Cited by 217Hormonal and reproductive studiesSperm and Testicular FunctionDiabetes, Cardiovascular Risks, and Lipoproteins

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ENDOGENOUS SEX HORMONE LEVELS IN OLDER ADULT MEN WITH DIABETES MELLITUS

BARRETT-CONNOR, E., KHAW, K.-T., YEN, S. S. C.·1990·American Journal of Epidemiology

DOI 10.1093/oxfordjournals.aje.a115732

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Abstract

In a Southern California population-based cohort of 985 men aged 40-79 years in 1972-1974, 110 men with diabetes had significantly lower mean levels of endogenous plasma testosterone and sex hormone-binding globulin than did 875 nondiabetic men. Mean androstenedione, estrone, and estradiol levels did not differ significantly by diabetic status. The testosterone and sex hormone-binding globulin differences were reduced but not eliminated after adjustment for age and body mass index (weight (kg)/height (m)2). Twenty-one percent of diabetic men compared with 13% of nondiabetic men had testosterone levels below a categorically defined normal level of 3,500 pg/ml. Testosterone was inversely related to degree of glycemia in the whole cohort. Throughout the whole range of plasma glucose, there was a stepwise decrease in mean testosterone levels per categorical increase in fasting plasma glucose, apparent in both diabetics and nondiabetics. The clinical and physiologic implications of the reduced testosterone levels in diabetic men merit further investigation.

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Items 101–200 of 216

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Background
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“On the other hand, when the age of the patients ranged from 40 to 79 years old, low levels of testosterone were observed in 21% of the diabetic men, and 13% of the non-diabetic (16).”
Background
MANAGEMENT OF ENDOCRINE DISEASE: Rationale and current evidence for testosterone therapy in the management of obesity and its complications
Lapauw, B., & Kaufman, J. (2020) · European Journal of Endocrinology · doi:10.1530/eje-20-0394 · Cited by 24
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Background
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“INTRODUCTION Male hypogonadism is highly prevalent in adult men with type 2 diabetes, affecting between 21 and 46% of these patients (Barrett-Connor et al., 1990; Dhindsa et al., 2010).”
Background
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“[1] An association between type 2 diabetes mellitus (DM) and hypogonadism came to limelight over two decades ago when a high prevalence of low testosterone levels was observed in men with type 2 diabetes.[2] Subsequently, a meta‐analysis confirmed that men with type 2 DM have significantly lower levels of testosterone…”
Background
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“This association between BMI and low testosterone was reported in several studies (Ali et al., 1993; American Diabetes Association, 2007a, 2007b; Barrett-Connor et al., 1990; Corona et al., 2006, 2011; Corrales et al., 2004; Dandona & Dhindsa, 2011; Dhindsa et al., 2004; Feldman et al., 2002; Gross et al., 2005; Kapoo…”
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The aging male – diagnosis and therapy of late‐onset hypogonadism
Schreiber, G., & Ziemer, M. (2008) · JDDG Journal der Deutschen Dermatologischen Gesellschaft · doi:10.1111/j.1610-0387.2008.06493.x · Cited by 14
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“The main reasons for the lower PSA levels may be the reduced testosterone levels and sex hormone-binding globulin levels (Barrett-Connor et al., 1990; Zitzmann et al., 2006; Han et al., 2008).”
Background
Derivatization with 2-hydrazino-1-methylpyridine enhances sensitivity of analysis of 5α-dihydrotestosterone in human plasma by liquid chromatography tandem mass spectrometry
Faqehi, A. M. M., Denham, S. G., Naredo, G., Cobice, D., Khan, S., Simpson, J. P., Sabil, G., Upreti, R., Gibb, F. W., Homer, N. Z. M., et al. (2021) · Journal of Chromatography A · doi:10.1016/j.chroma.2021.461933 · Cited by 12
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Elin, R. J., & Winters, S. J. (2004) · Clinics in Laboratory Medicine · doi:10.1016/j.cll.2004.01.010 · Cited by 13
“Total testosterone levels are likewise reduced in men who have type 2 diabetes, even when controlling for BMI [79–81].”
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Relation of Sexual Dysfunction to Hormone Levels, Diseases and Drugs Used in Andrological Patients
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Background
Oxidative Stress is Markedly Reduced by Combined Voluntary Exercise and Testosterone in the Heart of Diabetic Rats
Chodari, L. (2019) · Acta Endocrinologica (Bucharest) · doi:10.4183/aeb.2019.173 · Cited by 10
“Also, it is reported that testosterone deficiency contributes to many diabetes complications (14).”
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Perspectives for metabolomics in testosterone replacement therapy
Haring, R. (2012) · Journal of Endocrinology · doi:10.1530/joe-12-0119 · Cited by 10
Erectile dysfunction and hypogonadism (low testosterone).
Barkin, J. (2011) · PubMed · Cited by 10
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Hijazi, R. A., Betancourt-Albrecht, M., & Cunningham, G. R. (2004) · Medical Clinics of North America · doi:10.1016/j.mcna.2004.04.007 · Cited by 10
“The Rancho Bernardo study evaluated 985 men, aged 40 to 79 years, between 1972 and1974 [17].”
Method
Taurine Improves Sexual Function in Streptozotocin-Induced Diabetic Rats
Yang, J., Lin, S., Zhang, Y., Wu, G., Yang, Q., Lv, Q., & Hu, J. (2017) · Advances in experimental medicine and biology · doi:10.1007/978-94-024-1079-2_27 · Cited by 9
“A cross-sectional survey has found that the prevalence of hypogonadism in diabetic men was 20–60%, which increased in the elderly (Barrett-Connor et al. 1990).”
Background
The role of insulin and leptin in male reproduction
Lampiao, F., & Agarwal, A. K. (2009) · Cited by 9
The prevalence of hypogonadism in diabetic men in Isfahan Endocrine and Metabolism Research Center, Isfahan, Iran.
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Briansó‐Llort, L., Fuertes‐Rioja, L., Ramos‐Perez, L., Salcedo, M. T., Hernández, C., Simó, R., & Selva, D. M. (2022) · Journal of Cellular Physiology · doi:10.1002/jcp.30818 · Cited by 8
“since both type II diabetes and CVD have been associated with low plasma SHBG (Barrett‐Connor et al., 1990; Hua et al., 2014; Karim et al., 2008; Peter et al., 2010; Sutton‐Tyrrell et al., 2005).”
Background
Waist Circumference Is More Closely Associated with Hypogonadism than Is Hyperglycemia, Independent of BMI in Middle-Aged Men
Hsu, P.-S., Hung, C.-L., Tu, S.-K., Chen, H.-H., Yang, D., & Liao, C. (2021) · Journal of Diabetes Research · doi:10.1155/2021/1347588 · Cited by 8
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Basal Endogenous Steroid Hormones, Sex Hormone-Binding Globulin, Physical Fitness, and Health Risk Factors in Young Adult Men
Gagnon, S. S., Nindl, B. C., Vaara, J. P., Santtila, M., Häkkinen, K., & Kyröläinen, H. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2018.01005 · Cited by 7
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Background
Relationship Between Testosterone Deficiency and the Cardiovascular Risk Ractors, Diabetes and Hypertension
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Kanauchi, M., Nakajima, M., & Dohi, K. (2001) · The Nephron journals/Nephron journals · doi:10.1159/000045967 · Cited by 5
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Gore, J. L., & Rajfer, J. (2004) · Current Sexual Health Reports · doi:10.1007/s11930-004-0022-3 · Cited by 5
Late-Onset Hypogonadism (LOH): Incidence, Diagnosis, and Short-Term Effects
Bettocchi, C. (2005) · European Urology Supplements · doi:10.1016/j.eursup.2005.05.002 · Cited by 5
Influence of metabolic syndrome on infertility: A review
Tesfa, K. H., & Zewdie, A. N. (2026) · Metabolism Open · doi:10.1016/j.metop.2026.100469 · Cited by 4
“Population-based studies report that diabetic men have significantly lower testosterone and sex hormone-binding globulin (SHBG), despite similar levels of other sex steroids such as estradiol and androstenedione [64].”
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Corona, G., & Maggi, M. (2013) · PubMed · Cited by 4
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Oğuz, A., Şahin, M., Ülgen, C., Uyan, M., & Gül, K. (2021) · Andrologia · doi:10.1111/and.14271 · Cited by 5
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“25 26 – 28 However, in other studies, patients with advanced PCa and coincident diabetes who were receiving ADT progressed to castration ‐ resistant disease more quickly than their counterparts without diabetes.”
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Lakshmi, G., & Mahadevan, S. (2025) · Apollo Medicine · doi:10.1177/09760016251332088 · Cited by 4
“[7] Further studies revealed a structurally normal testis and hypothalamo-pituitary-gonadal (HPG) axis in these patients.”
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Mehrabianfar, P., Dehghani, F., Karbalaei, N., & Mesbah, F. (2020) · International Journal of Reproductive BioMedicine (IJRM) · doi:10.18502/ijrm.v13i8.7506 · Cited by 4
“Previous research has shown that testosterone levels in diabetics are reduced (32), as we find in our study (not shown in the result section).”
Result
Real Life Cancer Comorbidity in Greek Patients with Diabetes Mellitus Followed Up at a Single Diabetes Center: An Unappreciated New Diabetes Complication
Thanopoulou, A. C., & Pectasides, D. (2014) · Journal of Diabetes Research · doi:10.1155/2014/231425 · Cited by 4
New antidiabetic drugs' role in the management of testosterone deficiency and of the cardiovascular disease in hypogonadal diabetic men
Genchi, V. A., Zanni, E., Colzani, M., Lauriola, C., Cignarelli, A., Santi, D., & Greco, C. (2023) · Metabolism and Target Organ Damage · doi:10.20517/mtod.2023.06 · Cited by 3
Effect of Type2 Diabetes Mellitus on Sudanese Male Fertility
Mohieldin, J. M., Mohammed, N. B., & Abdalla, O. M. (2016) · Scholars Journal of Applied Medical Sciences · doi:10.21276/sjams.2016.4.6.72 · Cited by 3
“Some observational studies in diabetic men have reported a higher prevalence of hypogonadism when compared with non-diabetics [3, 4].”
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Age-Related Androgen Deficiency and Type 2 Diabetes
Ryan, G. J., & Jobe, L. J. (2011) · Journal of Pharmacy Practice · doi:10.1177/0897190010397719 · Cited by 3
“Hyperinsulinemia and obesity also seem to be associated with decreased SHBG production,(16,18-20) and patients with type 2 diabetes have been found to have lower levels of this globulin than age- and BMI-matched controls.(21) Until more is known about the relationships between SHBG, free testosterone, and total testos…”
Background
The levels of testosterone, zinc, manganese and selenium in type 2 diabetic patient in South-Eastern Nigeria
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Testosterone testing in adult males.
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Altıntaş, R. (2014) · Diabetes & Metabolic Disorders · doi:10.24966/dmd-201x/100002 · Cited by 3
“Several studies examining hypertensive men demonstrated a significant inverse relationship between blood pressure and total serum testosterone, which could be associated with impaired reproductive potential [29-31], free testosterone [32-34] and SHBG [34].”
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Variation of Atherosclerosis and Coronary Heart Disease by Age and Sex
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Omega-3 with and without insulin replacement alleviates detrimental effects of type II diabetes on reproductive system of male C57BL/6 mice
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Evidence of male hypogonadism at an early age as a familial risk of type 2 diabetes
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“Our findings are consistent with those of E. Barrett-Connor et al., who demonstrated that patients with diabetes have lower SHBG levels compared to age-and BMI-matched controls without diabetes [28].”
METABOLI) SYNDROME AND MALE REPRODUCTIVE HEALTH
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Elizabeth Barrett-Connor: Instrumental Contributor to the Understanding of Midlife Well-being and Health in Both Women and Men
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Self-citation
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“A meta-analysis by Ding et al. [15], further highlighted by two well designed prospective studies [10,16] found a strong association between low testosterone and the development of Type 2 diabetes mellitus in older men.”
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Authors: BARRETT-CONNOR, E., KHAW, K.-T., & YEN, S. S. C.
Affiliations: University of California San Diego (US)
Corresponding author: BARRETT-CONNOR, E.
ORCID: BARRETT-CONNOR, E.
KHAW, K.-T.
Venue: American Journal of Epidemiology
Publisher: Oxford University Press (OUP)
Published: 1990-11
Volume: 132
Issue: 5
Pages: 895-901
ISSN: 0002-9262 (ISSN-L)
1476-6256
DOI: 10.1093/oxfordjournals.aje.a115732
OpenAlex: W1957056004
Cited by: 217
References: 0
Citations by year: 2026: 3 · 2025: 4 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 5 · 2020: 6 · 2019: 6 · 2018: 6 · 2017: 5 · 2016: 9 · 2015: 10 · 2014: 7 · 2013: 7 · 2012: 7
FWCI: 2.83
Type: journal article
Language: en
Open access: closed
Locations: American Journal of Epidemiology (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r01hl034591-02, 5r01am031801-03)
National Heart, Lung, and Blood Institute (HL 34591, HV-1-2160-L)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: diabetes mellitus, testosterone, sex hormone-binding globulin, androstenedione, estrone, estradiol, older men, fasting blood glucose, glycemia, body mass index, hypogonadism
MeSH terms: Adult, Aged, Blood Glucose, Blood Pressure, Cholesterol, Diabetes Mellitus, Humans, Male, Middle Aged, Sex Hormone-Binding Globulin, Testosterone, Body Mass Index

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ENDOGENOUS SEX HORMONE LEVELS IN OLDER ADULT MEN WITH DIABETES MELLITUS

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