Prevalence Of Hypogonadism In Men Research Articles

Prevalence of hypogonadism in men with and without chronic obstructive pulmonary disease: A cross-sectional study

BackgroundHypogonadism is a common finding of chronic obstructive pulmonary disease (COPD). However, the prevalence of hypogonadism in COPD varies among studies. The aim of this study was to determine and compare the prevalence of hypogonadism in men with and without COPD. MethodsWe conducted a cross-sectional study with 134 patients with stable COPD and 70 age-matched men with non-COPD. Hypogonadism was defined by the presence of symptoms according to the Androgen Deficiency in Aging Males questionnaire, along with total testosterone deficiency (<300ng/dL). ResultsPatients had a mean age of 68 years (SD, 6), a body mass index of 28kg/m2 (SD, 6), and 17% were current smokers. The prevalence of hypogonadism was 41.8% in COPD men (N=56, 95%CI, 33–51) and 10.0% in non-COPD men (N=7, 95%CI, 4–20), with a prevalence ratio of 4.2 (95%CI, 2.0–8.7, p<0.001). The prevalence of low total testosterone concentrations (<300ng/dL) were significantly higher in COPD patients vs the control group (47.0% vs 15.7%, p=<0.001). In the COPD group, 89.3% of patients had hypogonadotropic hypogonadism and 10.7%, hypergonadotropic hypogonadism. The prevalence of hypogonadism was higher in severe vs non-severe COPD patients (55.8% vs 35.2%; p=0.024). ConclusionsThe prevalence of hypogonadism was high and greater in COPD vs non-COPD men. This study suggests that COPD patients should be screened for hypogonadism.

Hypogonadism, frailty, and postoperative outcomes among men undergoing radical nephrectomy.

Hypogonadism and frailty may impact postoperative outcomes for men undergoing radical nephrectomy (RN). We aimed to determine the prevalence of hypogonadism in men undergoing RN and whether hypogonadism and frailty are associated with adverse postoperative outcomes. We identified men undergoing RN between 2012 and 2021 using the IBM Marketscan database. Frailty was determined using the Hospital Frailty Risk Score (HFRS). Patients were considered to have hypogonadism if diagnosed <5 years before RN. Length of stay (LOS), complications, emergency department (ED) visits, and readmissions were evaluated between men with and without hypogonadism at the time of surgery. Subgroup analysis of men with hypogonadism was performed to determine the effect of testosterone replacement therapy (TRT) on clinical outcomes. Among 13 598 men who underwent RN, 972 (7.1%) had hypogonadism. Men with hypogonadism were more frail compared to men without hypogonadism (HFRS: median: 8.2, interquartile range [IQR]: 5.2-11.7 vs. median: 7.0, IQR: 4.3-10.7, p < 0.001) and had increased incidence of postoperative ileus (13.0% vs. 10.8%, p = 0.045), acute kidney injury (25.5% vs. 21.6% p = 0.005), and cardiac arrest (1.2% vs. 0.6%, p = 0.034). Hypogonadism was not associated with LOS, 90-day ED visit or readmission. However, high-risk frailty was associated with increased risk of 90-day ED visit (hazard ratio [HR]: 2.1, 95% confidence interval [95% CI]: 1.9-2.4, p < 0.001) and 90-day inpatient readmission (HR: 2.6, 95% CI: 2.2-3.1, p < 0.001), compared to low-risk frailty patients. Among men with hypogonadism, TRT was not associated with any postoperative outcomes. Hypogonadism and frailty should be considered in the preoperative evaluation for men undergoing RN as risk factors for adverse postoperative outcomes.

(091) The Association Between Hypogonadism, Frailty, and Postoperative Outcomes Among Men Undergoing Radical Cystectomy

Abstract Introduction Hypogonadism is associated with frailty, lower health-related quality of life, decreased muscle mass, and premature mortality, which may predispose patients to poor postoperative outcomes. However, the prevalence and importance of hypogonadism and frailty among men undergoing radical cystectomy (RC) remains unknown. Objective We aimed to determine the prevalence of hypogonadism in men undergoing RC and whether hypogonadism and frailty are associated with adverse postoperative outcomes in this population. Methods We utilized the IBM Marketscan database, which contains information on inpatient admissions, outpatient encounters, and outpatient prescriptions from Commercial and Medicare plans. Inpatient admissions were used to identify men who underwent RC between 2012-2021. Frailty was coded using diagnosis codes available in the year prior to RC and categorized as low-, intermediate-, or high-risk using published Hospital Frailty Risk Score (HFRS) ranges. Patients were considered to have hypogonadism if they had a diagnosis in the 5 years prior to RC. Demographics and surgical outcomes including length of stay (LOS), complications, and rate of 90-day ED visits and 90-day inpatient readmissions were collected. Sub-group analysis was also performed among men with hypogonadism to determine the effect of testosterone replacement therapy (TRT) on clinical outcomes. Differences in baseline characteristics between hypogonadism and control cohorts were assessed via Kruskal Wallis and Chi-squared tests, as appropriate. Multivariable Cox proportional hazards models were used to assess the association between hypogonadism and frailty and the rate of ED visits or inpatient readmissions following RC. To focus on post-RC events, patients without an ED visit or readmission were censored at 90 days. Significance was determined using p&amp;lt;0.05. Results Among 3,729 men who underwent RC, 228 (6.1%) had a diagnosis of hypogonadism within 5 years prior to RC. Overall, 564 (15.1%) men were categorized as low-risk frailty, 2,216 (59.4%) were intermediate-risk frailty, and 949 (25.4%) were high-risk frailty. Men with hypogonadism were significantly more frail compared to men without hypogonadism (p=0.001). There was no significant difference in age, LOS, postoperative complications, ED visits, or rate of inpatient readmissions between cohorts (p&amp;gt;0.05). However, high-risk frailty was independently associated with an increased risk of ED visit (HR 1.29, 95% CI [1.09-1.52], p=0.003) and inpatient readmissions (HR 1.55, 95% CI [1.27-1.89], p&amp;lt;0.001) following RC. On sub-group analysis of men with hypogonadism, 48 (21.1%) had a prescription for TRT within 5 years prior to RC. There was no difference in demographics, frailty, LOS, complications, or 90-day ED visits or 90-day inpatient readmissions between groups. Among men with hypogonadism, high-risk frailty was also associated with increased risk of inpatient readmission (HR 1.45, 95% CI [1.03-2.04], p=0.03). Conclusions Hypogonadism was associated with worse preoperative frailty, but was not independently associated with poor postoperative outcomes among men undergoing RC. However, high-risk frailty was associated with increased odds of postoperative ED visits and inpatient readmission. While prospective data is required to validate our results, these findings suggest that both hypogonadism and preoperative frailty should be evaluated prior to undergoing RC. Disclosure No.

The association between frailty, hypogonadism, and postoperative outcomes among men undergoing radical cystectomy

IntroductionHypogonadism is associated with frailty, lower health-related quality of life, decreased muscle mass, and premature mortality, which may predispose patients to poor postoperative outcomes. We aimed to determine the prevalence of hypogonadism in men undergoing radical cystectomy (RC) and whether hypogonadism and frailty are associated with adverse postoperative outcomes. Materials and methodsThe IBM MarketScan database was used to identify men who underwent RC between 2012 and 2021. Frailty was determined using published Hospital Frailty Risk Score ranges. Patients were considered to have hypogonadism if diagnosed within 5 years prior to RC. Length of stay (LOS), complications, emergency department (ED) visits and inpatient readmissions were compared. Sub-group analysis of men with hypogonadism was performed to determine the effect of testosterone replacement therapy (TRT) on clinical outcomes. ResultsAmong 3,727 men who underwent RC, 226 (6.1%) had a diagnosis of hypogonadism. Overall, 565 (15.2%) men were low-risk frailty, 2,214 (59.4%) intermediate-risk frailty, and 948 (25.4%) were high-risk frailty, and men with hypogonadism were significantly more frail compared to men without hypogonadism (P = 0.027). There was no significant difference in LOS, complications, or rate of ED visits and inpatient readmissions between cohorts (P > 0.05). However, high-risk frailty was associated with an increased risk of 90-day ED visit (HR 1.19, 95%CI 1.00–1.41, P = 0.049) and 90-day readmission (HR 1.60, 95%CI 1.29–1.97, P < 0.001) after RC. Among men with hypogonadism, 58 (25.7%) were on TRT. There was no significant difference in frailty, LOS, complications, or 90-day ED visits or 90-day inpatient readmissions between patient with hypogonadism prescribed TRT and those without TRT. ConclusionsThese findings suggest that hypogonadism and preoperative frailty may be important to evaluate prior to undergoing RC.

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.

1427-P: Long-Term Treatment with Testosterone Leads to Profound Weight Loss in Men with Hypogonadism and Type 2 Diabetes: Update of Real-World Data from a Registry Study

Background: Prevalence of hypogonadism in men with T2DM has been reported as high as 50%. ADA Guidelines recommend measuring testosterone in men with T2DM. Methods: Of 370 men with hypogonadism and T2DM, 302 (81.6%) were obese, 62 (16.8%) overweight and 6 (1.6%) had normal weight. 190 received injections of testosterone undecanoate 1000 mg/12 weeks (T-group) following an initial 6-week interval, 180 opted against treatment (CTRL) . Means and standard deviations of absolute measures over 13 years of treatment are reported. Results: Mean baseline age: 62.0±5.2 years, mean (median) follow-up: 9.3±3.1 (10) years. Waist circumference (cm) decreased from 117.9±14.8 to 98.2±4.3 in the T-group (p&amp;lt;0.0001) and increased in CTRL from 116.9±13.5 to 119.0±8.4 (p&amp;lt;0.0001) . Difference between groups at 13 years: 21.8 (p&amp;lt;0.0001) . Weight (kg) decreased from 114.4±13.8 to 88.3±7.6 in the T-group (p&amp;lt;0.0001) and increased in CTRL from 102.7±14.1 to 104.5±10.2 (p&amp;lt;0.0001) . Difference between groups: 21.4 (p&amp;lt;0.0001) . BMI (kg/m²) decreased from 36.5±4.4 to 28.5±2.4 in the T-group (p&amp;lt;0.0001) and increased in CTRL from 32.8±4.7 to 33.3±3.6 (p&amp;lt;0.0001) . Difference between groups: 6.9 (p&amp;lt;0.0001) . Weight change from baseline was -21.5±5.2% in the T-group and 9.3±3.0% in CTRL (p&amp;lt;0.00for both) . Difference between groups: 30.4% (p&amp;lt;0.0001) . Waist:height ratio decreased from 0.67±0.to 0.56±0.03 in the T-group and increased from 0.66±0.to 0.67±0.05) in CTRL (p&amp;lt;0.00for both) . Difference between groups: 0.12 (p&amp;lt;0.0001) . Visceral adiposity index (VAI) decreased from 5.9±3.1 to 1.8±0.4 in the T-group and increased from 5.2±2.6 to 9.1±4.4 in CTRL (p&amp;lt;0.00for both) . Difference between groups: 7.6 (p&amp;lt;0.0001) . Adherence to testosterone therapy was 100%. Conclusions: Long-term treatment with testosterone undecanoate injections results in profound weight loss maintained over up to 13 years. Untreated hypogonadal patients gain weight. Disclosure A.Haider: Other Relationship; Bayer AG. K.S.Haider: Other Relationship; Bayer AG. F.Saad: Consultant; Bayer AG, Stock/Shareholder; AbbVie Inc., Bayer AG, GlaxoSmithKline plc. Funding Bayer AG

Abstract 120: Prevalence of hypogonadism in men with type 2 diabetes mellitus and its association with insulin resistance, metabolic and clinical parameters

Background: Hypogonadism is commonly found in men with type 2 diabetes mellitus (T2DM). The inverse association between testosterone and insulin resistance is also reported.Aims and Objectives: To investigate the prevalence of hypogonadism in men with T2DM and to evaluate the association between hypogonadism with insulin resistance along with metabolic and clinical parameters.Methods: This is a cross sectional study of 257 consecutive men with T2DM. Hypogonadism is defined on the symptoms as defined in the androgen deficiency in aging male questionnaire (ADAM) along with low calculated testosterone levels (calculated by vermeulen equation taking total testosterone, albumin and sex hormone binding globulin). Insulin resistance is measured by HOMA-IR, QUICKI.Results: The overall prevalence of hypogonadism in our cohort was 11.67%. 86.67% patients had hypogonadotropic hypogonadism while rest were hypergonadotropic hypogonadism. There is a significant inverse correlation of fasting Insulin (r=-0.198, p<0.001), HOMA IR (r=-0.288, p<0.001) and BMI (r=0.139, p<0.001) with testosterone levels. On linear regression analysis, HOMA IR was independently associated with testosterone levels (odds ratio= -5.185; 95% CI= -8.29 -to -2.075) even after adjusting for age, BMI, HBA1c and lipid levels. Among chronic complications, only diabetic retinopathy was significantly associated with presence of hypogonadism.Conclusion: In our recruited population, hypogonadism was found in 11.67% of individuals. Markers of insulin resistance were independently associated with hypogonadism among T2DM men.

Hypergonadotropic hypogonadism in Nigerian men with type 2 diabetes mellitus

Background. Studies have reported a higher preva-lence of hypogonadism in men with type 2 diabetes mellitus (T2DM) than non-diabetic men. The pattern of hypogonadism in men with T2DM using gonado-tropin-releasing hormone (GnRH) stimulation test in Sub-Saharan Africa is unknown. Objective. This study was conducted to determine the prevalence and pattern of hypogonadism in Nigerian men with T2DM. Methods. A cross-sectional study involving 358 men with T2DM and 179 non-diabetic men as controls. Androgen Deficiency in the Ageing Male (ADAM) questionnaire was administered. Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) both at 0 hours and 4 hours after subcutaneous buserelin injec-tion, fasting total testosterone (TT), fasting plasma glucose and glycated haemoglobin were measured. Ninety-nine men with T2DM selected by randomiza-tion using a computer underwent GnRH stimulation test, with subcutaneous injection of 100 micrograms of buserelin. Results. The mean TT of T2DM men was significantly lower compared to the controls (8.79 ± 3.35 nmol/L vs 15.41 ± 3.79 nmol/L, p < 0.001). The prevalence of hypogonadism in T2DM men was 80.4%, comprising 38.5% of severe hypogonadism and 41.9% mild hypogonadism. The mean LH and FSH levels were significantly higher in T2DM men than the controls (9.62 ± 6.82 IU/L vs 8.24 ± 5.91 IU/L, p = 0.022 and 8.50 ± 8.17 IU/L vs 5.17 ± 3.89 IU/L, p < 0.001 respectively). There was a statistically significant exaggerated response in mean (±SD) LH and FSH levels at 4 hours after buserelin in-jection compared to the 0-hour levels (58.58 ± 40.72 IU/L vs 8.38 ± 6.10 IU/L, p < 0.001 and 23.03 ± 18.02 IU/L vs 8.41 ± 7.45 IU/L, p < 0.001 respectively) in men with T2DM who had GnRH stimulation tests. Conclusion. This study shows that the prevalence of hypogonadism in men with T2DM is significantly higher than in non-diabetic men with mild hypogonadism accounting for most cases. Hypergonadotropic hypo-gonadism occurs more frequently in men with T2DM in Nigeria.

1411-P: Dysfunction of Adipose Tissue and Testosterone Deficiency in Men with Type 2 Diabetes Mellitus

The prevalence of hypogonadism in men with type 2 diabetes mellitus (T2DM) is higher than in population. Though, the function of adipose tissue in men with hypogonadism and T2DM is still unclear. Aim: To study the function of adipose tissue in men with T2DM and functional hypogonadism. Materials and Methods: We examined 272 men with T2DM (mean age 53.8±2.7 years). Randomization: 1 group - 148 men with hypogonadism, according to the European Association of Urology criteria 2015; 2 group - 124 patients, not having hypogonadism. The groups were comparable by age and treatment of diabetes. Patients underwent clinical examination, analysis of carbohydrate metabolism and markers of adipose tissue function, such as resistin, leptin, adiponectin. Statistical analysis was carried out using the Mann Whitney U-test. Results: The analysis demonstrated that hypogonadal patients had a significantly higher body mass index, waist and hip circumferences. Levels of fasting glucose and HbA1c weren’t statistically different in two groups. At the same time, patients with hypogonadism had more pronounced hyperinsulinemia (16,2 [10,5; 30,2] vs. 12,7 [8,4; 21] μU/ml, p=0,002) and insulin resistance, calculated as HOMA-IR (6,2 [3,8; 11,0] vs. 4,6 [2,8; 7,0], p&amp;lt;0,001), compared to eugonadal men. The analysis revealed an increase in leptin (10,8 [7,2; 17,5] vs. 9,2 [5,8; 14,9] ng/ml, p=0,03) and resistin levels (7,5 [2,9; 13,3] vs. 3,8 [1,8; 6,5] ng/ml, p&amp;lt;0,001) in the 1st group compared to the 2nd. Contrary, levels of adiponectin (2,8 [0,5; 5,7] vs. 4,7 [0,8; 7,9] μg/ml, p=0.006) were higher in group 2 compared to the 1st one. Thus, despite the equal fasting glucose and HbA1c levels, men with T deficiency have more pronounced adipose tissue dysfunction compared to eugonadal men having T2DM. Conclusion: T deficiency leads to adipose tissue dysfunction in men with T2DM. Disclosure I.A. Khripun: None. S.V. Vorobyev: None. E.V. Bova: None. Funding Russian Science Foundation (14-25-00052)

The prevalence of hypogonadism in men with type 2 diabetes mellitus in clinical practice

BACKGROUND: Hypogonadism is a common complication in men with type 2 diabetes mellitus (DM), but its prevalence remains unknown.&#x0D; AIMS: To estimate the prevalence of hypogonadism in men with type 2 DM.&#x0D; MATERIALS AND METHODS: Male patients with type 2 DM were enrolled into a single-cohort contemporaneous multicenter non-interventional screening study. The study period was from November 2017 through August 2018. Assessments included total testosterone, luteinizing hormone (LH), sex hormone-binding globulin, HbA1c levels. Levels of free testosterone were calculated by Vermeullen method.&#x0D; RESULTS: TheThe median of age of 400 included men was 56 years [51; 58], total testosterone was 12.3 [9.2; 16.5] nmol/l, free testosterone 270 [217; 334] pmol/l, HbA1c 7,1% [6.1; 8.6]. Hypogonadism was found in 135 men (33.7%). The total testosterone level in that group was 7.9 [6.8; 9.8] nmol/l, and free testosterone 192 [164; 227] pmol/l. In hypogonadism-free men their levels were 15,1 [12,4; 18,6] nmol/l and 311 [270; 364] pmol/l, respectively. In most patients with hypogonadism LH level was low, but within normal ranges, and significantly lower than in men without hypogonadism 3.2 [2.1; 4.7] IU/L vs 3.8 [2.7; 4.9] IU/L, respectively (p=0.007). Most commonly hypogonadism was with normal LH levels (92,6%, median LH level 3.2 [2.2; 4.3] IU/L, p0,001). The frequency of hypogonadism with high LH level (10.2 [9.2; 14.7] IU/L) and low LH level (1.0 [0.6; 1.1] IU/L) was 4.4% and 3.0%, respectively.&#x0D; CONCLUSIONS: The prevalence of hypogonadism in men with type 2 DM was found to be 33.7%. Normal levels of LH are typical for this type of patients with hypogonadism.

202-LB: Effect of Testosterone Deficiency on Lipid Metabolism and the Severity of Type 2 Diabetes Mellitus Complications in Men

Testosterone (T) deficiency is more prevalent in men with type 2 diabetes mellitus (T2DM) than in population. However, there are no data on the effect of hypogonadism on the severity of T2DM complications. Aim: To study the effect of T deficiency on the severity of T2DM complications in men. Materials and Methods: A retrospective analysis of 487 case histories of men with T2DM was performed (mean age 54.4±5.7 years). The patients were divided into 2 groups: 1-217 men with hypogonadism, according to the EAU criteria 2015; 2-270 patients, not having hypogonadism. The groups were matched by age, duration and treatment of diabetes, HbA1c and fasting glucose levels. Clinical, anamnestic data, laboratory parameters of carbohydrate and lipid metabolism were analyzed. Statistical analysis was performed using the Mann Whitney U-test and a chi-square test. Results: The prevalence of hypogonadism in men with T2DM was 44.6%. The analysis revealed an increase in systolic (140 [130; 160] vs. 136 [128; 149] mm Hg) and diastolic blood pressure (87 [80; 96] vs. 83 [80; 90] mm Hg) in the 1stgroup compared to the 2nd (p=0.01). Levels of total cholesterol (5.4 [4.6; 6.4] vs. 5.1 [4.5; 6.0] mmol/l, p=0.04), triglycerides (2.0 [1.4; 3.0] vs. 1.7 [1.2; 2.2] mmol/l) and very low density lipoproteins (1.0 [0.7, 1; 6] vs. 0.8 [0.6; 1.0] mmol/l) (p=0.001); low density lipoproteins (3.1 [2.4; 4.1] vs. 2.9 [2.4; 3.6] mmol/l) (p=0.03) were higher in group 1 compared to 2. Diabetic retinopathy (70.5% vs. 32.6%), nephropathy (92.1% vs. 58.9%) and polyneuropathy (82.9% vs. 65.6%) were more prevalent in patients of group 1 (p&amp;lt;0.01). All diabetes complications were more severe in men with hypogonadism, despite comparable duration of T2DM and parameters of carbohydrate metabolism. Conclusion: The prevalence of hypogonadism in men with T2DM was 44.6%. The presence of T deficiency in men with T2DM contributes to the progression of micro-and macro-vascular complications of diabetes, and also impairs lipid metabolism. Disclosure I.A. Khripun: None. E.V. Bova: None. S.V. Vorobyev: None. Funding Russian Science Foundation (14-25-00052)

SUN-083 Hypertension and Hemodynamic Parameters in Men with Hypogonadism Improve Under Long-Term Treatment with Testosterone Undecanoate Injections (TU) Compared to Untreated Hypogonadal Control Patients

Background: The prevalence of hypogonadism in men with hypertension is high and may be related to overweight and obesity. In an ongoing registry study in a single urology practice, we monitored blood pressure and hemodynamic parameters for up to 12 years. Material and Methods: In a registry study of men with hypogonadism in a urological office, 676 of 805 patients (84%) had hypertension defined as systolic blood pressure (SBP) ≥130 and/ or diastolic blood pressure (DBP) ≥85 mmHg according to the harmonized definition of the metabolic syndrome. 376 received testosterone therapy (TTh) with TU 1000 mg/12 weeks following an initial 6-week interval (T-group). 304 had opted against TTh and served as controls (CTRL). 10-year data are reported. Changes over time between groups were compared by mixed effects model for repeated measures with random effect for intercept and fixed effects for time, group and their interaction, and adjusted for age, weight, waist circumference, fasting glucose, blood pressure and lipids to account for baseline differences between groups. Results: Mean (median) follow-up: T-group 7.7±2.6 (9), CTRL 8.1±2.1 (9) years. Total observation time: T-group 2900, CTRL 2463 years. Baseline age was 58.5±6.8 (T-group) and 63.8±4.8 years (CTRL). In the T-group, 189 men were and 187 were not aware of their hypertension at their first visit to the urologist, in CTRL, 139 and 161, respectively. Antihypertensives were used by 52.7% in T-group and 46.7% in CTRL. All patients were encouraged to improve their lifestyle at baseline. SBP decreased in the T-group by 23.6±0.7mmHg [95% CI: -24.9;-22.3] (p<0.0001) and increased in CTRL by 7.7±0.8mmHg [95% CI: 6.0;9.3] (p<0.0001), estimated adjusted difference between groups: -31.3mmHg [95% CI: -33.7;-28.9] (p<0.0001). DBP decreased in the T-group by 12.8±0.7 mmHg [95% CI: -14.1;-11.4] (p<0.0001) and increased in CTRL by 4.4±0.9 mmHg [95% CI: 2.6;6.1] (p<0.0001), difference between groups: -17.1 mmHg [95% CI: -19.5;-14.7] (p<0.0001). Heart rate decreased in the T-group by 1.6±0.3 bpm [95% CI: -2.3;-1.0] (p<0.0001) and increased in CTRL by 1.2±0 bpm [95% CI: 0.4;2.1] (p<0.005), difference between groups: -2.9 mmHg [95% CI: -4.0;-1.7] (p<0.0001). (p<0.0001). Pulse pressure, a surrogate marker of arterial stiffness, decreased in the T-group by 10.3±0.7 mmHg [95% CI: -11.7;-9.0] (p<0.0001) and increased in CTRL by 2.4±0.9 mmHg [95% CI: 0.7;4.0] (p<0.01), difference between groups: -12.7 mmHg [95% CI: -15.0;-10.4] (p<0.0001). Adverse events: T-group: 15 deaths (4%), no myocardial infarctions (MIs) or strokes. CTRL: 65 deaths (21.7%), 59 MIs (19.7%), 52 strokes (17.3%). Conclusion: Long-term testosterone therapy in hypogonadal men improved blood pressure, heart rate and arterial stiffness. In the untreated control group, all these parameters increased. Considerably less major adverse cardiovascular events occurred in the T-group.

PD24-12 URINARY AND ERECTILE FUNCTION IMPROVEMENTS IN HYPOGONADAL MEN WITH TYPE 2 DIABETES (T2DM) TREATED UP TO 10 YEARS WITH TESTOSTERONE IN COMPARISON TO AN UNTREATED CONTROL GROUP

INTRODUCTION AND OBJECTIVES:The high prevalence of hypogonadism in men with T2DM has caused the American Diabetes Association to recommend measuring testosterone in these patients in their 2018 gui...

Hypogonadism and its treatment following ischaemic stroke in men with type 2 diabetes mellitus

Premature mortality in Russia is a major socio-economic problem, especially from acute cerebrovascular diseases which constitute 21.4% of the total mortality and is a considerable contributor to chronic disability. Risk of vascular catastrophe is higher in males than females, thought, in part, due to anti-atherosclerotic effects of oestrogens in females whilst an associated age-related deficiency of testosterone is observed in men. Clinical symptoms such as high blood pressure, changes in lipid profile, insulin resistance, obesity, and blood coagulation factors often accompany declining testosterone in males and reduced total testosterone is considered a cardiovascular risk factor. In the present study, the prevalence of hypogonadism in men who had suffered ischaemic stroke was evaluated along with the efficacy of testosterone undecanoate injections (TU) in patients with testosterone deficiency and type-2 diabetes (T2DM) in the acute phase of hemispheric ischaemic stroke. Hypogonadism was present in 66.3% of patients with ischaemic stroke, 50% with T2DM, and 26.3% without T2DM, respectively. TU treatment, at both the 2 and 5-year observation points, demonstrated significant improvements in biochemical, physical, and mental parameters. This supports that testosterone deficiency is a contributing factor in ischaemic events and that long-term testosterone therapy could play an important role in patient recovery.

Statin Therapy and Serum Testosterone in Men with Type 2 Diabetes

There is a high prevalence of hypogonadism in men with type 2 diabetes. Statins could potentially decrease testosterone levels by reducing the availability of cholesterol for androgen synthesis. In this study we compared testosterone levels and hypogonadal symptoms with statin use in men with type 2 diabetes.

Statin Therapy and Serum Testosterone in Men with Type 2 Diabetes

There is a high prevalence of hypogonadism in men with type 2 diabetes. Statins could potentially decrease testosterone levels by reducing the availability of cholesterol for androgen synthesis. In this study we compared testosterone levels and hypogonadal symptoms with statin use in men with type 2 diabetes. PATIENTS AND METHODS Total testosterone, sex hormone–binding globulin (SHBG), and estradiol were measured by an enzyme-linked immunosorbent assay. Bioavailable testosterone was measured by the modified ammonium sulfate precipitation method. Free testosterone was calculated using Vermeulen's formula. Symptoms of hypogonadism were assessed using the Androgen Deficiency in the Aging Male questionnaire. RESULTS Statins were associated with lower total testosterone and a trend toward lower SHBG compared with untreated patients. Bioavailable testosterone, free testosterone, estradiol, and hypogonadal symptoms were not affected. Atorvastatin was associated with reduced total testosterone and a trend toward reduced SHBG compared with no treatment, and there was a dose-response effect with the lowest levels of total testosterone seen in men treated with ≥20 mg atorvastatin .Simvastatin use was not associated with significant reductions in testosterone or SHBG levels. CONCLUSION Assessing androgen status using total testosterone in men with type 2 diabetes treated with statins, particularly atorvastatin, may potentially lead to diagnostic error. Levels of bioavailable testosterone or free testosterone are recommended for the assessment of hypogonadism in this group if total testosterone levels are borderline.

A study to evaluate the prevalence of hypogonadism in Indian males with Type-2 diabetes mellitus.

Background:A high prevalence of hypogonadism in men with Type-2 diabetes mellitus (T2DM) has been reported worldwide.Objectives:To evaluate the prevalence of hypogonadism in Indian males with T2DM and assess the primary and secondary hypogonadism along with androgen deficiency.Materials and Methods:In this cross-sectional study, 900 men with T2DM were evaluated using androgen deficiency in aging male questionnaire. They were screened for demographic characteristics, gonadal hormone levels, lipid profile, and glycosylated hemoglobin.Results:The prevalence of hypogonadism in T2DM patients was found to be 20.7% (186 out of 900). Hypogonadism was of testicular origin (primary) in 48/186 (25.8%) patients, of pituitary or hypothalamic origin (secondary) in 14/186 (7.53%), and remaining 124/186 (66.67%) patients were found to have low testosterone with the inappropriate normal level of luteinizing hormone and Follicle-stimulating hormone. 451/900 (50.1%) patients were only symptomatic but had normal testosterone levels. Further 263 patients out 900 were asymptomatic, of which 51/900 (5.7%) patients had low levels of testosterone and 212/900 (23.5%) patients had normal testosterone level without symptoms. There were no deaths or other serious adverse events except mild pyrexia which was not related to the study.Conclusion:Hypogonadism diagnosis, at times, might not be validated with the help of androgen deficiency questionnaire or symptoms only. Given the large number of patients of T2DM in India, the incidence of hypogonadism is more in diabetic patients as compared to the general population. Hence, implementation of screening programs in diabetic patients is necessary to understand and detect individuals with low serum total testosterone at any early stage and to supplement testosterone accordingly.

Функциональное состояние половых желез у больных циррозом печени

This article presents the results of a study of the functional state of the gonads of patients with liver cirrhosis. Results of the study showed a high prevalence of hypogonadism in men and giperestrogenemii, cirrhotic patients, compared with those of the control group. Also noted the influence of etiological factors and the severity of the disease on the metabolism of sex hormones in the patients studied.

824 Prevalence of biochemical hypogonadism in men with non-obstructive azoospermia (NOA) before and after testicular sperm extraction (m-TESE)

824 Prevalence of biochemical hypogonadism in men with non-obstructive azoospermia (NOA) before and after testicular sperm extraction (m-TESE)

Clinicopathologic assessment of hypogonadism in men with type 2 diabetes mellitus.

Objective:To determine the prevalence of hypogonadism in men with type 2 diabetes mellitus and evaluate its clinical and pathologic correlates.Subjects and Methods:In a cross-sectional survey of 200 type 2 diabetic males aged 32–69 years, total testosterone (TT), follicle stimulating hormone, luteinizing hormone, waist circumference (WC), glycated hemoglobin, and lipids were measured. Clinical assessment of androgen deficiency was done using the androgen deficiency in aging male (ADAM) questionnaire. Overt hypogonadism was defined as a combination of positive ADAM score and TT < 8 nmol/L while possible hypogonadism was defined as positive ADAM score with TT 8–12 nmol/L.Results:Overt and possible hypogonadism occurred in 29.5% and 23% of the participants, respectively. Majority (76.3%) of the subjects who had overt hypogonadism had the hypogonadotrophic pattern. Hypogonadal subjects were significantly older (P = 0.014) and had higher mean WC (P = 0.009) than eugonadal ones. Erectile dysfunction was the most common symptom, occurring in 79.7% of overtly hypogonadal subjects. There was a significant negative correlation between WC and serum TT (r = −0.41, P = 0.001).Conclusion:There is a high frequency of symptomatic hypogonadism in men with type 2 diabetes and the frequency increases with advancing age and visceral adiposity.