Hypogonadism and its treatment following ischaemic stroke in men with type 2 diabetes mellitus

Figures & data

Table 1. Comparative properties of testosterone and control groups before the start of treatment.

Property	Testosterone group	Control group
Age, years	62.1 ± 5.4	63.0 ± 4.7
BMI, kg/m^2	32.0 ± 3.1	31.8 ± 2.9
SAP, mm Hg	169.4 ± 8.5	166.8 ± 7.1
DAP, mm Hg	94.5 ± 4.5	91.7 ± 3.6
Muscle strength, points	3.5 ± 0.3	3.1 ± 0.4
BDI	21.3 ± 2.7	20.8 ± 3.1
Total testosterone, nmol/L	9.2 ± 1.4	9.3 ± 1.6
Free testosterone, pmol/L	137.4 ± 11.7	142.0 ± 12.4
AMS	38.2 ± 2.7	39.1 ± 2.2
Duration of diabetes, years	7.1 ± 1.4	6.9 ± 2.4
HbA1c, %	7.2 ± 2.1	6.8 ± 1.2
Cholesterol, mmol/L	6.1 ± 0.6	6.2 ± 0.8
Triglycerides, mmol/L	2.6 ± 0.4	2.5 ± 0.4
LDL, mmol/L	3.7 ± 0.8	3.6 ± 0.9
HDL, mmol/L	1.0 ± 0.2	1.1 ± 0.3

Figure 1. (a) BMI decreased from baseline over the 5-year period after TU treatment, after ceasing TTH, BMI returned to near baseline (Tb group). (b) A significant increase in total T is observed from baseline over the 5-year period compared with the control group. (c) A significant increase in free T is observed from baseline over the 5-year period after TU treatment. (d) A significant decrease is observed at both the 2- and 5-year intervals after TU treatment. (e) After TTH treatment, a significant decrease in total cholesterol levels are observed over the first 2 years. (f) After TTH treatment, a significant decrease in triglyceride levels is observed over the first 2 years. (g) After TTH treatment, a significant decrease in LDL cholesterol levels is observed over the first 2 years. (h) No significant change in HDL cholesterol levels are observed over the course of the study in any group observed.

Table 2. Comparative properties of testosterone and control groups 2 years after stroke.

Property	Testosterone Group	p*	Control Group	p*
BMI, kg/m^2	26.4 ± 2.1	.02	32.3 ± 3.1	>.05
SAP, mm Hg	129.4 ± 4.2	<.001	141.8 ± 5.7	<.005
DAP, mm Hg	77.3 ± 3.5	<.005	82.5 ± 3.5	<.005
Muscle strength, points	4.1 ± 0.3	<.005	3.4 ± 0.1	>.05
BDI	14.7 ± 1.8	<.001	177 ± 0.9	>.05
Total testosterone, nmol/L	16.2 ± 1.5	<.001	8.9 ± 1.8	>.05
Free testosterone, pmol/L	268.4 ± 10.7	<.005	138.4 ± 9.2	>.05
AMS	29.4 ± 3.1	<.005	40.1 ± 1.6	>.01
HbA1c, %	6.6 ± 1.3	<.005	7.7 ± 1.4	>.05
Cholesterol, mmol/L	5.0 ± 0.6	<.005	6.2 ± 0.8	>.05
Triglycerides, mmol/L	1.9 ± 0.3	<.005	2.4 ± 0.6	>.05
LDL, mmol/L	2.8 ± 0.7	<.005	3.4 ± 0.8	>.05
HDL, mmol/L	1.1 ± 0.2	>.05	1.0 ± 0.2	>.05

*Significance of differences relative to initial figures.

Table 3. Comparative properties of testosterone and control groups 5 years after stroke (differences between 2 and 5 years after the treatment).

Property	Group 1	p*	Control Group	p*
BMI, kg/m^2	27.2 ± 2.6	<.01	33.4 ± 2.9	<.005
SAP, mm Hg	142.2 ± 3.7	<.01	154.2 ± 4.9	<.01
DAP, mm Hg	76.1 ± 2.2	<.01	84.9 ± 2.9	<.05
Muscle strength, points	3.5 ± 0.5	<.01	2.9 ± 0.4	<.05
BDI	12.2 ± 1.3	<.001	18.2 ± 0.2	<.05
Total testosterone, nmol/L	17.7 ± 0.8	<.01	7.2 ± 0.5	<.01
Free testosterone, pmol/L	314.2 ± 14.4	<.005	114.7 ± 5.7	<.01
AMS	26.3 ± 3.3	<.005	42.4 ± 2.8	<.05
HbA1c, %	6.9 ± 0.8	<.005	9.2 ± 0.7	<.001
Cholesterol, mmol/L	4.8 ± 0.4	>.01	7.1 ± 1.1	<.05
Triglycerides, mmol/L	2.0 ± 0.4	>.05	2.7 ± 0.7	<.05
LDL, mmol/L	2.6 ± 0.7	>.05	3.6 ± 0.7	>.05
HDL, mmol/L	1.1 ± 0.2	>.05	1.0 ± 0.3	>.05

*Significance of differences between 2 and 5 years after the treatment.

Figure 2. (a) After TTH treatment, a significant decrease in SAP is observed over the first 2 years. (b) After TU treatment, a significant decrease in SAP is observed over the first 2 years.

Figure 3. (a) A significant increase in muscle strength was observed between baseline and the 2-year follow-up. (b) A significant decrease in AMS was observed between baseline and the 2-year follow-up with further significant improvements observed at 5 years. (c) A significant decrease in Beck depression scores was observed between baseline and the 2-year follow-up with further significant improvements observed at 5 years.

Figure 4. (a) A significant difference in the rate of reoccurring stoke is observed between the TU and control group after 2 years. (b) A significant difference in the rate of mortality is observed between those that remain on TTH and those who are either in the control group or have ceased treatment at the 5-year follow-up.