Prevalence of hypogonadism in male Type 2 diabetes mellitus patients with and without coronary artery disease

Abstract

Aim:The present study is carried out to investigate hypogonadism using serum testosterone levels in male Type 2 diabetes mellitus (T2DM) subjects with and without coronary artery disease (CAD).Subjects and Methods:A total of 150 age and body mass index-matched male subjects in the age group of 30–70 years were recruited in three groups; Group A - subjects with normal glucose tolerance, Group B - T2DM subjects without CAD, and Group C - T2DM subjects with CAD (n = 50 each group). Subjects with CAD were diagnosed on the basis of electrocardiogram, treadmill testing, stress echocardiography, or coronary angiography. Total testosterone (TT), free testosterone (FT), bioavailable testosterone, calculated FT and glycemic parameters were measured and compared between all the three study groups. One-way ANOVA followed by post hoc Tukey's test and Pearson's coefficient of correlation tests were used for analysis.Results:Hypogonadism (TT <3 ng/ml) was observed in 40% (20/50) of subjects in Group C and 32% (16/50) of subjects in Group B as compared to only 14% (7/50) of subjects in Group A (Groups A vs. B; P = 0.055, Groups A vs. C; P = 0.006 and Groups B vs. C; P = 0.53). Group C subjects had significantly lower levels of TT (3.55 ± 1.46 ng/ml vs. 4.73 ± 2.17 ng/ml, P = 0.005), calculated FT (0.062 ± 0.0255 pg/ml vs. 0.0951 ± 0.0508 pg/ml, P ≤ 0.001), and bioavailable testosterone (1.48 ± 0.65 ng/ml vs. 2.18 ± 1.20 ng/ml, P ≤ 0.001) compared to control Group A subjects. There was no significant difference in any of the testosterone parameters between Groups A and B. Furthermore, an overall positive correlation was found between hypogonadism and CAD (r = 0.177, P = 0.030, n = 150).Conclusion:We observed hypogonadism as indicated by low testosterone levels in a significant proportion of male T2DM subjects with CAD.

Estimation of serum testosterone concentration in type 2 diabetic males

“…Madhu et al, Hypogonadism was observed in 40% diabetic males with coronary artery disease and 32% diabetic males without coronary artery disease. 13 In another study conducted by Dhindsa et al involving 103 patients in the United States of America, the prevalence was found to be around 33%. 4 In this study sensitivity and specificity of ADAM questionnaire in Study Group was found to be 78.46% and 94.29% respectively.…”

Frequency of Hypogonadism in Type 2 Diabetes Mellitus Patients with and without Coronary Artery Disease

“…We found a significantly higher prevalence of hypogonadism in diabetic subjects with CAD compared to diabetic subjects without CAD. Madhu et al evaluated the prevalence of hypogonadism in T2DM and its relationship with CAD [1]. In their study, hypogonadism was found to be highest in T2DM patients with CAD (40%, 20/50) as compared to T2DM patients who did not have CAD (32%, 16/50; p-value: 0.53).…”

“…Hypogonadism is a clinical condition comprising both clinical and biochemical evidence of testosterone deficiency [1][2][3]. Males with type 2 diabetes mellitus (T2DM) have low testosterone levels in comparison to healthy individuals [4].…”

Hypogonadism and diabetes mellitus - Implications for cardiovascular risk

“…There have been recent reports of hypogonadism in 30-40% of male subjects with DM [1][2][3] particularly in those with evidence of coronary artery disease (CAD) [8]. A significant positive correlation has also been reported between hypogonadism and CAD [8] and atherosclerosis [9]. Coupled with its documented association with insulin resistance and metabolic syndrome, these findings would suggest that testosterone deficiency is not only an important CV risk factor but could also be a major contributor to the CV burden associated with diabetes.…”

“…However, it is also known that a large part of the CV risk associated with DM remains unexplained by conventional risk factors and the search for newer risk factors is still on. There have been recent reports of hypogonadism in 30-40% of male subjects with DM [1][2][3] particularly in those with evidence of coronary artery disease (CAD) [8]. A significant positive correlation has also been reported between hypogonadism and CAD [8] and atherosclerosis [9].…”