Clinical and Biochemical Assessment of Hypogonadism in Men With Type 2 Diabetes Mellitus

Objectives : Hypogonadism is a clinical condition comprising both symptoms and biochemical evidence of testosterone deficiency. It has been reported that testosterone levels are lower in diabetic men compared with nondiabetic subjects. The aim of our study was to assess the prevalence of  hypogonadism, based on both symptoms and biochemically available measures of testosterone deficiency in men with type 2 diabetes mellitus (DM) and to compare with control group. Materials and Methods: A cross sectional study was carried out in type 2 patients who attended the outpatient clinic of Diabetes Kartal Training and Research hospital. Between the 1th July and 15th July 2012, 65 consecutive patients were included to the study. Control group is created by age matched 40 non diabetic patients. Blood pressure, waist circumference, height, weight and testosterone levels were measured. Body mass index (BMI) was calculated. Bioavailable testosterone and free testosterone levels were calculated on the internet (http://www.issam.ch/www.androloji.org.tr) by using the levels of albumin, total testosterone and sex hormone binding protein. Results: Diabetic patients and control group’s mean age was respectively 52.2±5.0 and 50.8±6.0 year, mean BMI 27.8±2.9 and 27.9±3.9 kg/m 2 and mean waist circumference 100.8±7.3 and 97.9±17.5 cm. Men with type 2 diabetes had significantly lower total testosterone and SGBH than control group (respectively p= 0,005 ve p= 0,02). According to total testosterone levels, overt hypogonadism was seen in 8.2% of diabetic patients, borderline hypogonadism was seen in  29.5 % of diabetic patients. In control group overt hypogonadism was seen in 5.7 %, borderline hypogonadism was seen in 20 % of control group. According to chemical hypogonadism based on total, bioavailable and calculated testosterone levels, there were no statistically difference between groups. In diabetic group, 11 % severe, 30.2 % moderate, 34.9 % mild complaints were recorded according to AMS results. In control group, 2.5 % severe, 15 % moderate, 47.5 % mild complaints were recorded according to AMS results. Men with type 2 diabetes had significantly higher severe and moderate complaints of hypogonadism than control group. In diabetic group waist circumference, BMI and in control group waist circumference were negatively correlated with testosterone levels. Conclusion: This study demonstrates that men with type 2 DM had significantly lower total testosterone but not significantly higher biochemical hypogonadism than control group. At the same time, men with type 2 DM had significantly higher severe and moderate complaints of  hypogonadism than control group. In diabetic group waist circumference, BMI and in control group waist circumference were associated with low testosterone levels.