Lipid metabolism and testosterone status at men with type 2 diabetes mellitus at the religious fasting
Ametov A.S., Kamynina L.L., Rozhdestvenskaia O.A.
Russian Medical Academy of Post-Graduate Education, Moscow, Russian Federation
Objective: To assess the lipid metabolism and testosterone (Tst) status as the important component of the type 2 diabetes mellitus (T2DM) management at the religious fasting (RF).
Material and methods: In the observational clinical study 62 men with T2DM and visceral obesity (medians of body mass index (BMI) 32,2 kg/m2, waist circumference (W) 103 cm) were included. 
We studied interventional and control groups: RF(+) (n=30) and RF(-) (n=32) correspondently. The dynamics of the lipidogram parameters (total cholesterol (CHOL), triglyceride (TG), lipoproteins high (LPHD) and low (LPLD) density); the levels of glycosylated hemoglobin HbA1c, Tst had been investigated during the Lent and the Navity religious fasting. The physical activity (PhA) was assumed as high, mild and low in depending of profession and fitness. The total Tst (tTst), free Tst (fTst), PSA and AMS-index (without IIEF-5 due to sex deprivation during a religious fasting) were assumed before and after the RF. The processing data was made using Statistica6.0, and the differences were with s atistical significance if p<0,05.
Results: The safety of RF for patients with T2DM was demonstrated.
The maximal improvement of the metabolic parameters and Tststatus had been associated with adequate PhA. 
In the interventional group RF(+)PhA(+) the dynamics was -0,3% for HbA1c, -0,4 mmol/L for TG, -0,4 mmol/L for CHOL, -0,5 mmol/L for LPLD, +0,2 mmol/L for LPHD. Meanwhile tTst rised from 13,4 to 15,1 mcmol/L, and fTst – from 13,4 to 15,1 pg/ml. AMS-score reduced from 33 to 28 were observed (p<0,05). In other interventional group RF(+) PhA(-) the dynamics of those parameters was neutral as in the control group RF(-)PhA(+). The worst dynamics was in the controlgroup RF(-)PhA(-). BMI was changed from 33,4 to 34,1 kg/m2, W – from 105 to 107 cm, and the median AMS-score – from 35 to 37 (p<0,05). PSA was constant in all groups (p<0,05).
Conclusions: The physical activity at the men with T2DM and visceral obesity is the key modificated factor for the good T2DM management during religious fasting. The high and mild PhA at the men with T2DM, visceral obesity and androgen deficiency is positively correlated with the improvement of the lipid metabolism and enhancement of the Tst-status.