Correlation Between VitD Deficiency And Type 2 Diabetes Complicated By Hypogonadism In Men

Objective(s):30-40%of male patients with Type 2 diabetes mellitus(T2DM)have hypogonadism,but the pathogenesis is still unclear.Vitamin D(VitD)plays a role in regulating glucose-insulin homeostasis in non-skeletal tissues.Its receptors are distributed in the testis,pituitary and hypothalamus,and may participate in the regulation of hypothalamic-pituitary-testicular gonad axis hormone secretion.Therefore,relevant studies were conducted on VitD deficiency and T2DM complicated male hypogonadism.Methods:A total of 658 male patients with T2DM aged 18-70 years were selected from the Department of Endocrinology,the First Affiliated Hospital of Kunming Medical University from December 2015 to December 2019.According to the total testosterone?350ng/dl(12nmol/L)as the diagnostic criteria for hypogonadism,A total of 464 patients with T2DM complicated with hypogonadism were screened.Among them,luteinizing hormone(LH)?6IU/L was the high promotion group,and luteinizing hormone(LH)<6IU/L was the low promotion group.According to the internationally recognized stratification method,464 T2DM male patients with hypogonadism were divided into three study groups according to the level of 25-hydroxyvitamin D(25(OH)D):25(OH)D<20.0 ng/ml was defined as the VitD deficiency group,20.0?25(OH)D<29.9 ng/ml was defined as the VitD insufficiency group,25(OH)D?30.0ng/ml was defined as the VitD equilibrium group.Collected during the research object in the hospital's age,fasting plasma glucose(FPG),two hours postprandial blood glucose(2hPBG),total testosterone(TT),luteinizing hormone(LH),fasting insulin(FINS),triglyceride(TG),height,weight,hemoglobin A1c(HbA1c),25-hydroxyvitamin D(25(OH)D),the calculation for body mass index(BMI)and homeostasis mode assessment of insulin resistance(HOMA-IR).The clinical indicators FPG,2hPBG,HbA1c,TG,LH,HOMA-IR and TT among the three groups of VitD were compared and analyzed,and their correlations with 25(OH)D serum levels were analyzed.After being divided into low-promoting subgroup and high-promoting subgroup according to LH value,the comparison of FPG,2hPBG,HbAlc,TG,HOMA-IR and TT among subgroups was conducted.Binary logistic regression analysis was used to analyze the effect of VitD deficiency on LH and TT levels.Results:1.Among the male hospitalized patients with T2DM,70.52%of the patients had hypogonadism.There was no statistical difference in the basic information in the three groups of VitD(P>0.05),and the baseline levels of the three groups of VitD were consistent.There were 184 people(39.66%)in the VitD equilibrium group,111 people(23.92%)in the VitD insufficiency group,and 169 people(36.42%)in the VitD deficiency group.There were 95 people(51.63%)with low promotion in VitD equilibrium group,and 89 people(48.37%)with high promotion in VitD equilibrium group.There were 68 people(61.26%)with low promotion in VitD insufficiency group,and 43 people(38.74%)with high promotion in VitD insufficiency group.There were 98 people(57.99%)with low promotion in VitD deficiency group,and 71 people(42.01%)with high promotion in VitD deficiency group.In the three groups of VitD,the low promotion group had a higher proportion than the high promotion group.2.The difference between FPG and 2hPBG in the three groups of VitD was statistically significant(P<0.05),and FPG and 2hPBG were higher in VitD deficiency group than in VitD insufficiency group and VitD equilibrium group.Among the three groups of VitD with hypergonadotropin hypogonadism,the difference between TG groups was statistically significant(P<0.05),and TG was higher in the VitD deficiency group than in VitD insufficiency group and the VitD equilibrium group.3.In the VitD deficiency group,2hPBG was negatively correlated with 25(OH)D serum levels(r=-0.152,P=0.049).4.In the results of the binary logistic regression analysis that affected the low level of serum TT,VitD deficiency was an independent influencing factor of lower TT level(OR:0.660,95%CI:0.449?0.972).Conclusion(s):1.Among the male hospitalized patients with T2DM,patients with hypogonadism accounted for 70.52%,and patients with VitD deficiency accounted for 36.42%.Patients with hypogonadotropin hypogonadism were the main subjects in the three groups of VitD.2.In the three VitD groups,FPG and 2hPBG were higher in the VitD deficiency group than the VitD insufficiency group and the VitD equilibrium group;In the three groups of VitD with hypergonadotrophic hypogonadism,TG was higher than VitD insufficiency group and VitD equilibrium group in VitD deficiency group;2hPBG was negatively correlated with 25(OH)D serum level in VitD deficiency group.3.In patients with T2DM complicated by hypogonadism,VitD deficiency is an independent influencing factor for lower TT levels.