Hypogonadism In Male Patients Research Articles

Hypogonadism in male patients with cushing's syndrome: prevalence and outcome

Hypogonadism in male patients with cushing's syndrome: prevalence and outcome

A CLINICAL CASE OF A PRIMARY PARTIAL EMPTY SELLA PRESENTING WITH HYPOGONADOTROPIC HYPOGONADISM

Primary empty sella (PES) is a rare condition characterized by the herniation of the subarachnoid space into the sellaturcica, with variable filling of cerebrospinal fluid (CSF). We present a clinical case of a 19-year-old male with primary partial empty sella who presented with hypogonadotropic hypogonadism, a condition typically observed in females at an older age. The patient exhibited delayed puberty with characteristic hormonal abnormalities and bilateral atrophic testicles. Magnetic resonance imaging (MRI) revealed a partial empty sella with preserved pituitary function. Hormonal replacement therapy was initiated, leading to improved virilization however, fertility induction was unsuccessful despite intervention. The etiology of PES remains unclear, with proposed mechanisms involving sellar and pituitary factors. Genetic studies have identified candidate genes associated with PES development. Hormonal replacement therapy remains the cornerstone of treatment, aiming to alleviate symptoms and prevent long-term complications. This case underscores the importance of early recognition and management of hypogonadotropic hypogonadism in male patients with PES, with consideration for comprehensive therapeutic approaches, including fertility induction where appropriate.

The prevalence of hypogonadism in male patients with type 2 diabetes mellitus and clinically relevant factors

Aims: Hypogonadism has been reported at high rates in male patients with type 2 diabetes mellitus (T2DM). However, the origin of male hypogonadism in patients with T2DM is poorly known. The aim of this study was to determine the prevalence of hypogonadism and to investigate the potential impact of certain clinical and biochemical variables on hypogonadism in patients with T2DM. Methods: The study included a total of 513 consecutive males (aged 30 - 60 years) with T2DM who presented at the endocrinology outpatient clinic. The demographic and clinical characteristics of the patients were recorded. Biochemical parameters, total testosterone (TT), gonadotrophins, prolactin, serum lipids, and hemoglobin A1c (HbA1c) were measured. Correlations between metabolic and clinical conditions and T levels were analyzed. Results: The mean age of the study population was 45.5±12.6 years. Hypogonadism was present in 122 (23.7%) patients, of which 24 (23.3%) were determined with primary hypogonadism. Compared with participants with normal testosterone, those with hypogonadism had lower estimated glomerular filtration rate (eGFR), and the liver function test results, HbA1c and triglycerides levels, and duration of diabetes were higher. Correlation analyses showed that TT was negatively correlated with body mass index (BMI), waist circumference, age, fasting blood glucose, HbA1c, uric acid and triglycerides, and positively correlated with eGFR and high density lipoprotein cholesterol (HDL-C). Multivariate logistic regression analysis revealed that BMI, age, diabetes course, hypertrglyceridemia, hyperuricemia and eGFR <60 ml/min/1.73 m2 are independent risk factors for hypogonadism in male patients with type 2 diabetes. Conclusion: The current study results demonstrated that the prevalence of hypogonadism is higher in men with type 2 diabetes than in the general population and age, diabetes duration, BMI, triglycerides and uric elevation are independent risk factors.

Noninvasive Indices of MASLD Are Associated With Hypogonadism in Male Patients With Type 2 Diabetes Mellitus.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease, affecting one-fourth of the adult population worldwide. Recent data found an association between MASLD and hypogonadism, but this relation in patients with type 2 diabetes mellitus (T2DM) is still unclear. To evaluate in men with T2DM the association between total testosterone (TT) and noninvasive indices of hepatic steatosis (Fatty Liver Index [FLI], Hepatic Steatosis Index [HSI], Dallas Steatosis Index [DSI]) and fibrosis (AST to Platelet Ratio Index [APRI], Fibrosis-4 Index [FIB-4]), and their predictive cutoff values in identifying hypogonadism. Cross-sectional study on 189 men with T2DM, without history of liver diseases and alcoholism, recruited on an outpatient basis. Interventions were andrological evaluation, metabolic parameters, TT, and liver indices. The main outcome measures were comparison of steatosis and fibrosis indices with testosterone levels and presence of hypogonadism. Receiver operating characteristic curves were used to identify cutoff values of liver indices in predicting low testosterone (<12 nmol/L). FLI, HSI, and DSI were negatively related with TT and were higher in the low-testosterone group than in the normal-testosterone group (FLI: 74.1 [61.4-93.5] vs 56.5 [32.1-78.2], P < .001; HSI: 41.5 [39.2-45.9] vs 40.1 [36.6-43.2], P = .005; DSI: 0.45 [-0.08-+1.04] vs -0.07 [-1.02-+0.58], P < .001). FLI and DSI also correlated with clinical symptoms of hypogonadism. No differences between groups were observed for APRI and FIB-4. FLI ≥63 was the best parameter as predictive index of low TT (sensitivity 73%, specificity 64%). We found an association between noninvasive indices of steatosis and hypogonadism in patients with T2DM. These indices could be used to direct the patients to andrological evaluation.

Prevalance and Risk Factors of Hypogonadism in Male Patients with Type 2 Diabetes in El Minya, Egypt

Prevalance and Risk Factors of Hypogonadism in Male Patients with Type 2 Diabetes in El Minya, Egypt

Prevalence and Risk Factors for Hypogonadism in Male Patients with Type 2 Diabetes Mellitus

Prevalence and Risk Factors for Hypogonadism in Male Patients with Type 2 Diabetes Mellitus

PMON78 Improvement in Resistant Hypogonadism with use of Clomiphene in Prolactinomas Treated with Dopamine Agonist: A Case Study and Review of Literature

Abstract Introduction Prolactinomas account less than half of all pituitary adenomas and cause persistent hypogonadism and infertility despite treatment with dopamine agonists such as cabergoline or bromocriptine and improvement of prolactin levels (Gillam 2006). Conventional therapy for persistent hypogonadism in males is testosterone supplementation but this can cause fluctuations in serum testosterone levels and inhibition of spermatogenesis and infertility. Clomiphene citrate has been used to treat infertility and hypogonadism in males and females for over 50 years. Below we present a patient with persistent hypogonadism and review of available literature while on cabergoline with improving prolactin levels being treated with clomiphene Case Report A 21-year-old Caucasian male presented to our clinic after being diagnosed with macroadenoma measuring 1.6 x1.7×1.8 cm without stalk compression. Further pituitary functional work up was normal except for elevated prolactin levels of 232 ng/mL and total testosterone level of 107 ng/dL and free testosterone level of 4.1 ng/dL. Patient was started on cabergoline and titrated according to prolactin levels. Despite being on high dose cabergoline, 3.5 mg weekly, and improvement of prolactin levels (Prolactin level 53 ng/mL), he continued to have persistent hypogonadism (Total Testosterone 188 ng/dL and Free Testosterone 8.5 ng/dL) along with hypogonadal symptoms. Patient expressed his desire to preserve his future fertility and was uncertain he could use gel or self-inject replacement therapy therefore clomiphene citrate 25 mg tablet daily was started. Repeat testosterone levels six weeks later normalized (Testosterone 532 ng/dL and Free Testosterone 19 ng/dL) and symptoms improved. Treatment was continued with subsequent testosterone levels remained stable along with improved prolactin levels over the last year. Discussion/Conclusion A prospective study of hypogonadism in 14 males treated for prolactinomas with dopamine agonist showed 71% of patients responded to clomiphene treatment with improved testosterone levels and symptoms (Ribeiro 2009). A second study done by Vilar et al in 2018 of similar hypogonadal males on dopamine agonist treatment for prolactinomas showed 72% improvement in symptoms and testosterone levels over 12 weeks of clomiphene treatment. Our case, along with reviewed literature, showed that clomiphene is an effective alternative treatment option for resistant or persistent hypogonadism in male patients with prolactinomas being treated with dopamine agonists. References Gillam, M. P., Molitch, M. E., Lombardi, G., &amp; Colao, A. (2006). Advances in the treatment of prolactinomas. Endocrine Reviews. https://doi.org/10.1210/er.2005-9998Ribeiro, R. S., &amp; Abucham, J. (2009). Recovery of persistent hypogonadism by clomiphene in males with prolactinomas under dopamine agonist treatment. European Journal of Endocrinology, 161(1), 163–169. https://doi.org/10.1530/EJE-09-0084Vilar, L., Lyra, R., The, A. C., Trovao, E., Gadelha, P., Albuquerque, L. (2018). The role of clomiphene citrate in the resolution of hypogonadism in male patients with prolactinomas under cabergoline therapy. 20th European Congress of Endocrinology. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Cardiometabolic indices predict hypogonadism in male patients with type 2 diabetes

PurposeTo evaluate in men with type 2 diabetes the association of cardiometabolic indices [Visceral Adiposity Index (VAI), Triglyceride Glucose Index (TyG), and lipid accumulation product (LAP)] with total testosterone (TT) levels, and their predictive cut-off values in identifying hypogonadism.Methods265 consecutive men aged 40–70 years with type 2 diabetes performed an andrological evaluation; metabolic parameters and TT were determined. Receiver operating characteristic (ROC) curves were used to identify cut-off values of cardiometabolic indices in predicting low testosterone (TT < 12 nmol/l).ResultsVAI, TyG, and LAP were negatively associated with TT levels. The prevalence of hypogonadism in men in the fourth quartiles of VAI, TyG, and LAP was ~ 70.0–75.0% compared to ~ 10.0–17.0% in men in the first quartiles (p < 0.001). The sensitivity and specificity of the three cardiometabolic indices in predicting TT < 12 nmol/l were significantly higher concerning BMI, waist circumference, lipid profile and HbA1c. Cut off values of VAI ≥ 3.985, TyG ≥ 4.925, and LAP ≥ 51.645 predict hypogonadism with good sensitivity and specificity.ConclusionThis is the first study evaluating the association of VAI, TyG, and LAP with hypogonadism in men with type 2 diabetes. Alterations in these indices should direct the patients to andrological evaluation.

Treatment of congenital hypogonadotropic hypogonadism in male patients.

Congenital hypogonadotropic hypogonadism (CHH) is characterized by complete or partial failure of pubertal development because of inadequate secretion of gonadotropic hormones. CHH consists of hypogonadotropic hypogonadism with anosmia or hyposmia, Kallmann syndrome, and the normosmic variation normosmic idiopathic hypogonadotropic hypogonadism. CHH is one of the few treatable diseases of male infertility, although men with primary testicular dysfunction have irreversibly diminished spermatogenic capacity. The approach to CHH treatment is determined by goals such as developing virilization or inducing fertility. This review focuses on the current knowledge of therapeutic modalities for inducing puberty and fertility in men with CHH.

Effect of Diabetes Mellitus on Hypogonadism in Chronic Renal Failure

Hypogonadism in male patients with chronic renal failure and diabetes mellitus has been known separately; up to now, the effect of these two diseases together on testosterone deficiency and the impact of testosterone deficiency on metabolic values have not been known precisely, therefore in this study we aimed to investigate testosterone deficiency in patients with diabetes mellitus and chronic renal failure. Eighty-seven chronic renal failure patients and 45 control patients who were followed at endocrinology and nephrology clinics were included in the study. After exclusion criteria, the patients were divided into two groups according to diabetes mellitus status. Groups were compared according to testosterone levels. Testosterone deficiency and good groups were compared to blood glucose, Hba1c, and lipid profile levels. The mean age of 87 CRF patients and 45 people in the control group were similar (59.85 ± 9.99 and 56.67 ± 8.56, respectively, p= 0.16). Testosterone deficiency was 24.1% (21/87) in CRF group and 8.8% (4/45) in control group (p= 0.04). The total testosterone levels were notably lower in the diabetic-CRF patients, 3.44 ± 1.3 vs. 4.26 ± 1.46 mg/dl (p= 0.02). The testosterone deficient CRF group had higher blood glucose and HbA1c according to the testosterone sufficient group. (161.20 ± 61.24 mg/dl vs 133.25 ± 59.87 mg/dl blood glucose, p= 0.04 and 7.54 ± 1.46 vs 6.79 ± 1.14 % HbA1c, p= 0.04). Serum triglyceride and LDL levels did not significantly change between groups (p= 0.20 and 0.76, respectively). Testosterone deficiency in male CRF patients is not uncommon. Male patients with both T2DM and CRF have more common testosterone deficiency. In testosterone-sufficient patients, blood glucose regulation was better. Therefore, in these patients, it may be helpful not to neglect testosterone deficiency, which affects gonadal function, body metabolism, and cardiac and skeletal health.

Hypogonadism in Male Patients with Pituitary Adenoma and Its Related Mechanism: A Review of Literature.

Maintaining normal gonadal axis hormone levels is important for improving the condition of male patients with pituitary adenoma. The current literature is somewhat divided on the results of evaluations of gonadal axis function in male patients with pituitary adenoma before and after treatment, and the increasing demand for better quality of life has provided motivation for this research to continue. In this article, we summarize the feasibility of using testosterone as an indicator for assessing male function and discuss the changes reported in various studies for gonadal hormones before and after treatment in male patients with pituitary adenoma. It is important for clinicians to understand the advantages of each treatment option and the effectiveness of assessing gonadal function. The rationale behind the theory that pituitary adenomas affect gonadal function and the criteria for evaluating pituitary–gonadal axis hormones should be explored in more depth.

Serum testosterone levels and clinical signs of hypogonadism in men with type 2 diabetes

Background: Diabetes mellitus is a common metabolic disease that its association with low level of testosterone has already been shown in many studies. Considering the role of testosterone hormone in impotency, fatigue, and bone mass deficiency this study aimed to evaluate the total and free testosterone levels and clinical signs of hypogonadism in male patients with type 2 diabetes.Methods: In this descriptive-cross sectional study, sixty-five diabetic male patients aged 35-70 years were randomly selected and enrolled to the study. The necessary information such as patient demographics, BMI, past medical history, drug history, and history of smoking, education level and employment were completed by a checklist. Then, the patients were evaluated for total and free testosterone levels and symptoms related to decreased testosterone, hypogonadism symptoms by ADAM questionnaire. Finally, the data were statistical analyzed by spss version 21.Results: The mean age of patients was 57.12±4.7 years with age range of 38-69 years. According to the ADAM questionnaire, 51 (78.4%) of the patients were positive and 14 (21.6%) were negative. 16 (24.6%) of all patients had hypogonadism. Among ADAM positive patients, 46 (90.1%) had erectile dysfunction and 33 (64.7%) had decreased libido. Most people (75%) with hypogonadism had BMI more than 30.Conclusions: Testosterone levels are commonly found low in diabetic men, most of whom have symptoms of hypogonadism. Body mass index is known as an independent risk factor for hypogonadism in T2D men. There was also a significant correlation between free testosterone levels and hypogonadism.

Incidence and Risk Factors of Hypogonadism in Male Patients With Latent Autoimmune Diabetes and Classic Type 2 Diabetes.

ObjectivesThis study aimed to compare the prevalence of hypogonadism between male patients with latent autoimmune diabetes (LADA) and type 2 diabetes (T2DM) and investigate the risk factors for hypogonadism in these patients.MethodsThis cross-sectional study evaluated 367 male patients with LADA (n=73) and T2DM (n=294) who visited the endocrinology department of Shanghai Tenth People’s Hospital between January 2016 and October 2019 for diabetes management. Sex hormones, lipid profiles, sex hormone-binding globulin (SHBG), glycosylated hemoglobin A1c, beta-cell function, uric acid, and osteocalcin were determined in serum samples. Hypogonadism was defined as calculated free testosterone (cFT) less than 220 pmol/L along with the presence of symptoms (positive ADAM score).ResultsThe rate of hypogonadism in the LADA and T2DM group were 8.2, and 21.7%, respectively (p=0.017). After adjusting possible confounders, the rate of hypogonadism in the LADA group was comparable to those of the T2DM group. Univariate logistic regressions demonstrated that age, BMI, fasting C-peptide, triglycerides, total cholesterol and uric acid were associated with hypogonadism in men with diabetes, BMI, triglycerides and estradiol were independent risk for hypogonadism in men with diabetes.ConclusionThis is the first evidence to explore the rate of hypogonadism in male patients with latent autoimmune diabetes (LADA). In the population requiring admission to a large urban hospital in China, the rate of hypogonadism was comparable to those of the T2DM group after adjusting for possible confounders. BMI, triglycerides and estradiol were independently associated with the presence of HH in male diabetic patients.

Testosterone replacement therapy in hypogonadal male patients with hypogonadism and heart failure: a meta-analysis of randomized controlled studies.

The recently published guidelines of the European Academy of Andrology (EAA) recommended not to prescribe testosterone replacement therapy (TRT) in male patients with hypotestosteronemia and severe heart failure (HF) [New York Hearth Association (NYHA) class III and IV] since the risk in these patients has not been formally documented. Therefore, the aim of this study was to systematically evaluate the risk of TRT on the cardiac function and angina, in male patients with hypotestosteronemia and HF or coronary heart disease. Randomized controlled trials (RCTs) on male patients with hypotestosteronemia and chronic HF (ejection fraction <40%) or stable angina documenting the effect of TRT on NYHA class, left ventricular ejection fraction (LVEF), adverse events, ST depression and other indexes of cardiovascular function. Seven articles were included, for a total of 140 participants with HF (71 on TRT and 69 on placebo or no treatment). Included patients were of NYHA class II and III. TRT had no effect on death and rehospitalization rates of patients with HF and significantly delayed the time to ischemia in patients with chronic angina. TRT had no effect on the NYHA class, the LVEF, and on the Minnesota Living with Heart Failure questionnaire. Although a significant increase of oxygen consumption was found in the TRT group, no improvement to the physical exercise tolerance tests was observed. TRT showed no effect on systolic nor diastolic blood pressure, but it significantly ameliorated the heart rate. It significantly decreased the insulin serum levels and the HOMA index. These results suggest the safety of TRT, in patients with hypotestosteronemia and severe HF (class NYHA II and III). Although deriving from a limited number of studies, these data could prompt to perform other RCTs on the effects of TRT in patients with hypotestosteronemia and severe HFrEF (NYHA class III).

GH-induced LH hyporesponsiveness as a potential mechanism for hypogonadism in male patients with acromegaly.

Male patients with acromegaly frequently have hypogonadism. However, whether excess GH affects gonadal function remains unclear. We retrospectively compared clinical features affecting total testosterone (TT) and free testosterone (FT) levels between 112 male patients with acromegaly and 100 male patients with non-functioning pituitary adenoma (NFPA) without hyperprolactinemia. Median maximum tumor diameter (14.4 vs. 26.5 mm) and suprasellar extension rate (33 vs. 100%) were lower in acromegaly, but LH, FSH, TT, and FT were not significantly different. In acromegaly, TT was less than 300 ng/dL in 57%, and FT was below the age-specific reference range in 77%. TT and FT were negatively correlated with GH, IGF-1, and the tumor size, and positively correlated with LH. In NFPA, they were positively correlated with IGF-1, LH, FSH, ACTH, cortisol, and free T4, reflecting hypopituitarism. Multiple regression analysis showed that TT and FT had the strongest correlation with GH in acromegaly, and with LH in NFPA. Surgical remission was achieved in 87.5% of 56 follow-up patients with acromegaly. TT and FT increased in 80.4 and 87.5%, respectively, with a significant increase in LH. In acromegaly, the degree of postoperative increase in TT(FT) correlated with the fold increase of TT(FT)/LH ratio, a potential parameter of LH responsiveness, but not with fold increase of LH, whereas in NFPA it correlated with both. These results suggest that excessive GH is the most relevant factor for hypogonadism in male acromegaly, and may cause impaired LH responsiveness as well as the suppression of LH secretion.

Pay Attention to Hypogonadism in Male Patients with COVID-19-A Review

Although there were significant gender differences in severity and mortality of COVID-19, most of the young male patients of childbearing age survived Studies

Effect of Serum Total Testosterone and Its Relationship with Other Laboratory Parameters on the Prognosis of Coronavirus Disease 2019 (COVID-19) in SARS-CoV-2 Infected Male Patients: A Cohort Study

Background: Higher mortality rate related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led clinicians to investigate newer parameters that might predict prognosis of coronavirus disease 2019 (COVID-19). Our hypothesis was whether serum testosterone and other gonadal hormones might play an important role on the prognosis of COVID-19 in male patients. Therefore, in this cohort study, we aimed to investigate effect of serum testosterone and its relationship with other laboratory parameters on the prognosis of COVID-19 in SARS-CoV-2 infected male patients. Methods: The study included 221 consecutive male patients (>18 years old) with laboratory confirmed SARS-CoV-2 who had been hospitalized due to COVID-19. The patients were divided into 3 groups: Asymptomatic patients (n: 46), symptomatic patients who were hospitalized in the internal medicine unit (IMU) (n: 129), and patients who were hospitalized in the intensive care unit (ICU) (n: 46). Demographic characteristics, co-morbidities, laboratory results, computer tomographic (CT) scan findings, admission to the ICU, days in the ICU and duration of hospital stay were prospectively recorded in every patient. In the patients who had pre-COVID-19 serum gonadal hormones test (n: 24), the hormone levels were compared from pre-COVID-19 to the time of COVID-19. Findings: At the beginning of COVID-19, hypogonadism (serum total testosterone level of Interpretation: For the first time, our data suggest that COVID-19 might deteriorate serum testosterone level in SARS-CoV-2 infected male patients. Low serum total testosterone level at baseline has a significant increased risk for the ICU and mortality in patients with COVID-19. Future studies related to testosterone treatment in this population would discover possible improvement in clinical outcomes with the testosterone treatment in SARSCoV-2 infected hypogonadal male patients. Funding Statement: None.Declaration of Interests: All authors declare no competing interests.Ethics Approval Statement: The study was approved by the local ethics committee, consisting of the members from the Turkish Ministry of Health and University of Mersin School of Medicine (2020/#378). An informed consent was taken from all patients, included in the study.

1639-P: Correlates and Prevalence of Hypogonadism in Male Patients with Latent Autoimmune Diabetes, Classic Type 1 Diabetes, and Classic Type 2 Diabetes

Objectives: The study aims to compare the prevalence of hypogonadism in male patients with latent autoimmune diabetes (LADA) and classic type 1 diabetes (T1DM) and type 2 diabetes (T2DM), and explore risk factors for hypogonadism in those patients. Methods: Form 1 January 2016 and 9 October 2019, a total of 399 male patients with LADA(n=71), T1DM (n=72) and T2DM (n=256) respectively were recruited from the endocrinology department in Shanghai Tenth People’s Hospital for this cross-sectional study. Serum FSH, LH, testosterone, lipid profile, uric acid, HbA1c, and beta-cell function were determined in blood samples. The diagnosis of hypogonadism was based on the levels of LH, FSH, and total testosterone. Results: The mean age of male patients with LADA, T1DM and T2DM was 54.44 ± 1.54, 47.50±1.83 and 56.55±0.74 years old, respectively. The serum total testosterone concentration in the LADA group was similar to the T1DM group, but higher than those in the T2DM group. The rate of hypogonadism in the LADA group, T1DM group, T2DM group were 1.6%, 2.4% and 20.8%, respectively (p &amp;lt;0.05). Total testosterone was positively correlated with SHBG and HDL-c, and negatively correlated with uric acid, HbA1c, BMI, SBP, DBP and TG in all, LADA, T1DM and T2DM groups. Logistic regression indicate that after adjusting for age, duration of diabetes, smoking, drinking and family history of diabetes, the independent risk factors for developing hypogonadism in male with diabetes were BMI (OR=1.31, P&amp;lt;0.05), C-peptide (OR=1.88, P&amp;lt;0.05), HDL-c (OR=0.41,P&amp;lt;0.05) and SBP (OR=1.01,P&amp;lt;0.05). Conclusion: Our results indicate that in a population of admission to a large urban hospital in China, the rate of hypogonadism was lower in LADA patients and T1DM patients than T2DM patients. High levels of BMI, C-peptide, SBP and low level of HDL-c are risk factors for developing hypogonadism in male with diabetes. Disclosure M. Cai: None. J. Gao: None. C. Sheng: None. H. Li: None. S. Qu: None. M. Zhang: None. Funding National Key Research and Development Program of China (2018YFC1314100); National Natural Science Foundation of China (81970677)

Multisystemic Impairments in 93 Chinese Patients With Myotonic Dystrophy Type 1.

Background: Myotonic dystrophy type 1 (DM1) is an autosomal dominant neuromuscular disease characterized by muscle weakness and multisystemic impairments, which significantly impact the quality of life. There is currently an increasing consensus on the necessity of a multidisciplinary assessment in patients with DM1, to improve the management of the disease.Methods: To analyze the prevalence and pairwise relationships between various organs involved, we performed a retrospective study by reviewing demographic and clinical information of DM1 patients including age, disease duration, clinical history, muscular impairment rating scale score (MIRS), results of blood biochemistry, electrocardiogram, echocardiography, and ophthalmologic examination.Results: Ninety three DM1 patients (60 males and 33 females), aged 34.7 ± 12.6 (mean ± standard deviation) years were recruited. Of which, two congenital cases were of maternal and paternal inheritance, respectively. In the other 91 patients, cataract was found in 44.1% of patients, followed by hypogonadism (40.8%), frontal balding (40.7%), and cardiac abnormalities (34.5%). Thyroid dysfunction and insulin insensitivity were relatively uncommon. Age (p < 0.001) is independently correlated with cataract, and MIRS correlates positively with cardiac abnormalities (p = 0.005) and frontal balding (p = 0.015). Male patients more frequently had frontal balding (Risk ratio, 3.98; 95% confidence interval, 1.493–10.611) compared with female patients. Male patients with cataract presented more frequent cardiac abnormalities (Risk ratio, 4.40; 95% confidence interval, 1.055–18.358) compared with non-cataract male patients. Hypogonadism in male patients was characterized as decreased testosterone level, accompanied by elevated levels of luteinizing hormone and follicle-stimulating hormone.Conclusions: In Chinese patients with DM1, we conclude that (1) cataract, hypogonadism, frontal balding and cardiac abnormalities are frequently observed; (2) age is an independent indicator to cataract and MIRS is the only predictor for cardiac abnormalities and frontal balding; (3) a positive correlation between ophthalmologic and cardiac impairments in male patients is found; (4) endocrine abnormalities show diverse manifestations and hormone tests are recommended; (5) particular attention should be given to patients with older age and higher MIRS score.

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