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Effect of pioglitazone on testosterone in eugonadal men with type 2 diabetes mellitus: a randomized double‐blind placebo‐controlled study
Author(s) -
Sridhar Subbiah,
Walia Rama,
Sachdeva Naresh,
Bhansali Anil
Publication year - 2013
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2012.04510.x
Subject(s) - pioglitazone , medicine , endocrinology , testosterone (patch) , placebo , sex hormone binding globulin , metformin , diabetes mellitus , glimepiride , type 2 diabetes , androstenedione , androgen , hormone , alternative medicine , pathology
Summary Objectives Pioglitazone is an insulin sensitizer used for the management of type 2 diabetes mellitus (T2 DM ). It has been shown to reduce testosterone level in patients with polycystic ovarian syndrome. However, its effect on testosterone in men has not been studied. Research design and methods A randomized, double‐blind, placebo‐controlled trial with 6 months follow‐up. Fifty (25 in each group) eugonadal men (well virilized and total testosterone ≥12 n m ) with T2 DM , aged 30–55 year and H b A 1c of ≤7·5% were randomly assigned to receive pioglitazone 30 mg per day or placebo along with existing glimepiride and metformin therapy. Results As compared to placebo, 6 months of pioglitazone therapy in patients with T 2 DM resulted in significant reduction in mean total testosterone level (16·1 to 14·9 vs 17·1 to 17·0 n m ; P = 0·031), calculated free testosterone ( P = 0·001) and bioavailable testosterone ( P = 0·000) despite significant increase in sex hormone‐binding globulin ( P = 0·000). Plasma androstenedione (∆ 4 ) level increased (1·5 to 1·9 vs 1·7 to 1·7 ng/ml; P = 0·051) following pioglitazone therapy. The decrease in testosterone was independent of change in body weight, body fat and H b A 1c. Conclusion Pioglitazone therapy significantly decreases total, free and bioavailable testosterone in eugonadal men with T 2 DM . The effects of these alterations need to be determined by further long‐term studies.