Prevalence of Adult-Onset Hypogonadism and Erectile Dysfunction in Males with Prediabetes

Background: The prevalence of prediabetes is high globally; however, few studies have investigated the prevalence of adult-onset hypogonadism (AOH) and erectile dysfunction (ED) in men with prediabetes, and there is no study from India. Aims: The aim of this study was to evaluate the prevalence of AOH and ED in men with prediabetes and to correlate the risk of testosterone deficiency with prediabetes. Methods: This cross-sectional study was performed on 100 diagnosed cases of prediabetes and 100 normoglycemic controls. Prediabetes was defined as impaired fasting glucose, impaired glucose tolerance, or both. AOH was defined as a positive response in the Androgen Deficiency in Ageing Males (ADAM) questionnaire in the setting of low testosterone. ED was assessed by the International Index of Erectile Function Questionnaire (IIEF-5) score. Results: AOH and ED were diagnosed in 34 (34%) and 79 (79%) males with prediabetes as compared to 16 (16%) and 58 (58%) males in the control population, respectively (p = 0.004 and p = 0.001). Both AOH and ED were observed in significantly more younger males with prediabetes (< 50 years) than in controls. On multivariate analysis, total testosterone remained significantly low in males with prediabetes as compared to controls after adjustment for possible confounders (odds ratio 2.5; p = 0.028). Conclusion: Males with prediabetes even in the younger age group are at an increased risk of AOH, ED, and testosterone deficiency.