Prevalance and Risk Factors of Hypogonadism in Male Patients with Type 2 Diabetes in El Minya, Egypt

Background: Hypogonadism in adult men is a clinical and biochemical syndrome associated with low level of testosterone, which may adversely affect multiple organ functions and quality of life. It is closely related to the development of diabetes. This study was designed to determine the incidence of hypogonadism and related risk factors among men with type 2 diabetes (T2D). Patients and Methods: A total of 300 male patients diagnosed with T2D age from 30-70 years were enrolled in the study. Arabic version of the Androgen Deficiency in Aging Male (ADAM) questionnaire was employed to assess the androgen insufficiency in men. Hemoglobin A1c, FSH, LH, total and free testosterone, levels were measured by enzyme immunoassay. Results: T2D patients were divided into two groups: 48 (16%) patients with hypogonadism and 252 (84%) patients without hypogonadism. Multiple logistic regression analysis for factors affecting Hypogonadism among patients according to (total testosterone + ADAM +ve) versus those without hypogonadism it was found that age, random blood sugar, body mass index (BMI), Hb A1c are independent risk factors for the development of hypogonadism with odds ratio (0.95, 1, 1.1, 1.37) with p value (0.02, 0.03, 0. 03, 0.008) respectively. The ROC analysis of the accuracy of indices and cut off values for the studied total testosterone for predicting the hypogonadism according to total testosterone + ADAM score positive: The AUC was 0.98 «p-value <0.0001» with sensitivity 100% and specificity of 96.4% at Cut off value ≤ 12. Conclusion: Several risk factors of diabetes are associated closely with hypogonadism. Age, BMI, blood sugar, and Hb A1c are independent risk factors for the development of hypogonadism in male patients with T2D.