Published Online
on February 7, 2008

A more recent version of this article appeared on April 1, 2008

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Submitted on August 27, 2007
Revised on September 11, 2007

Imbalance in Sex Hormone Levels Exacerbates Diabetic Renal Disease

Qin Xu; Corinne C. Wells; Joseph H. Garman; Laureano Asico; Crisanto S. Escano; and Christine Maric^*

From the Departments of Medicine (Q.X., C.C.W., C.M.), Physiology and Biophysics (J.H.G.), and Pediatrics (L.A., C.S.E.), and Center for the Study of Sex Differences: in Health, Aging and Disease (C.M.), Georgetown University Medical Center, Washington, DC.

^* To whom correspondence should be addressed. E-mail: cm255{at}georgetown.edu.

Abstract—Studies suggest that the presence of testosterone exacerbates, whereas the absence of testosterone attenuates, the development of nondiabetic renal disease. However, the effects of the absence of testosterone in diabetic renal disease have not been studied. The study was performed in male Sprague-Dawley nondiabetic, streptozotocin-induced diabetic, and streptozotocin-induced castrated rats (n=10 to 11 per group) for 14 weeks. Diabetes was associated with the following increases: 3.2-fold in urine albumin excretion, 6.3-fold in glomerulosclerosis, 6.0-fold in tubulointerstitial fibrosis, 1.6-fold in collagen type I, 1.2-fold in collagen type IV, 1.3-fold in transforming growth factor- protein expression, and 32.7-fold in CD68-positive cell abundance. Diabetes was also associated with a 1.3-fold decrease in matrix metalloproteinase protein expression and activity. Castration further exacerbated all of these parameters. Diabetes was also associated with a 4.7-fold decrease in plasma testosterone, 2.9-fold increase in estradiol, and 2.1-fold decrease in plasma progesterone levels. Castration further decreased plasma testosterone levels but had no additional effects on plasma estradiol and progesterone. These data suggest that diabetes is associated with abnormal sex hormone levels that correlate with the progression of diabetic renal disease. Most importantly, our results suggest an important role for sex hormones in the pathophysiology of diabetic renal complications.

Key words: diabetes • kidney • sex hormones • glomerulosclerosis • tubulointerstitial fibrosis

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