Performance of the Androgen Deficiency in Aging Male questionnaire for the clinical detection of androgen deficiency in black sub-Saharan African men with Type-2 diabetes mellitus

Abstract

Background:The Androgen Deficiency in Aging Male (ADAM) questionnaire is increasingly popular for evaluation of androgen deficiency (AD) in sub-Saharan African men with type 2 diabetes mellitus (DM). However, its reliability in this population is unknown. Methods: Total testosterone < 8 nmol/L was used as the gold standard for diagnosis of AD in this cross-sectional survey of 200 type 2 DM males aged 30-69 years. Participants also completed the Saint Louis University ADAM questionnaire whereby AD was diagnosed by a 'yes' answer to question 1 (reduced libido) or 7 (erectile dysfunction) or any other three questions. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy of the ADAM tool were computed. Results: The mean age of the participants was 58.0 ± 8.8 years. A total of 142 subjects (71.0%) had AD based on the ADAM questionnaire. However, AD was biochemically confirmed in 59 subjects (29.5%). The ADAM questionnaire rendered a sensitivity of 88.1%, specificity of 44.7%, PPV of 50.0%, NPV of 85.7% and accuracy of 61.4%. Conclusion: Despite an impressive sensitivity, the low specificity and overall accuracy of the ADAM questionnaire makes it unreliable for the detection of AD in sub-Saharan African men with type 2 DM.

Sensitivity, Specificity and Accuracy of Androgen Deficiency in Ageing Male (ADAM) Questionnaire for the Clinical Detection of Androgen Deficiency in the Male Population in Pakistan

“…The ADAM questionnaire showed adequate sensitivity but as it lacks adequate specificity we can conclude that it is not a good alternative for serum testosterone assays. This was consistent with a study conducted in Kenya which showed an 88.1% sensitivity and 44.7% specificity with 61.4% accuracy [ 10 ]. Chu et al also found similar results in the Chinese population with 86% sensitivity and 40% specificity [ 11 ].…”

“…They found that specificity for the questionnaire for reduced libido is higher compared to the specificity of the ADAM questionnaire (75.5% vs. 44.7%). Based on this finding, Ugwu et al recommended continuing using the ADAM questionnaire for screening, especially in low-income countries, as yes to the question related to loss of libido may be a good indicator for low testosterone levels [ 10 ].…”

Hypogonadism and associated risk factors in male patients with type 2 diabetes mellitus attending the diabetic clinic of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia

“…Subjects whose BP readings were ≥ 140/90 mmHg were considered hypertensive. 13 Symptoms of hypogonadism were assessed using the ADAM 14 questionnaire, which is the most widely accepted screening questionnaire consisting of 10 questions. Subjects who can read and write completed the ADAM questionnaire on their own, and those who could not were assisted by an experienced nurse.…”

The flavonoid baicalin improves glucose metabolism by targeting the PH domain of AKT and activating AKT/GSK3β phosphorylation

“…Diabetes is a chronic metabolic disorder in which blood glucose levels are abnormally elevated (hyperglycemia) , and it has long been a major disease that harms human health . Insulin resistance results in damage to the tissues of the liver, muscles, fat, and other tissues involved in the regulation of blood glucose metabolism and plays a key role in type 2 diabetes (T2D) .…”