, who were he was treated in Endocrinology Research Centre, Moscow. The study was conducted from October 2021 to January 2022. Medical history assessment, physical examination with determination of body mass index (BMI), measurement estimation of total testosterone by isotope dilution liquid chromatography/tandem mass spectrometry, glycated hemoglobin (HbA1c) and lipid profiles were performed. The groups were compared using the Mann-Whitney U-test for quantitative indicators and χ² with Yates’ correction for qualitative ones. Differences were considered statistically significant with p0,05.

RESULTS

RESULTS: Hypogonadism was detected in 355 (70.3%) men with T2DM. Patients with hypogonadism had statistically significantly higher BMI, worse glycemic control, lower HDL levels, and higher triglycerides than eugonadal men. An additional comparative analysis among non-obese individuals showed the presence of statistically significant differences in the level of HbA1c (higher in hypogonadal men) and HDL (lower in hypogonadal men). An analysis of hypogonadal patients depending on the presence of obesity showed statistically significant differences between groups in the level of total testosterone (lower in obese men) and triglycerides (higher in obese men).

CONCLUSIONS

CONCLUSIONS: The prevalence of male hypogonadism in type 2 diabetes was 70,3%. Its development was associated with obesity and poor glycemic control.

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The authors declare that there are no conflicts of interest present.