Association between estimated glucose disposal rate and testosterone deficiency in male patients with type 2 diabetes mellitus.

BACKGROUND: Insulin resistance (IR) is intricately associated with the reduction or deficiency of testosterone (TD) in males. Estimated glucose disposal rate (eGDR) has emerged as a novel marker for assessing IR. This study aims to examine the association between eGDR and total testosterone, as well as the risk of TD, in male patients diagnosed with type 2 diabetes mellitus (T2DM). METHODS: This cross-sectional study evaluated 957 male patients with T2DM admitted to the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University between 2019 and 2022. The study explored the association between eGDR and testosterone, as well as the risk of TD, utilizing multivariable linear and logistic regression analyses. Additionally, the study elucidated the mediating roles of AIP and SII in the effect of eGDR on TD through the mediation analysis. RESULTS: After adjusting for potential confounding variables, eGDR demonstrates a significant negative linear association with the risk of TD (OR = 0.83, 95% CI: 0.77, 0.89) and a significant positive linear association with total testosterone (β = 0.15, 95% CI: 0.10, 0.19). The subgroup analyses showed that this association was stronger in individuals younger than 60. Additionally, AUC for eGDR was significantly higher (AUC = 0.656, 95% CI: 0.618, 0.695) compared to waist circumference, HbA1c, and TyG. Mediation analysis identified that AIP and SII accounted for 14.9% and 8.8% of the association between eGDR and TD, respectively. CONCLUSION: The study demonstrates that, in adult patients with T2DM, an elevated eGDR is positively associated with testosterone and inversely associated with the risk of TD. CLINICAL TRIAL: Not applicable.