Abstract
Diabetes mellitus, an endocrine disorder, has been implicated in many including hypogonadism in men. Given the fact that diabetes mellitus is becoming a fast-growing epidemic and the morbidity associated with it is more disabling than the disease itself. This study sought to assess the prevalence of low testosterone levels and predictors in type 2 diabetes mellitus patients and non-diabetic men in a district hospital in Ghana. This hospital-based case-control study comprised 150 type 2 diabetics and 150 healthy men. A pre-structured questionnaire and patient case notes were used to document relevant demographic and clinical information. Venous blood sample of about 6 ml was taken to measure FBS, HbA1c, FSH, LH, and testosterone levels. All data were analyzed using STATA version 12 (STATA Corporation, Texas, USA). The overall hypogonadism in the study population was 48% (144/300). The prevalence of hypogonadism in type 2 diabetic subjects was almost three times more than in healthy men (70.7% vs 25.3%). The odds of having hypogonadism was lower in the men with normal weight and overweight with their underweight counterparts (AOR = 0.33, 95% CI; 0.12-0.96, p = 0.042) and (AOR = 0.29, 95% CI; 0.10-0.84, p = 0.023) respectively. Also, the odds of suffering from hypogonadism was lower in non-smokers compared with smokers (AOR: 0.16, 95% CI; 0.05-0.58, p = 0.005). Participants who were engaged in light (AOR: 0.29, 95% CI; 0.14-0.61, p = 0.001), moderate (AOR: 0.26, 95% CI; 0.13-0.54, p<0.001) and heavy (AOR: 0.25, 95% CI; 0.10-0.67, p = 0.006) leisure time activities had lower odds hypogonadal compared to those engaged in sedentary living. Type 2 diabetic men have high incidence of hypogonadism, irrespective of their baseline clinical, lifestyle or demographic characteristics. Smoking and sedentary lifestyle and BMI were associated with hypogonadism in the study population. Routine testosterone assessment and replacement therapy for high risk patients is recommended to prevent the detrimental effect of hypogonadism in diabetic men.
Highlights
The relationship between sex hormones and Type 2 diabetes mellitus (T2DM) is of great concern in the health sector, given the fact that diabetes mellitus is becoming a fast-growing epidemic and the morbidity associated with it is more disabling than the disease itself
There was statistically significant difference between the type 2 diabetic men and the healthy controls when categorized by age (p = 0.003), body mass index (p
The body mass index (BMI) of the healthy controls was significantly higher than the type 2 diabetic men
Summary
The relationship between sex hormones and Type 2 diabetes mellitus (T2DM) is of great concern in the health sector, given the fact that diabetes mellitus is becoming a fast-growing epidemic and the morbidity associated with it is more disabling than the disease itself. Millions of people around the world are diagnosed with T2DM, many more remain undiagnosed [1]. The world prevalence of diabetes mellitus among adults (aged 20–79 years) in 2010 was 6.4% and expected to increase to 7.7%, by 2030 [2]. It is estimated that in 2000, about 7, 146, 000 people in sub-Saharan Africa had diabetes mellitus, with a projected increase to 18, 645, 000 in 2030 [3, 4]. The prevalence of diabetes mellitus in Ghana is 6.4% and about 69.9% remain undiagnosed [4]. Diabetes mellitus has been implicated in male sexual dysfunction, libido dissociations, retrograde ejaculation, erectile dysfunction and lack of efficient endocrine control of spermatogenesis [5]
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