Low Testosterone and High C-Reactive Protein Concentrations Predict Low Hematocrit in Type 2 Diabetes

OBJECTIVE —After the demonstration that one-third of male patients with type 2 diabetes have hypogonadotrophic hypogonadism, we have shown that patients with hypogonadotrophic hypogonadism also have markedly elevated C-reactive protein (CRP) concentrations. We have now hypothesized that type 2 diabetic subjects with hypogonadotrophic hypogonadism may have a lower hematocrit because testosterone stimulates, whereas chronic inflammation suppresses, erythropoiesis. RESEARCH DESIGN AND METHODS —Seventy patients with type 2 diabetes at a tertiary referral center were included in this study. RESULTS —The mean hematocrit in patients with hypogonadotrophic hypogonadism ( n = 37), defined as calculated free testosterone (cFT) of n = 33) was 43.3 ± 0.7% ( P = 0.011). The hematocrit was related to cFT concentration ( r = 0.46; P r = 0.41; P 3 mg/l (39.9 ± 1.1%; P P CONCLUSIONS —We conclude that hypogonadotrophic hypogonadism in male type 2 diabetic subjects is associated with a lower hematocrit and a frequent occurrence of mild normocytic normochromic anemia with normal or high erythropoietin concentrations. In these patients, hematocrit is also inversely related to CRP concentration. Thus, low testosterone and chronic inflammatory mechanisms may contribute to mild anemia. Such patients may also have a high risk of atherosclerotic cardiovascular events in view of their markedly elevated CRP concentrations.