Background. Subtle abnormalities in the hypothalamic-pituitary-gonadal axis have frequently been reported in diabetic patients, in whom disturbances of sexual function, including complete erectile impotence have been found. Methods. To check the integrity of the hypothalamic-pituitary-gonadal interaction, in 21 diabetic males (13 type I, 8 type II; 11 with sexual dysfunction, 10 normally potent) and 12 healthy control males we measured serum testosterone and gonadotropin (FSH an LH) levels in the basal state, together with prolactin, peripheral (total and free) thyroid hormones, 17-β-estradiol. Each subject was also randomly administered luteinizing hormone-releasing hormone (LHRH) or thyrotropin-releasing hormone (TRH) to assess the pituitary response of the two gonadotropins to LHRH, and of prolactin and TSH to TRH. Results. The baseline hormones of diabetics and controls were similar except for testosterone, which in orally-treated type II patients was significantly (p < 0.02) lower than in controls. Impotent diabetics had the highest mean serum 17-β-estradiol, which was above the upper healthy adult male level. In diabetics and normals a similar behaviour was observed for LH at the basal state and after LHRH stimulation, whereas FSH, both in the basal state and after GNRH, was markedly higher in diabetic groups (significantly in type I, type II, impotent diabetics) than in normals. The response of TSH to TRH was the same in diabetics and normals, while TRH-induced prolactin release tended to be more elevated in type I subjects. Conclusions. While lowered testosterone in orally-treated type II males highlights a possible detrimental effect of hypoglycemic drugs on Leydig cell function, the marked FSH response to LHRH in all diabetic men suggests that diabetes per se may have an adverse effect on spermatogenesis.

Evaluation of the hypothalamic-pituitary-testicular interaction in diabetic males

GIAMPIETRO, OTTAVIO;MATTEUCCI, ELENA
1994

Abstract

Background. Subtle abnormalities in the hypothalamic-pituitary-gonadal axis have frequently been reported in diabetic patients, in whom disturbances of sexual function, including complete erectile impotence have been found. Methods. To check the integrity of the hypothalamic-pituitary-gonadal interaction, in 21 diabetic males (13 type I, 8 type II; 11 with sexual dysfunction, 10 normally potent) and 12 healthy control males we measured serum testosterone and gonadotropin (FSH an LH) levels in the basal state, together with prolactin, peripheral (total and free) thyroid hormones, 17-β-estradiol. Each subject was also randomly administered luteinizing hormone-releasing hormone (LHRH) or thyrotropin-releasing hormone (TRH) to assess the pituitary response of the two gonadotropins to LHRH, and of prolactin and TSH to TRH. Results. The baseline hormones of diabetics and controls were similar except for testosterone, which in orally-treated type II patients was significantly (p < 0.02) lower than in controls. Impotent diabetics had the highest mean serum 17-β-estradiol, which was above the upper healthy adult male level. In diabetics and normals a similar behaviour was observed for LH at the basal state and after LHRH stimulation, whereas FSH, both in the basal state and after GNRH, was markedly higher in diabetic groups (significantly in type I, type II, impotent diabetics) than in normals. The response of TSH to TRH was the same in diabetics and normals, while TRH-induced prolactin release tended to be more elevated in type I subjects. Conclusions. While lowered testosterone in orally-treated type II males highlights a possible detrimental effect of hypoglycemic drugs on Leydig cell function, the marked FSH response to LHRH in all diabetic men suggests that diabetes per se may have an adverse effect on spermatogenesis.
Giampietro, Ottavio; Ferdeghini, M; Cerri, M; Cecere, M; Uncini Manganelli, C; Ruberti, F; Matteucci, Elena
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11568/208059
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