Relationship Between Serum Testosterone Levels and Features of the Metabolic Syndrome Defining Criteria in Patients with Type 2 Diabetes Mellitus

Background: There are increasing reports on the association between the testosterone deficiency syndrome (TDS) and increased risk of development of the metabolic syndrome - a well recognized cardiovascular risk factor in men with diabetes mellitus.

Objective: To determine the relationship between serum testosterone levels and components of the metabolic syndrome in Type 2 diabetes mellitus in Nigerian men.

Methods: A total of 203 men with type 2 DM aged 30-86 years were evaluated for the testosterone deficiency syndrome (TDS). The diagnosis of the TDS or hypogonadism was made using a combination of clinical features of hypogonadism and subnormal levels of total testosterone. The presence of the metabolic syndrome was sought for in those with and without the TDS. The metabolic syndrome was diagnosed using the new criteria by the International Diabetes Federation and related bodies.

Results: The overall prevalence rates of the TDS and the metabolic syndrome in the study subjects were 36% and 44% respectively. The proportion of the subjects with the Metabolic Syndrome (METS) was comparable in subjects with and without the TDS. (47% vs 43%, p = 0.6). Using the Mann Whitney U test, the mean rank of the testosterone level in the subjects with the METS was lower than that of those without the METS but this difference was not statistically significant (67.2 vs 66, p =0.9).

Conclusion: The frequency of occurrence of the metabolic syndrome in men with type 2DM is comparable in those with hypogonadism and those without hypogonadism. There is no correlation between serum testosterone levels and the metabolic syndrome defining parameters.