ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet2017483-92ometendo-9451Research ArticleНовости мировой медициныNewsРекомендации по диагностике и лечению дефицита тестостерона (гипогонадизма) у мужчин с сахарным диабетомGuidelines for the Diagnosis and Treatment of testosterone deficiency (hypogonadism) in male patients with diabetes mellitushttps://orcid.org/0000-0002-8175-7886ДедовИван ИвановичDedovIvan I.

д.м.н., профессор, академик РАН

ScD, Professor

endocrin@endocrincentr.ruhttps://orcid.org/0000-0002-5634-7877МельниченкоГалина АфанасьевнаMel'nichenkoGalina A.

д.м.н., профессор, академик РАН 

ScD, Professor

teofrast2000@mail.ruШестаковаМарина ВладимировнаShestakovaMarina V.

д.м.н., профессор, академик РАН 

ScD, Professor

shestakova.mv@gmail.comhttps://orcid.org/0000-0002-5386-4289РоживановРоман ВикторовичRozhivanovRoman V.

д.м.н.

ScD

rrozhivanov@mail.ruhttps://orcid.org/0000-0002-1232-3099ТереховаАнна ЛеонтьевнаTerehovaAnna L.

к.м.н.

PhD

tepexova@mail.ruhttps://orcid.org/0000-0003-3494-8011ЗиловАлексей ВадимовичZilovAlexey V.

к.м.н.

PhD

azilov@hotmail.comЛадыгинаДарья ОлеговнаLadyginaDaria O.

к.м.н.

PhD

ladygina.do@gmail.comhttps://orcid.org/0000-0002-5660-6760КурбатовДмитрий ГеннадьевичKurbatovDmitriy G.

д.м.н., профессор

ScD, Professor

kurbatov.d@mail.ru<p>ФГБУ &laquo;Национальный медицинский исследовательский центр эндокринологии&raquo; Минздрава России</p>Россия<p>Endocrinology Research Centre</p>Russian Federation<p>ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет)</p>Россия<p>I.M.Sechenov First Moscow State Medical University</p>Russian Federation<p>ФГБУ ЦКБ с поликлиникой УДП РФ</p>Россия<p>Central Clinical Hospital of the Management Affair of President Russian Federation</p>Russian Federation2017271220171448392Copyright &#x00A9; Дедов И.И., Мельниченко Г.А., Шестакова М.В., Роживанов Р.В., Терехова А.Л., Зилов А.В., Ладыгина Д.О., Курбатов Д.Г., 20172017Дедов И.И., Мельниченко Г.А., Шестакова М.В., Роживанов Р.В., Терехова А.Л., Зилов А.В., Ладыгина Д.О., Курбатов Д.Г.Dedov I.I., Mel'nichenko G.A., Shestakova M.V., Rozhivanov R.V., Terehova A.L., Zilov A.V., Ladygina D.O., Kurbatov D.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/9451

Гипогонадизм у мужчин, определяемый как снижение уровня тестостерона в сыворотке крови в сочетании с характерными симптомами и/или признаками (подробно описаны далее), часто встречается при сахарном диабете (СД). Эти рекомендации не охватывают всего диапазона патологий, обусловливающих развитие дефицита тестостерона (гипогонадизма), а фокусируются на его клинических вариантах, характерных для мужчин с диабетом. В рекомендациях представлены данные о распространенности гипогонадизма при СД, его этиологии. В разделе «диагностика» подробно представлены особенности анамнеза пациентов с гипогонадизмом при СД, необходимые методы физикального и лабораторного обследования. Отдельно рассмотрены факторы риска и клинические последствия гипогонадизма. В разделе «выбор методов лечения» представлены возможные варианты лечения таких пациентов с использованием различных средств андрогенной терапии с учетом потребностей мужчины, сохранения его репродуктивной функции и факторов риска. Особое внимание уделено показаниям, противопоказаниям и факторам риска андрогенной терапии у мужчин с диабетом, особенно в пожилом возрасте. С учетом этого разработаны принципы мониторинга проводимого лечения. На основании большого числа исследований продемонстрированы благоприятные эффекты андрогенной заместительной терапии у мужчин с гипогонадизмом и СД.

Hypogonadism in men, defined as a reduction in serum testosterone in combination with characteristic symptoms and/or signs (described in detail later), is common in diabetes mellitus (DM). These recommendations do not cover the whole range of pathologies that cause the development of testosterone deficiency (hypogonadism), but focus on its clinical variants and characteristic for men with diabetes. The recommendations provide data on the prevalence of hypogonadism in diabetes, its etiology. In the section "diagnostics" the features of anamnesis of patients with hypogonadism with diabetes, the necessary methods of physical and laboratory examination are presented in detail. The risk factors and clinical consequences of hypogonadism are separately examined. In the section "choice of treatment methods", there are possible treatment options for such patients using various androgenic therapies, taking into account the needs of the man, maintaining his reproductive function and risk factors. Particular attention is paid to indications, contraindications and risk factors for androgen therapy in men with diabetes, especially in old age. With this in mind, principles for monitoring the treatment are developed. Based on a large number of studies, favorable effects of androgen replacement therapy in men with hypogonadism and diabetes have been demonstrated.

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The authors declare that there are no conflicts of interest present.