ASSOCIATIONS OF SERUM TESTOSTERONE WITH DIABETIC RETINOPATHY AMONG DIABETIC MEN AND WOMEN: A CASE-CONTROL STUDY
Anjum A., Ahmed S., Waris A.*, Sukul R.R., Ahmed A. and Siddiqui S.S.
Aim: Sex steroid hormones are essential for reproductive function, but can also affect the physiology of a non-reproductive system, such as that of eye, and are probably the cause of the large majority of known sex differences in function and disease. The aim of this study is to measure the levels of serum testosterone and to study the relationship with diabetic retinopathy. Subjects and Methods: To meet the aim a hospital-based, cross-sectional study was conducted on 120 eyes of 60 diabetic patients, who were referred from the Rajiv Gandhi Center for Diabetes and Endocrinology to the Retina Clinic, Institute of Ophthalmology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh. Serum testosterone, blood sugar fasting, blood sugar post-prandial, glycated hemoglobin was measured in subjects with diabetic retinopathy and subjects without diabetic retinopathy. In addition, correlation of serum testosterone with age, duration of disease, blood pressure, glycemic profile and sex steroid hormonal status of subjects with diabetic retinopathy Results: The mean serum testosterone level was found to be significantly higher (p<0.05) in subjects with diabetic retinopathy (DR) as compared to subjects without diabetic retinopathy (DR). A significant positive correlation of serum testosterone was found with blood sugar fasting (BSF) (p<0.01), HBA1c (p<0.05), serum progesterone (p<0.01) whereas a significant negative correlation was found with serum estrogen (p<0.01), serum LH (p<0.01) and serum FSH (p<0.01). However when the various stages of diabetic retinopathy was compared with serum testosterone, it was found maximum in the severe NPDR category, whereas minimum in moderate NPDR category, with a non-significant result (p >0.05). Conclusion: A possible susceptibility and association of high levels of serum testosterone with diabetic retinopathy encourages further studies needed for justification of the quantum of influence of serum testosterone and other sex hormones have, in relation to gender with regard to progression of diabetic retinopathy as well as diabetic duration and blood glucose control to understand the mechanism of progression of diabetic retinopathy.
Keywords: Sex steroid hormone, testosterone, diabetic retinopathy, blood sugar fasting, blood sugar post-prandial, glycated hemoglobin.
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