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Peer-reviewedCC BY 4.0Journal of Endocrinological Investigation

Late-onset hypogonadism and lower limb vascular complications in men with type 2 diabetes: an observational study in a tertiary care centre

  • Rita Matrone1
  • Paola Caruso2
  • Miriam Longo1
  • Alessandro Pontillo2
  • Carla Carbone2
  • Paolo Cirillo1
  • Chiara Porcellini1
  • Maria Tomasuolo3
  • Lorenzo Scappaticcio1,2
  • Maria Ida Maiorino1,2
  • Giuseppe Bellastella1,2
  • Katherine Esposito1,2
  1. 1Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
  2. 2Division of Endocrinology and Metabolic Diseases, University of Campania “Luigi Vanvitelli”, Piazza Luigi Miraglia 2, 80138 Naples, Italy
  3. 3Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
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Abstract

Purpose: The aim of this study was to evaluate the relationship between late onset hypogonadism (LOH) with inflammation and lower-limb vascular complications in men with type 2 diabetes (T2D).

Methods: This single-centre, retrospective observational study included men with T2D who underwent hormonal evaluation between 2020 and 2024. LOH was diagnosed according to SIAMS/SIE and EAU guidelines and participants were classified as hypogonadal or eugonadal. Demographic, metabolic, inflammatory, and haematological parameters were collected. Lower-limb vascular complications, including peripheral artery disease (PAD), diabetic foot ulcer (DFU), osteomyelitis and amputation, were assessed. Logistic regression analyses were performed to evaluate the association between testosterone (T) levels and vascular complications.

Results: The study population included 155 men, with a prevalence of LOH of 50.3%. Hypogonadal men showed significantly lower haemoglobin and haematocrit levels and higher inflammatory markers compared with eugonadal subjects. Microvascular complications did not differ between groups, except for a higher prevalence of DFU in hypogonadal men. Conversely, macrovascular lower-limb complications were more frequent in men with LOH, including PAD, osteomyelitis, and amputation. Higher T levels were associated with a reduced number of these outcomes. After multivariable adjustment, T levels remained independently associated with the risk of PAD and lower limb amputation.

Conclusion: In our cohort of men with T2D, hypogonadism is associated with an increased burden of macrovascular and lower limb complications. Lower T levels were independently associated with PAD and amputation, supporting hypogonadism as a marker of vascular impairment.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s40618-026-02967-4.

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Cite

BibTeXRIS
BibTeX
@article{matrone2026lateonset,
  title = {{Late-onset hypogonadism and lower limb vascular complications in men with type 2 diabetes: an observational study in a tertiary care centre}},
  author = {Rita Matrone and Paola Caruso and Miriam Longo and Alessandro Pontillo and Carla Carbone and Paolo Cirillo and Chiara Porcellini and Maria Tomasuolo and Lorenzo Scappaticcio and Maria Ida Maiorino and Giuseppe Bellastella and Katherine Esposito},
  journal = {Journal of Endocrinological Investigation},
  year = {2026},
  month = jun,
  doi = {10.1007/s40618-026-02967-4},
  url = {https://doi.org/10.1007/s40618-026-02967-4},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Late-onset hypogonadism and lower limb vascular complications in men with type 2 diabetes: an observational study in a tertiary care centre
AU  - Rita Matrone
AU  - Paola Caruso
AU  - Miriam Longo
AU  - Alessandro Pontillo
AU  - Carla Carbone
AU  - Paolo Cirillo
AU  - Chiara Porcellini
AU  - Maria Tomasuolo
AU  - Lorenzo Scappaticcio
AU  - Maria Ida Maiorino
AU  - Giuseppe Bellastella
AU  - Katherine Esposito
PY  - 2026
DA  - 2026/06/26
JO  - Journal of Endocrinological Investigation
DO  - 10.1007/s40618-026-02967-4
UR  - https://doi.org/10.1007/s40618-026-02967-4
AB  - Purpose: The aim of this study was to evaluate the relationship between late onset hypogonadism (LOH) with inflammation and lower-limb vascular complications in men with type 2 diabetes (T2D).  Methods: This single-centre, retrospective observational study included men with T2D who underwent hormonal evaluation between 2020 and 2024. LOH was diagnosed according to SIAMS/SIE and EAU guidelines and participants were classified as hypogonadal or eugonadal. Demographic, metabolic, inflammatory, and haematological parameters were collected. Lower-limb vascular complications, including peripheral artery disease (PAD), diabetic foot ulcer (DFU), osteomyelitis and amputation, were assessed. Logistic regression analyses were performed to evaluate the association between testosterone (T) levels and vascular complications.  Results: The study population included 155 men, with a prevalence of LOH of 50.3%. Hypogonadal men showed significantly lower haemoglobin and haematocrit levels and higher inflammatory markers compared with eugonadal subjects. Microvascular complications did not differ between groups, except for a higher prevalence of DFU in hypogonadal men. Conversely, macrovascular lower-limb complications were more frequent in men with LOH, including PAD, osteomyelitis, and amputation. Higher T levels were associated with a reduced number of these outcomes. After multivariable adjustment, T levels remained independently associated with the risk of PAD and lower limb amputation.  Conclusion: In our cohort of men with T2D, hypogonadism is associated with an increased burden of macrovascular and lower limb complications. Lower T levels were independently associated with PAD and amputation, supporting hypogonadism as a marker of vascular impairment.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s40618-026-02967-4.
SN  - 0391-4097
SN  - 1720-8386
ER  -