Unnikrishnan Ambika G, Saboo Banshi D, Majumdar Anirban, Saraogi Ravi K, Sundar Shanmuga, Mahadevan Shriraam, Ramakrishnan Anantharaman, Basu Indraneel, Dutta Deep, Bhattacharya Arpan D, Bharathi Prakadeesh, Gawand Kalpesh
Department of Endocrinology, Chellaram Diabetes Institute, Pune, Maharashtra, India.
Department of Endocrinology, DiaCare Research, Ahmedabad, Gujarat, India.
Indian J Endocrinol Metab. 2024 Sep-Oct;28(5):473-479. doi: 10.4103/ijem.ijem_262_23. Epub 2024 Sep 4.
Hypogonadism is a common comorbidity associated with several metabolic disorders including type 2 diabetes (T2D) that can remain undetected without proper screening. Here, we evaluated the prevalence of hypogonadism in Indian male patients with T2D with or without obesity.
In this prospective, observational study, male patients with T2D and hypogonadism were evaluated symptomatically using the androgen deficiency in ageing male (ADAM) questionnaire at baseline and confirmed on the basis of total testosterone (TT) levels (<300 ng/dL) at Days 5-7 (Visit 2) and 9-14 (Visit 4) assessed after 12 hours of fasting between 8 AM and 10 AM. Prevalence of hypogonadism was presented as proportion of patients.
Of 598 enrolled patients, 526 completed the study. Mean (standard deviation [SD]) age was 50.4 (9.12) years. The percentage of patients with TT <300 ng/dL at visit 2 was 18.4%, while upon repeat confirmation, it reduced to 8.6%. Thus, the prevalence of true hypogonadism was 8.6%. Prevalence of hypogonadism in patients with BMI range of >30 kg/m (obese) was 11.1%. At screening, 81.4% (487 of 598) patients had positive ADAM questionnaire results.
Prevalence of hypogonadism in Indian patients with T2D was found to be 8.6% upon repeat evaluation of testosterone. Symptomatic (ADAM questionnaire) as well as biochemical (total testosterone levels with repeat evaluation) confirmation is vital in the definite diagnosis of male hypogonadism.
性腺功能减退是一种常见的合并症,与包括2型糖尿病(T2D)在内的多种代谢紊乱相关,若未进行适当筛查可能仍未被发现。在此,我们评估了印度男性T2D患者(无论是否肥胖)中性腺功能减退的患病率。
在这项前瞻性观察研究中,对患有T2D和性腺功能减退的男性患者在基线时使用老年男性雄激素缺乏(ADAM)问卷进行症状评估,并根据上午8点至10点禁食12小时后第5 - 7天(访视2)和第9 - 14天(访视4)的总睾酮(TT)水平(<300 ng/dL)进行确诊。性腺功能减退的患病率以患者比例表示。
在598名登记患者中,526名完成了研究。平均(标准差[SD])年龄为50.4(9.12)岁。访视2时TT <300 ng/dL的患者百分比为18.4%,而再次确认后降至8.6%。因此,真正性腺功能减退的患病率为8.6%。体重指数(BMI)范围>30 kg/m²(肥胖)的患者中性腺功能减退的患病率为11.1%。在筛查时,81.4%(598名中的487名)患者的ADAM问卷结果为阳性。
对睾酮进行重复评估后发现,印度T2D患者中性腺功能减退的患病率为8.6%。症状性(ADAM问卷)以及生化(重复评估总睾酮水平)确认对于男性性腺功能减退的明确诊断至关重要。