Estimation of serum testosterone concentration in type 2 diabetic males
Keywords:Hypogonadism, Total Testosterone, Type 2 Diabetes Mellitus
Background: A high incidence of hypogonadism in men with Type 2 Diabetes Mellitus has been globally reported. The present study was aimed at determining the frequency of hypogonadism in T2DM males. Screening and management of hypogonadism in Diabetic males should be done.
Methods: In this case control study conducted from January 2018 to August 2019 at SGRDIMSR Sri Amritsar 100 Type 2 Diabetic males were taken as cases. 50 age matched nondiabetic males were taken as controls. Apart from BMI and waist hip ratio routine investigations, HbA1C, serum total and free testosterone levels were done. All the subjects were subjected to ADAM questionnaire to evaluate for hypogonadism.
Results: Majority of subjects were in the age of 40-50 years. Mean Serum Total Testosterone levels in Study and Control Groups were 4.94±5.32 nmol/L and 6.63±4.54 nmol/L respectively (p=0.045). Mean Serum Free Testosterone levels in Study and Control Groups were 4.12±3.43 pg/ml and 6.05±3.24 pg/ml respectively (p=0.001). A statistically highly significant negative correlation was found between BMI and Serum Testosterone levels in both groups. Prevalence of hypogonadism (Total Testosterone <4.56 nmol/L) in Study and Control Groups was 73% and 58% respectively. Sensitivity and specificity of ADAM questionnaire was found to be 78.46% and 94.29 % respectively.
Conclusions: Prevalence of hypogonadism among T2DM males is high. So, screening for hypogonadism should be done. ADAM questionnaire can be used as a screening tool, results must be confirmed with Serum Total Testosterone levels.
Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research–INdia DIABetes (ICMR–INDIAB) study. Diabet. 2011;54(12):3022-7.
Jones TH. Clinical awareness and diagnosis of male hypogonadism. J Men’s Health. 2008;5:S26-34.
Jones TH. Testosterone Deficiency in Men. Oxford, United Kingdom: Oxford University Press; 2008a.
Dhindsa S, Miller MG, McWhirter CL, Mager DE, Ghanim H, Chaudhuri A, et al. Testosterone concentrations in diabetic and nondiabetic obese men. Diabet care. 2010;33(6):1186-92.
Kapoor D, Clarke S, Channer KS, Jones TH. Erectile dysfunction is associated with low bioactive testosterone levels and visceral adiposity in men with type 2 diabetes. Intern J androl. 2007;30(6):500-7.
Mårin P, Holmäng S, Jönsson L, Sjöström L, Kvist H, Holm G, Lindstedt G, Björntorp P. The effects of testosterone treatment on body composition and metabolism in middle-aged obese men. International journal of obesity and related metabolic disorders: J Intern Associat Study Obes. 1992;16(12):991-7.
Tadesse K, Amare H, Hailemariam T, Gebremariam T. Prevalence of hypertension among patients with type 2 diabetes mellitus and its socio demographic factors in Nigist Ellen Mohamed Memorial Hospital Hosanna, Southern Ethiopia. J Diabet Metab. 2018;9(4):792.
Singh S, Singh AP, Multani MK, Purohit A. Clinical and biochemical profile of Indians with type 2 diabetes mellitus: A problem lurking for India. Trop J Med Res. 2014;17(2):91.
Trivedi J, Kapoor S, arora r. Variation in Serum Total Testosterone Levels in Men with Type 2 Diabetes Mellitus. J Clin Diagnos Res. 2019;13(6).
Chaudhary S, Kaushik M, Jaswal VM, Raina R, Thakur R, Thakur MK, et al. Testosterone levels in men with type 2 diabetes mellitus. Int J Res Med Sci. 2018;6(7):13–7.
Al Hayek AA, Robert AA, Alshammari G, Hakami H, Al Dawish MA. Assessment of hypogonadism in men with type 2 diabetes: a cross-sectional study from Saudi Arabia. Clinical Medicine Insights: Endocrinol Diabet. 2017;10:1179551417710209.
Kapoor D, Aldred H, Clark S, Channer KS, Jones TH. Clinical and biochemical assessment of hypogonadism in men with type 2 diabetes: correlations with bioavailable testosterone and visceral adiposity. Diabet care. 2007;30(4):911-7.
Madhu SV, Aslam M, Aiman AJ, Siddiqui A, Dwivedi S. Prevalence of hypogonadism in male Type 2 diabetes mellitus patients with and without coronary artery disease. Ind J Endocrinol Metabol. 2017;21(1):31.
Ugwu TE, Ikem RT. Performance of the Androgen Deficiency in Aging Male questionnaire for the clinical detection of androgen deficiency in black sub-Saharan African men with Type-2 diabetes mellitus. J Endocrinol, Metabol Diabet South Africa. 2017;22(1):60-3.
Zheng R, Cao L, Cao W, Chu X, Hu Y, Zhang H, et al. Risk factors for hypogonadism in male patients with type 2 diabetes. J Diabet Res. 2016;2016.