SAT-030 The Barnsley Diabetes Hypogonadal Questionnaire (BDHQ) - Validation for the Clinical Use to Support the Diagnosis of Testosterone Deficiency in Men with Type 2 Diabetes (T2D)

Abstract

The Aging Males’ Symptoms (AMS) scale is used to assess health-related quality of life (HRQOL) and erectile dysfunction (ED) in hypogonadal men. However, this questionnaire hasn’t been validated specifically for use in hypogonadal men with T2D. BDHQ was developed using data collected in the Barnsley Type 2 Diabetes Cohort Longitudinal Study based on AMS, The International Index of Erectile Function Questionnaire, and The Short Form (36) Health Questionnaire. Statistical analysis identified the 19 most sensitive and specific questions for identifying men with hypogonadism in a T2D population.Objectives: To assess the significance of AMS and BDHQ in hypogonadal men with T2D.Methods: The research data from a study involving men with T2D was used. All men were divided into 2 groups according to their baseline total testosterone (TT) status: group 1 (n = 82) - men with low TT (<10.4nmol/l; 300ng/dl), and group 2 (n = 64) - men with normal TT (≥10.4nmol/l; 300ng/dl). Data was also assessed using calculated freeT and bioavailableT. The statistical analysis was carried out using SPSS software and the data analysed using General Linear Model Univariate analysis of variance and Receiver Operating Characteristic (ROC) curve.Results: Mean age for group 1 was 59.4 ± 10.1 years (range 25 - 77) and for group 2 was 61.5 ± 9.8 years (range 30 - 80). Mean TT for group 1 was 7.9 ± 1.8 nmol/l (range 1.3 - 10.3); for group 2TT was 14.9 ± 4.1 nmol/l (range 10.4 - 29.5). There was statistically significant difference in the scores in both questionnaires between the groups (AMS, p=0.012; BDHQ, p=0.035). Area under the curve (AUC) by ROC analysis showed no significant difference in sensitivity and specificity between the two questionnaires (AMS, AUC=0.623; BDHQ, AUC=0.606). To achieve sensitivity of 80%, it showed that the cut-off for positive test should be 40 out of 85 for AMS, and 44 out of 95 for BDHQ.Conclusion: The BDHQ can be used to support a diagnosis of hypogonadism in the presence of persistent testosterone deficncy when TT is <10.4nmol/l. Whilst AMS is well-recognised tool for assessing HRQOL and ED in hypogonadal men in general population, the cut-off for positive test should be lower in diabetic population. In addition, this study showed that BDHQ is not inferior test to AMS in assessing HRQOL and ED in hypogonadal men with T2D.