Agarwal Pankaj Kumar, Singh Parminder, Chowdhury Subhankar, Sharma S K, Majumdar Anirban, Shah Parag, Sahay Rakesh, Ayyar S Vageesh, Phatale Hemant, Batra Chandar M, Syed Raeesuddin, Shetty Pradeep
Hormone Care and Research Center, Near St. Mary's School, Ghaziabad, Uttar Pradesh, India.
Department of Endocrinology, Dayanand Medical College and Hospital, Civil Lines, Ludhiana, Punjab, India.
Indian J Endocrinol Metab. 2017 Jan-Feb;21(1):64-70. doi: 10.4103/2230-8210.196008.
A high prevalence of hypogonadism in men with Type-2 diabetes mellitus (T2DM) has been reported worldwide.
To evaluate the prevalence of hypogonadism in Indian males with T2DM and assess the primary and secondary hypogonadism along with androgen deficiency.
In this cross-sectional study, 900 men with T2DM were evaluated using androgen deficiency in aging male questionnaire. They were screened for demographic characteristics, gonadal hormone levels, lipid profile, and glycosylated hemoglobin.
The prevalence of hypogonadism in T2DM patients was found to be 20.7% (186 out of 900). Hypogonadism was of testicular origin (primary) in 48/186 (25.8%) patients, of pituitary or hypothalamic origin (secondary) in 14/186 (7.53%), and remaining 124/186 (66.67%) patients were found to have low testosterone with the inappropriate normal level of luteinizing hormone and Follicle-stimulating hormone. 451/900 (50.1%) patients were only symptomatic but had normal testosterone levels. Further 263 patients out 900 were asymptomatic, of which 51/900 (5.7%) patients had low levels of testosterone and 212/900 (23.5%) patients had normal testosterone level without symptoms. There were no deaths or other serious adverse events except mild pyrexia which was not related to the study.
Hypogonadism diagnosis, at times, might not be validated with the help of androgen deficiency questionnaire or symptoms only. Given the large number of patients of T2DM in India, the incidence of hypogonadism is more in diabetic patients as compared to the general population. Hence, implementation of screening programs in diabetic patients is necessary to understand and detect individuals with low serum total testosterone at any early stage and to supplement testosterone accordingly.
全球范围内报道了2型糖尿病(T2DM)男性患者性腺功能减退的高患病率。
评估印度T2DM男性患者性腺功能减退的患病率,并评估原发性和继发性性腺功能减退以及雄激素缺乏情况。
在这项横断面研究中,使用老年男性雄激素缺乏问卷对900名T2DM男性进行评估。对他们进行了人口统计学特征、性腺激素水平、血脂谱和糖化血红蛋白的筛查。
T2DM患者中性腺功能减退的患病率为20.7%(900例中有186例)。性腺功能减退在48/186(25.8%)患者中为睾丸源性(原发性),在14/186(7.53%)患者中为垂体或下丘脑源性(继发性),其余124/186(66.67%)患者睾酮水平低,但促黄体生成素和促卵泡生成素水平正常。451/900(50.1%)患者仅有症状,但睾酮水平正常。另外,900例患者中有263例无症状,其中51/900(5.7%)患者睾酮水平低,212/900(23.5%)患者睾酮水平正常且无症状。除了与研究无关的轻度发热外,没有死亡或其他严重不良事件。
有时,仅借助雄激素缺乏问卷或症状可能无法确诊性腺功能减退。鉴于印度T2DM患者数量众多,与普通人群相比,糖尿病患者中性腺功能减退的发生率更高。因此,有必要在糖尿病患者中实施筛查计划,以在早期阶段了解和检测血清总睾酮水平低的个体,并相应地补充睾酮。