老年男性代谢综合征患者性激素和性激素受体的变化

目的 探讨老年男性代谢综合征患者性激素和性激素受体与老年男性代谢综合征各组分的相互关系. 方法老年男性587例,其中代谢综合征患者187例(代谢综合征组),健康人400例(健康组).测定总睾酮(TT)、游离睾酮(FT)、脱氢表雄酮硫酸酯(DHEAS)、性激素结合球蛋白(SHBG)、雌二醇(E2)、黄体生成素(LH)、卵泡刺 激素(FSH)水平,同时采用流式细胞术检测外周血雄激素受体(AR)水平.结果 代谢综合征组患者DHAES、TT、SHBG、FT、AR荧光强度均低于健康组,而FSH、E2高于健康组.年龄与舒张压、FT呈负相关,与收缩压、E2 呈正相关.AR荧光强度与收缩压、LH呈负相关.DHEAS、SHBG进入logistic回归方程,与代谢综合征的发病呈负相关趋势.结论 老年男性代谢综合征患者存在低水平的DHEAS、TT、SHBG、FT、AR,同时存在高水平的FSH、E2;低水平的DHEAS、SHBG可能是老年男性代谢综合征潜在的危险因素.     

雄激素及其受体与老年男性冠状动脉粥样硬化性心脏病的相关性研究

目的 观察老年男性冠状动脉粥样硬化性心脏病(冠心病)患者性激素及雄激素受体水平的变化及相关性. 方法 横断面调查老年男性539例,其中健康人(对照组)400例,年龄62～92岁,平均(71.4±5.2)岁;冠心病患者139例,年龄60～88岁,平均(73.6±6.4)岁.测定总睾酮、游离睾酮、脱氢表雄酮硫酸酯(DHEAS)、性激素结合球蛋白(SHBG)、雌二醇、黄体生成素(LH)、卵泡刺激素(FSH)水平,同时采用流式细胞术检测外周血雄激素受体(AR)水平. 结果 老年男性冠心病患者DHAES、总睾酮、SHBG、游离睾酮、AR荧光强度均低于对照组(均为P<0.01),而FSH、E2高于对照组(均为P<0.01).年龄与总睾酮、游离睾酮呈负相关(r分别为-0.28、-0.17,P<0.01和P<0.05);与E2、SHBG呈正相关(r分别为0.33、0.14,P<0.01和P<0.05).AR荧光强度与收缩压呈负相关(r=-0.12,P<0.01).Logistic回归分析显示,总睾酮(OR=1.065,95%CI:1.012～1.121,P<0.05)、SHBG(OR=0.994,95%CI:0.990～0.998,P<0.01)和AR(OR=0.971,95%CI:0.956～0.986,P<0.01)与老年男性冠心病相关. 结论 老年男性冠心病患者存在低水平的DHEAS、总睾酮、SHBG、游离睾酮、AR,同时存在高水平的FSH、E2;低水平总睾酮、SHBG和AR可能是老年男性冠心病独立的危险因素.     

性激素和雄激素受体与老年男性糖尿病的相关性研究

目的 研究老年男性糖尿病患者的性激素和雄激素受体水平的变化,探讨老年男性糖尿病患者性激素和雄激素受体与糖尿病的相关性. 方法横断面调查老年男性492例,其中健康对照组104例,平均年龄(71.4±5.2)岁;非糖尿病对照组259例,平均年龄(71.5±5.0)岁;糖尿病组129例,平均年龄(73.0±6.3)岁.测定总睾酮(TT)、游离睾酮(FT)、脱氢表雄酮硫酸酯(DHEAS)、性激素结合球蛋白(SHBG)、雌二醇(E_2)、黄体生成素(LH)、卵泡刺激素(FSH)水平,采用流式细胞术检测外周血白细胞雄激素受体(AR)水平. 结果糖尿病组TT水平显著低于两对照组,分别为(17.1±6.1)、(15.8±6.0)nmol/L和(13.8±4.7)nmol/L(P<0.01),FT、SHBG、AR阳性率、AR荧光强度健康对照组、非糖尿病对照组和糖尿病组3组间呈下降趋势.但差异无统计学意义.多元回归分析町见TT、E_2,E_2/T,SHBG与血糖水平呈负相关;SHBG与糖尿病病程呈正相关.TT和AR阳性率与糖尿病病程呈负相关.Logistic多元同归分析示年龄、腰臀围比、FSH、SHBG、AR阳性率是糖尿病的危险因素. 结论低水平的TT、SHBG和AR可能是糖尿病的危险因素,在老年男性糖尿病的发生和发展中起到一定作用.     

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该文探讨老年男性高血压患者的雄激素及其受体以及雌激素水平变化。方法：选择老年男性高血压患者（高血压组）172例和同龄健康男性（健康组）104例，检测所有入选者血清7种性激素，黄体生成素（LH）、卵泡刺激素（FSH）、总睾酮（TT）和雌二醇（E2）采用化学发光法检测；游离睾酮（FT），硫酸脱氢表雄酮（DHEA-s）和性激素结合球蛋白（SHBG）采用酶联免疫吸附法检测。     

雄激素及其受体和雌激素变化在老年男性高血压患者中的初步研究

目的探讨老年男性高血压患者的雄激素及其受体以及雌激素水平变化。方法选择172例老年男性高血压患者(高血压组)和104例同龄健康男性(健康组),检测所有入选者血清7种性激素,黄体生成素(LH)、卵泡刺激素(FSH)、总睾酮(TT)和雌二醇(E2)采用化学发光法检测;游离睾酮(FT),硫酸脱氢表雄酮(DHEA-s),性激素结合球蛋白(SHBG)采用酶联免疫吸附法检测。使用流式细胞技术测定外周淋巴细胞的雄激素受体(AR)含量(AR平均荧光强度)。结果(1)与健康组比较,高血压组体重指数(BMI),腰围,腰臀比,空腹血糖和E2/TT明显增高,TT明显下降(P<0.01)(。2)控制BMI因素影响后,与收缩压相关的性激素有TT(P=0.047)和E2/TT(P=0.001);与舒张压相关的因素有E2,E2/TT和AR荧光强度(P<0.05)。结论男性高血压患者TT明显下降、E2/TT明显升高。E2/TT与收缩压和舒张压呈正相关,E2和AR荧光强度与舒张压呈正相关。     

男性迟发性性腺功能减退症患者血清性激素分析

目的通过观察老年男性迟发性性腺功能减退症(late onset of hypogonadism,LOH)患者的血清性激素变化情况,探讨性激素对LOH的诊断意义。方法 2009年11月至2014年6月,采用分层多阶段整群抽样方法,选择上海市及浙江省嘉善县17个社区3000例40~80岁中老年男性作为调查对象,分别记录国际勃起功能(IIEF-5)问卷及老年男性症状(AMS)量表,同时测定其血清总睾酮(TT)、黄体生成素(LH)、性激素结合球蛋白(SHBG),计算睾酮游离指数(TSI)、游离睾酮(FT)及生物活性睾酮(Bio-T)。结果研究对象平均年龄为(58.47±8.15)岁,AMS量表筛查LOH的阳性率为34.92%(937/2683)。LOH阳性组人群的TT和LH水平与阴性组比较差异无统计学意义(P0.05);FT、TSI在LOH阳性组较阴性组明显降低(P0.05);SHBG及Bio-T在2组间差异亦有统计学意义(P0.01)。Pearson相关分析显示:TSI、SHBG及Bio-T与LOH显著相关,FT与LOH弱相关,而TT及LH与LOH无明显相关性。结论 SHBG及Bio-T对LOH患者的诊断价值优于TT,Bio-T的下降及SHBG的增高应作为LOH患者重要的诊断指标。     

性激素对老年男性T2DM患者骨密度的影响

目的探讨数据分析性激素对老年男性2型糖尿病(T2DM)患者骨密度的影响。方法选取2011年6月至2013年6月在该院接受治疗的T2DM男性患者224例,依照骨量状况分为骨质疏松(OP)组和非OP(NOP)组。比较两组的一般资料,进行性激素对骨密度的偏相关和多元回归分析。结果 OP组比NOP组年龄更大,病程更长,但体重指数(BMI)比NOP组低,卵泡刺激素(FSH)和性激素结合球蛋白(SHBG)水平比NOP组高(均P0.05)。睾酮(T)与三个部位的骨密度均存在明显的正相关关系(P0.05)。SHBG仅与全髋(TH)部位的骨密度存在明显的负相关关系(P0.05)。雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)与三个部位的骨密度,SHBG与第2~4腰椎(L2~4)、股骨颈(FN)不存在相关性(P0.05)。E2、T、SHBG是影响L2-4骨密度的主要因素;E2、SHBG是影响股骨颈(FN)和TH骨密度的主要因素。FSH、LH未进入回归模型。结论性激素对男性T2DM老年患者骨密度具有一定程度的影响。     

雄激素受体及雄激素在老年男性高血压患者中的变化及意义

目的探讨男性高血压患者性激素水平的变化,并进一步研究性激素与高血压患者雄激素受体、肥胖的相关性。方法收集高血压患者112例,正常健康者120例,记录临床资料,包括身高、体重、年龄。采用酶联免疫吸附法及化学发光法检测血浆总睾酮(TSTO),游离睾酮(FT),脱氢表雄酮硫酸酯(DHEAS),性激素结合球蛋白(SHBG),雌二醇(E2),黄体生成素LH),卵泡刺激素(FSH)水平。用流式细胞术测定外周血白细胞雄激素受体(AR),以上各项指标在两组之间进行比较。结果高血压患者总睾酮(TSTO)浓度明显低于正常对照组,差异有显著性(P<0．05)。高血压组体重指数、腰围／臀围、E2／T与正常对照组相比均存在显著性差异(P<0．05)。高血压患者血浆总睾酮与雄激素受体含量、体重指数呈显著相关,分别与雄激素受体含量正相关(r=0．08,P<0．01);与体重指数负相关(r=-0．58,P<0．01)。结论血浆雄激素水平可作为评估高血压发病危险因素的一项新指标。     

血清性激素水平与老年男性骨代谢指标及骨密度的关系

目的：探讨老年男性血清性激素表达水平与骨代谢指标及骨密度之间的关系。方法：收集老年男性患者230例,年龄65～95岁,分别测定雌二醇（E2）、睾酮、游离睾酮（FT）、性激素结合球蛋白（SHBG）、脱氢表雄酮（DHEA）、骨钙素、骨碱性磷酸酶（BALP）、25-羟维生素D3及尿Ⅰ型胶原交联氨基末端肽（NTX）等指标,同时利用双能X线分别测定髋关节及腰椎（L1～L4）的骨密度,分析老年男性骨密度、骨代谢指标与血清性激素以及年龄与骨密度的相关性。结果：血清E2、FT与腰椎及髋关节的骨密度呈正相关,而睾酮、SHBG、DHEA与骨密度无关。血清E2、FT与骨代谢指标NTX、BALP呈负相关,血清E2与25-羟维生素D3呈正相关,而睾酮、SHBG、DHEA与骨代谢指标NTX、BALP无关。年龄与腰椎L1、L2、L4、L1～4及髋部骨密度呈负相关,与腰椎L3骨密度无关。结论：老年男性骨密度的变化受性激素中FT、E2表达水平的影响,而受E2的影响程度超过雄激素。血清FT及血清E2的水平可作为老年男性骨质疏松症的独立观察指标。     

男性Graves病患者唾液睾酮及血清性激素水平的变化

本文观察了20例男性Graves病患者抗甲状腺药物治疗前后的唾液睾酮及血清中几种性激素水平的变化,并与年龄、性别相配对的20例健康者进行了比较分析。患者治疗前唾液睾酮水平明显低于正常,治疗后显著上升,与血T_3、T_4的变化呈负相关;治疗前血总睾酮、雌二醇、LH及FSH显著高于正常,治疗2个月后除雌二醇外均随T_3、T_4的下降而下降。本文结果支持唾液睾酮不受SHBG的影响,提示Graves病患者游离睾酮减低。     

老年男性心力衰竭患者雄激素水平与心血管危险因素的关系

目的探讨老年男性心力衰竭患者体内雄激素水平与心血管危险因素的相关性。方法选择临床诊断为慢性心力衰竭、超声心动图检查LVEF≤45%、年龄≥60岁的男性住院患者100例(心力衰竭组),另选400例年龄≥60岁同龄健康男性为正常对照组。检测总睾酮、游离睾酮、脱氢表雄酮硫酸酯、性激素结合球蛋白水平;同时详细记录心力衰竭组患者体重指数、血压、血糖、血脂、尿酸、吸烟等心血管危险因素情况,进行多元相关分析。结果与正常对照组比较,心力衰竭组患者总睾酮、游离睾酮、脱氢表雄酮硫酸酯明显降低,性激素结合球蛋白明显升高(P0.05,P0.01)。心力衰竭患者总睾酮与舒张压、TC、TG呈负相关,游离睾酮与舒张压、TC、LDL-C、尿酸呈负相关;性激素结合球蛋白与体重指数及吸烟呈正相关。结论老年男性心力衰竭患者雄激素水平低下可能对心血管危险因素产生不利影响,从而对心血管系统产生不利影响。     

Relationship of level of sex hormone and sex hormone receptor with development of metabolic syndrome in elderly men

Objective The sex hormone and the corresponding receptor may play some roles in the development of the metabolic syndrome （MS） in the elderly men. This study was designed to examine the relationship of level of the sex hormone and androgen receptor with MS in elderly men, thus to investigate the possible pathogenesis of MS. Methods This cross sectional study enrolled 587 elderly men, including 400 healthy controlls aged 62-92 years and 187 MS patients aged 60-87 years in Wan Shou Lu area of Beijing city. Dehydroepiandrosterone sulfate （DHAE-S）, total testosterone （TT）, sex hormone binding globulin （SHBG）, free testosterone （FT）, follicle-stimulating hormone （FSH）,Estradiol （E2）,luteinizing hormone（LH） and androgen receptor （AR） in blood were tested. Statistical analyses included the comparison analysis of variables and independent variables, correlation analysis using multi-factor linear regression, and multiple logistic regression analysis. Results DHAE-S, TT, SHBG, FT and AR fluorescence intensity in healthy control group were higher than those in MS group, however, FSH and E2 levels were lower in healthy group. Age was negatively correlated with diastolic blood pressure （DBP） and FT, but positively correlated with systolic blood pressure （SBP） and E2. AR fluorescence intensity was negatively correlated with SBP and LH. The logistic regression equation showed the negative correlation between DHEA-S, SHBG and the development of MS. Conclusions There are low levels of DHEA-S, TT, SHBG, FT and AR in the elderly patients with MS. On the contrary, FSH and E2 concentration are higher. It can be suggested that low levels of DHEA-S and SHBG may be the potential risk factors of MS in elderly men.     

Oestradiol is a protective factor for non-alcoholic fatty liver disease in healthy men

Visceral fat is a risk factor for non‐alcoholic fatty liver disease (NAFLD). A reduction in sex hormones is associated with increased abdominal fat. Thus, we investigated whether reduced testosterone (T) or oestradiol (E2) levels in men are associated with NAFLD and central obesity. The study involved a survey of 1,882 men between 20 and 60 years of age. We detected hepatic fat infiltration by ultrasound. Early morning serum was analyzed for total testosterone (TT), E2, sex hormone‐binding globulin (SHBG), follicle‐stimulating hormone (FSH) and luteinizing hormone (LH). Free testosterone (FT) was calculated using the Vermeulen method. In the studied population, the prevalence of NAFLD, FSH, LH and SHBG increased with age, TT and FT declined with age, and E2 remained stable. However, in the NAFLD group, TT remained stable, FT and E2 declined, and hepatic fat infiltration increased (P < 0.001 for both). Using multivariate analysis, a correlation was found between E2 and NAFLD, with an odds ratio of 0.954 (95% confidence interval: 0.946–0.967). E2 is one of the protective factors against NAFLD in healthy men. T has no significant correlation with NAFLD. Further investigation would be required to assess the clinical consequences of reduced E2 in men with NAFLD, particularly for men whose TT remained stable.     

健康高龄老年人甲状腺激素水平变化趋势分析

目的 探讨80岁以上高龄老年人甲状腺激素水平变化趋势.方法 将602例健康志愿者按年龄分为中青年组(20～59岁)226例、老年组(60～79岁)195例和高龄组(80～102岁)181例,采用化学发光法及放射免疫法测定志愿者血清三碘甲状腺原氨酸(TT3)、甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、反T3(rT3)水平,并以SPSS 13.0进行统计分析.结果 老年组与中青年组比较,血清FT3和TT3降低,差异有统计学意义(t值分别为2.793和3.627,均为P＜0.01);高龄组与中青年组比较,TT3、TT4、FT3、TSH、rT3浓度差异有统计学意义(t值分别为10.930、6.065、15.398、-2.933、-5.643,均为P＜0.01);老年组与高龄组比较,TT3、TT4、FT3、TSH、rT3浓度差异有统计学意义(t值分别为8.382、4.298、11.573、-3.383、-5.148,均为P＜0.01).FT3、TT3、TT4浓度与年龄呈负相关(r值分别为-0.51、-0.39、-0.25,P＜0.01),rT3、TSH浓度与年龄呈正相关(r值分别为0.32、0.12,P＜0.01),FT4与年龄无相关.高龄组高于或低于临床正常参考值范围的阳性发生率,在TT3、TT4、FT3、FT4、TSH、rT3中分别为0、0、13.8%、0、6.6%、21%.结论 随着年龄增长,老年人血清甲状腺激素水平及促甲状腺激素均有改变,特别是80岁及以上高龄老年人,血清FT3、rT3、TSH变化更为明显,建议临床设立老年人不同年龄段的血清甲状腺激素正常参考值范围,以减少假阳性的发生率.

Abstract：

Objective To explore the variation tendency of serum thyroid hormone level in the elderly aged over 80 years.Methods The 602 healthy volunteers were divided into 3 groups by age:young group (20-59 years of age,n= 226),elderly group (60-79 years of age,n= 195),and advanced age group (80-102 years of age,n=181).Fasting blood of all persons was harvested,then the levels of serum total triiodothyroxine (TT3),total thyroxine (TT4),free tri-iodothyronine (FT3),free thyroxine (FT4),thyroid-stimulating hormone (TSH) and reverse tri-iodothyronine (rT3) were determined by chemistry luminescence technique and radioimmunoassay.Statistical analysis was made by the software SPSS 13.0.Results The levels of serum FT3 and TT3 were lower in elderly group than in young group (t=2.793,3.627,P=0.005,0.000).There were significant differences in the levels of serum TT3,TT4,FT3,TSH and rT3 between young group and advanced-age group (t =10.930,6.065,15.398,- 2.933,- 5.643,all P = 0.000),also between elderly group and advanced-age group (t= 8.382,4.298,11.573,-3.383,-5.148,all P＜0.001).The levels of serum FT3,TT3 and TT4 were negatively correlated with age (r=- 0.51,-0.39 and -0.25,respectively,all P＜0.01).And the levels of serum rT3 and TSH showed positive relationships with age (r=0.32,0.12,all P＜0.01).There were no relationships between the level of serum FT4 and age.The positive rate of serum TT3,TT4,FT3,FT4,TSH and rT3 concentration beyond the reference value was 0,0,13.8%,0,6.6% and 21% in advanced-age group,respectively.Conclusions The levels of serum thyroid hormone and thyroid-stimulating hormone change with age.The levels of FT3,rT3 and TSH change obviously in the elderly aged over 80 years.It could reduce the false positive rate in clinical practice if normal reference range for serum thyroid hormone levels in different aged elderly is established.     

年龄依赖性胰岛素抵抗与睾酮水平的相关性

目的探讨健康男性年龄对胰岛素抵抗的影响和胰岛素抵抗与睾酮的关系。方法在北京、上海、西安和重庆四城市调查20～78岁健康男性1080例,同时测定空腹血糖、胰岛素、总睾酮、雌二醇、黄体生成激素(LH)、卵泡刺激激素(FSH)和性激素结合球蛋白(SHBG),计算稳态模型胰岛素抵抗指数(HOMA-IR)、游离睾酮(cFT)、睾酮分泌指数(TSI)和游离睾酮指数(FTI),将空腹血糖、胰岛素和HOMA-IR与其他检验结果进行相关分析。结果空腹血糖、胰岛素和HOMA-IR与年龄(r=0.1644、0.1536和0.1587;均为P<0.01)、LH(r=0.1909、0.1310和0.1920;均为P<0.01)和FSH(r=0.1 704、0.1543和0.1907;均为P<0.01)呈显著正相关,与总睾酮(r=-0.0825、-0.2187和-0.1619;P>0.05、P<0.01和P<0.01)、cFT(r=0.1238、-0.1 567和-0.1346;P<0.01、P<0.01和P<0.05)和TSI(r=-0.2143、-0.2098和-0.2488;均为P<0.01)呈显著负相关。结论健康男性随年龄增长伴有空腹血糖、胰岛素和HOMA-IR的逐渐升高,年龄依赖性雄激素水平降低对这种胰岛素抵抗的变化可能起着重要作用。     

The effects of aging in normal men on bioavailable testosterone and luteinizing hormone secretion: response to clomiphene citrate

Serum testosterone (T) levels in men decline with age while serum LH levels, as measured by RIA, increase. To assess if the decline in serum T levels in healthy aging men is paralleled by an age-related decline in the bioavailable non-sex hormone-binding globulin (SHBG)-bound fraction of T and to determine whether there are age-related changes in LH secretion or LH control of T production, we studied 29 young (aged 22-35 yr) and 26 elderly (aged 65-84 yr) healthy men. All men had single random blood samples drawn, and 14 men in each age group underwent frequent blood sampling for 24 h, both before and after 7 days of clomiphene citrate (CC) administration. Both mean 24-h serum total T levels and non-SHBG-bound T were reduced in elderly men compared to those in young men (P less than 0.05), while estradiol and SHBG levels were similar in the 2 age groups. Serum FSH determined by RIA and LH by RIA and bioassay were higher in the elderly men compared to those in young men (P less than 0.05), but the ratios of LH bioactivity to immunoreactivity and the LH pulse frequency and amplitude were similar. After CC administration, mean serum total T and non-SHBG-bound levels in young men increased by 100% and 304%, respectively, while in older men these values increased by only 32% and 8%, respectively. However, CC-stimulated LH pulse characteristics and serum levels of estradiol, SHBG, FSH, and bioactive and immunoreactive LH were similar in the 2 groups. Thus, both at baseline and after CC stimulation, elderly men had significantly lower serum total T and non-SHBG-bound (bioavailable) T levels than did young men, despite similar or increased levels of bioactive LH and similar bioactive to immunoreactive LH ratios and LH pulse characteristics. These results suggest that major age-related changes in the hypothalamic-pituitary-testicular axis occur at the level of the testes and are manifested by decreased responsiveness to bioactive LH. Administration of CC to young and elderly men resulted in similar changes in LH pulse characteristics and LH bioactivity and immunoreactivity, suggesting preserved hypothalamic-pituitary responsiveness in the elderly.     

Low free testosterone is an independent risk factor for Alzheimer's disease

The purpose of this study was to assess pituitary gonadotropins and free testosterone levels in a larger cohort of men with Alzheimer's disease (AD, n=112) and age-matched controls (n=98) from the Oxford Project to Investigate Memory and Ageing (OPTIMA). We measured gonadotropins (follicle stimulating hormone, FSH, and luteinizing hormone, LH), sex hormone binding globulin (SHBG, which determines the amount of free testosterone) and total testosterone (TT) using enzyme immunoassays. AD cases had significantly higher LH and FSH and lower free testosterone levels. LH, FSH and SHBG all increased with age, while free testosterone decreased. Low free testosterone was an independent predictor for AD. Its variance was overall explained by high SHBG, low TT, high LH, an older age and low body mass index (BMI). In controls, low thyroid stimulating hormone levels were also associated with low free testosterone. Elderly AD cases had raised levels of gonadotropins. This response may be an attempt to normalize low free testosterone levels. In non-demented participants, subclinical hyperthyroid disease (a risk factor for AD) which can result in higher SHBG levels, was associated with low free testosterone. Lowering SHBG and/or screening for subclinical thyroid disease may prevent cognitive decline and/or wasting in men at risk for AD.     

Frequent occurrence of hypogonadotropic hypogonadism in type 2 diabetes

Type 2 diabetes is associated with lower total testosterone (T) levels in cross-sectional studies. However, it is not known whether the defect is primary or secondary. We investigated the prevalence of hypogonadism in type 2 diabetes by measuring serum total T, free T (FT), SHBG, LH, FSH, and prolactin (PRL) in 103 type 2 diabetes patients. FT was measured by equilibrium dialysis. FT was also calculated by using T and SHBG (cFT). Hypogonadism was defined as low FT or cFT. The mean age was 54.7 +/- 1.1 yr, mean body mass index (BMI) was 33.4 +/- 0.8 kg/m(2), and mean HbA1c was 8.4 +/- 0.2%. The mean T was 12.19 +/- 0.50 nmol/liter (351.7 +/- 14.4 ng/dl), SHBG was 27.89 +/- 1.65 nmol/liter, and FT was 0.250 +/- 0.014 nmol/liter. Thirty-three percent of patients were hypogonadal. LH and FSH levels were significantly lower in the hypogonadal group compared with patients with normal FT levels (3.15 +/- 0.26 vs. 3.91 +/- 0.24 mIU/ml for LH and 4.25 +/- 0.45 vs. 5.53 +/- 0.40 mIU/ml for FSH; P < 0.05). There was a significant inverse correlation of BMI with FT (r = -0.382; P < 0.01) and T (r = -0.327; P < 0.01). SHBG correlated inversely with BMI (r = -0.267; P < 0.05) but positively with age (r = 0.538; P < 0.001) and T (r = 0.574; P < 0.001). FT correlated strongly with cFT (r = 0.919; P < 0.001) but not with SHBG. LH levels correlated positively with FT (r = 0.287; P < 0.05). We conclude that hypogonadotropic hypogonadism occurs commonly in type 2 diabetes.