Age-related androgen deficiency and erectile dysfunction in men of the reproductive age presenting with type 2 diabetes mellitus

Abstract

Aim of the study. To detect hypogonadism and elucidate its relationship with erectile dysfunction (ED) and the main risk factors of cardiovascular diseases (CVD) among the patients with type 2 diabetes mellitus (DM2). Materials and methods. This clinical epidemiological study included 261 men with DM2 at the age varying from 30 to 59 years. The following exclusion criteria were used: type 1 diabetes mellitus, primary hypogonadism, drug-induced and congenital diseases accompanied by hypogonadism, oncological and cardiovascular diseases. All the patients underwent routine clinical examination, questionnaire and instrumental studies, laboratory analysis including assays for sex hormones. Results. Hypogonadism was diagnosed based on the results of all above studies in 114 (43.7%) men presenting with type 2 diabetes mellitus whereas the AMS questionnaire revealed a 10% higher incidence of age-related hypogonadism (in 141 or 54% subjects). It means that the incidence of hypogonadism increases with age both among the patients with DM2 and in the general male population. For example, only 17.5% of the men at the age of 30-39 years suffered hypogonadism compared with thrice this frequency in the groups of 40-49 and 50-59 year-old subjects. The summarized international erectile function index (IEFI) in the patients with hypogonadism and DM2 was 14.2±0.5 compared with 19.0±0.9 in the group without hypogonadism (p<0.001). Erectile dysfunction was diagnosed in 42 (28.6%) of the 147 patients with DM2 in the absence of hypogonadism whereas all the patients with hypogonadism suffered ED. The groups of the patients presenting with DM2 and hypogonadism and with DM2 without hypogonadism were not significantly different in terms of the number of smokers and hypokinetic subjects (roughly 70%). A similar tendency was documented in the occurrence of such parameters as waist circumference and serum triglycerides levels whereas the total and LDLP cholesterol levels, arterial pressure and body mass index were significantly higher in the patients with hypogonadism. Conclusion. Almost each second man with type 2 diabetes mellitus suffers hypogonadism and the number of such patients increases with age. The presence of DM2 increases the risk of development of ED. Also, the probability of ED and its severity increase under effect of androgen deficiency. The combination of DM2 and hypogonadism promotes manifestation of the main risk factors of cardiovascular diseases.