Prevalence Of Hypogonadism Research Articles

The clinical characteristics, biochemical parameters and insulin response to oral glucose tolerance test (OGTT) in 25 transfusion dependent β-thalassemia (TDT) patients recently diagnosed with diabetes mellitus (DM).

Background:Patients with transfusion dependent β-thalassemia (TDT) are at high risk for developing, over the time, a form of diabetes distinct from type 1 and type 2 diabetes, but with similarities to both.Aims of study:The aim of this study is to describe the clinical and laboratory data, and the insulin secretion and sensitivity, in TDT patients recently diagnosed with diabetes mellitus (DM).Materials and Methods:The medical records of 25 TDT patients with DM, diagnosed by standardized oral glucose tolerance test (OGTT) and insulin secretion, were analysed; data were compared to TDT patients without diabetes and to a group of healthy subjects. Natural history of glucometabolic status before the diagnosis of DM was also reviewed.Results:On average, the TDT patients with DM were younger compared to TDT patients without diabetes. The mean age at diagnosis of DM in female and male TDT patients was 24.0 ± 7.1 years and 31.9 ± 5.6 years, respectively (P: 0.007). Serum alanine aminotransferase values, basal insulin levels and prevalence of hypogonadism were consistently higher in TDT patients with DM compared to those without diabetes. Decreased insulin secretion and increased insulin resistance was observed in patients with DM.Conclusion:The natural history of glucometabolic status in TDT patients is characterized by a deterioration of glucose tolerance over time. Iron overload and liver dysfuction are the main factors responsible for glucose disturbances (GD) in TDT patients. The therapeutic approach must be individualized and followed by a multidisciplinary team. (www.actabiomedica.it)

Updated protocols for optimizing sperm recovery after steroid use

The prevalence of hypogonadism is an increasing problem that affects increasingly more men of reproductive age. With the mainstay of hypogonadal treatment involving testosterone therapy (TTh), the fertility potential of many of these men must be investigated and considered accordingly

CF and male health: Sexual and reproductive health, hypogonadism, and fertility

Over 30,000 people in the United States are diagnosed with cystic fibrosis (CF), and over 50% of those with CF are male. Men with CF face specific and sometimes difficult sexual and reproductive health (SRH) issues, including infertility and hypogonadism. Male infertility affects over 95% of men with CF, with obstructive azoospermia resulting from congenital bilateral absence of the vas deferens being the primary cause of infertility. SRH education for males with CF represents an important opportunity for clinical improvement, as the majority of men with CF know that their disease impacts their fertility, however the depth of this understanding varies significantly. Hypogonadism is a clinical syndrome that affects men with low testosterone level, a common finding among men with CF that has clinical implications and can significantly affect quality of life. Better understanding of SRH attitudes, the prevalence of hypogonadism, and management of infertility in men with CF should remain future research priorities.

Prevalence and determinants of low testosterone levels in men with type 2 diabetes mellitus; a case-control study in a district hospital in Ghana.

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.

The Prevalence of Hypogonadism and the Effectiveness of Androgen Administration on Body Composition in HIV-Infected Men: A Meta-Analysis.

Background: Hypogonadism is a common comorbidity in human immunodeficiency virus (HIV)-infected men, although the real prevalence is difficult to be estimated. Moreover, in HIV settings, the efficacy of exogenous testosterone (Te) administration at improving body composition remains unclear. Aim of the study: This review has a double aim. First, to estimate the prevalence of pituitary–testis axis abnormality in HIV-infected patients compared to uninfected subjects. Second, to evaluate the effect of androgen administration on body composition in HIV-infected men. Materials and Methods: A systematic review of the literature and meta-analysis was carried out. Two separated literature searches were performed, the first to evaluate the prevalence of Te deficiency in HIV-infected men and the second one to evaluate effects of androgen administration on body composition. Results: The overall prevalence of Te deficiency in HIV-infected men was calculated from 41 studies, showing a 26% prevalence, which was even higher when free T (fT) levels, more than total T, were considered. Indeed, TT serum levels were similar between HIV patients and controls, although higher SHBG and lower fT were detected in HIV populations. When HIV-infected men were treated with exogenous Te, a significant increase in body weight, lean body mass and fat free mass was detected. Conclusion: The systematic review confirms the high prevalence of Te deficiency in HIV-infected men, particularly when fT has been considered. Moreover, chronic androgen supplementation improves body composition, affecting the lean mass compartment. However, considering the general frailty of HIV patients, a tailored indication for Te therapy should be advocated.

The relationship of serum testosterone levels with the clinical course and prognosis of COVID-19 disease in male patients: A prospective study.

BackgroundA potential role of testosterone among sex hormones has been hypothesized in identifying sex‐related differences in the clinical consequences of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) infection. Due to the high global prevalence of hypogonadism, the relationship between hypogonadism and SARS‐CoV‐2 infection outcomes deserves an in‐depth study.ObjectiveThe present study aimed to investigate the relationship of serum testosterone with other laboratory parameters on the prognosis of coronavirus disease‐19 (COVID‐19) in male patients with COVID‐19 diagnosis.Materials and methodsThis prospective cohort study included 358 male patients diagnosed with COVID‐19 and 92 COVID‐19 negative patients admitted to the urology outpatient clinics as a control group. The COVID‐19 patients were divided into groups according to prognosis (mild‐moderate and severe group), lung involvement in chest computed tomography (<50% and >50%), intensive care unit needs, and survival.ResultsThe measured serum total testosterone level of the COVID‐19 patients group was found to be significantly lower than that of the control group (median, 140 ng/dl; range, 0.21–328, 322 ng/dl; range, median, 125–674, p < 0.001, respectively). The serum TT levels were statistically significantly lower in severe COVID‐19 patients compared to mild‐moderate COVID‐19 patients (median, 85.1 ng/dl; range, 0.21–532, median, 315 ng/dl; range, 0.88–486, p < 0.001, respectively), in COVID‐19 patients in need of intensive care compared to COVID‐19 patients who did not need intensive care (median, 64.0 ng/dl; range, 0.21–337, median, 286 ng/dl; range, 0.88–532 p < 0.001, respectively), and in COVID‐19 patients who died compared to survivors (median, 82.9 ng/dl; range, 2.63–165, median, 166 ng/dl; range, 0.21–532, p < 0.001, respectively).Discussion and conclusionOur data are compatible with low TT levels playing a role on the pathogenesis of the disease in Covid‐19 patients with poor prognosis and a mortal course and may guide clinicians in determining the clinical course of the disease.

383-P: Comparative Study of Serum Testosterone Levels in Male T2DM and Nondiabetic Subjects as a Risk Marker for Atherosclerotic Coronary Artery Disease

Background: Historically, higher levels of serum testosterone were presumed deleterious to the cardiovascular system. cardiovascular disease (CVD) risk factors prevalence were increased due to low testosterone levels. Material and Methods: This was a prospective observational study, conducted among men with type 2 diabetes with documented CAD (n = 60) and controls healthy men (n = 50). Pearson correlation between sex hormones and CAD risk factors was done. The association between sex hormones and CAD risk factors among patients was analyzed by multiple logistic regression. The statistical significance was set at the 0.05 level. Result: Mean age of diabetics was 44.5 ±7.9 years and non diabetics was 42.54 ± 5.63 years. 56% of Diabetics and 20 % non diabetics had lower levels of total testosterone. 68% of Diabetics and 26 % non diabetics had lower levels of free testosterone. Mean SHBG levels in Diabetics and non - diabetics was 8.6 ± 1.8 and 16 ± 3.2. Prevalence of Hypogonadism was 22% in Diabetics and 10% in Non diabetics. Among the cases, a significant positive correlation was found between total testosterone/FTI and waist circumference, W/H ratio, triglyceride levels, hs-CRP, and CIMT (P &amp;lt; 0.01). In addition, a significant negative correlation was found between total testosterone and FTI with high-density lipoprotein-cholesterol levels (P &amp;lt; 0.01). The multiple logistic regression analysis showed that total testosterone levels (P &amp;lt; 0.01) and SHBG (P &amp;lt; 0.01) are independently associated with the occurrence of atherosclerotic CAD in T2DM men. Conclusion: We conclude that increased serum testosterone levels and low SHBG in T2DM men are associated with the development of atherosclerotic cardiovascular risk factors. Disclosure A. K. Das: None. A. Bhagat: None. N. Sinha: None.

238-OR: Treatment with Testosterone Undecanoate Injections (TU) Up to 12 Years Improves Glycemic Control in Patients with Hypogonadism and Type 2 Diabetes (T2DM): Update of Real-World Data with 3,149 Patient-Years

Background: Prevalence of hypogonadism has been reported as high as 50% in men with T2DM. ADA Guidelines recommend assessment of hypogonadism in men with T2DM. Methods: In a registry of 865 men with hypogonadism, 361 men (41.7%) had T2DM. 183 received TU 1000 mg/12 weeks (T-group), 178 opted against treatment (CTRL). Changes over time between groups were compared and adjusted for age, weight, waist circumference, fasting glucose, blood pressure, lipids and quality of life to account for baseline differences between the two groups. Results: Mean follow-up 8.7±3.1, baseline age: 60.7±5.5 (T-group) and 63.0±4.9 (CTRL) years. T-group: HbA1c progressively decreased by 3.7±0.2% at 12 years (unadjusted from 9.4±1.4% to 5.6±0.2%). CTRL: HbA1c increased by 3.2±0.2% (from 7.8±0.7% to 10.4±1.2%) (p&amp;lt;0.0001 for both). Fasting glucose (mmol/L) decreased in T-group by 1.9±0.1 (from 7.8±1.3 to 5.4±0.1) and increased in CTRL by 1.8±0.1 (from 6.3±0.7 to 8.0±1.2) (p&amp;lt;0.0001 for both). In the T-group, 89 men (48.6%) received insulin at baseline at a mean dose of 38.0±13.3 U/d. Dose requirement declined by 32.7±1.3 U/d (from 38.0±13.3 to 8.8±9.2) during the observation period. In CTRL, 69 men (38.8%) received insulin at baseline at a mean dose of 31.3±6.2 U/d. Dose requirement increased by 20.0±1.4 U/d (from 31.3±6.2 to 43.8±7.8) (p&amp;lt;0.0001 for both). HOMA-IR decreased by 8.0±0.3 (from 10.1±2.1 to 1.7±0.4) in the T-group and increased by 6.5±0.4 (from 7.3±1.3 to 14.3±2.3) in CTRL (p&amp;lt;0.0001 for both). In CTRL, 22 patients were started on insulin during the observation period. 37 patients had incident T2DM during the observation time. Conclusions: Long-term testosterone therapy with TU in men with hypogonadism and T2DM progressively improved glycemic control which deteriorated in untreated men. Disclosure F. Saad: Consultant; Self; Bayer AG, Stock/Shareholder; Self; AbbVie Inc., Bayer AG, Novo Nordisk. K. S. Haider: Other Relationship; Self; Bayer AG. A. Haider: Other Relationship; Self; Bayer AG. Funding Bayer AG

1220-P: Treatment with Testosterone Undecanoate Injections (TU) Results in Sustained Weight Loss in Men with Hypogonadism and Type 2 Diabetes: Update of Real-World Data from a Urological Practice

Background: The prevalence of hypogonadism is particularly high in men with obesity and T2DM. Methods: Of 361 men with hypogonadism and T2DM, 293 (81.2%) were obese, 61 (16.9%) overweight and 7 (1.9%) had normal weight. 183 received TU 1000 mg/12 weeks (T-group) following an initial 6-week interval, 178 opted against treatment (CTRL). Changes over time between groups were compared and adjusted for age, weight, waist circumference, fasting glucose, blood pressure, lipids and quality of life to account for baseline differences between groups. Results: Mean baseline age: 61.8±5.3 years, mean (median) follow-up: 8.7±3.1 (10) years. T-group: weight decreased by 22.5±0.5 kg (unadjusted numbers in brackets) (from 114.1±14.0 to 89.5±7.9) at 12 years. CTRL: weight increased by 8.5±0.5 (from 102.8±14.0 to 103.9±10.1) (p&amp;lt;0.0001 for both). T-group: waist circumference decreased by 13.6±0.4 cm (from 117.1±14.4 to 98.9±4.9). CTRL: WC increased by 8.5±0.4 cm (from 116.9±14.0 to 118.2±8.5) (p&amp;lt;0.0001 for both). T-group: BMI decreased by 7.4±0.2 kg/m² (from 36.5±4.5 to 28.9±2.6). CTRL: BMI increased by 2.8±0.2 kg/m² (from 33.4±5.3 to 33.2±3.6) (p&amp;lt;0.0001 for both). There was a weight loss of 19.7±0.4% in the T-group and weight gain of 9.1±0.4% in CTRL (p&amp;lt;0.0001 for both). Waist:height ratio decreased by 0.08±0.00 (from 0.66±0.08 to 0.56±0.03) in the T-group and increased by 0.05±0.00 (from 0.66±0.08 to 0.67±0.05) in CTRL (p&amp;lt;0.0001 for both). Visceral adiposity index (VAI) decreased by 3.1±0.2 (from 5.8±3.1 to 1.9±0.5) in the T-group and increased by 3.7±0.2 (from 5.1±2.5 to 8.1±3.7) in CTRL (p&amp;lt;0.0001 for both). Since injections were administered in the office and documented, there was a 100% adherence to testosterone therapy. Conclusions: Treatment with testosterone undecanoate injections results in profound weight loss that is maintained long-term with continued testosterone therapy. Disclosure A. Haider: Other Relationship; Self; Bayer AG. K. S. Haider: Other Relationship; Self; Bayer AG. F. Saad: Consultant; Self; Bayer AG, Stock/Shareholder; Self; AbbVie Inc., Bayer AG, Novo Nordisk. Funding Bayer AG

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.

Compensated hypogonadism in men with sickle cell disease.

To evaluate the prevalence of hypogonadism in a population of men with SCD and characterize its aetiology. Sickle cell disease (SCD) is associated with the development of hypogonadism, but there is still controversy regarding its aetiology and clinical implications. We performed a cross-sectional study of 34 men with SCD aged > 18 years. Sociodemographic and clinical data, including anthropometric measurements (weight, height and BMI), were obtained. Early morning, blood samples were collected and total testosterone (TT), free testosterone (FT), luteinizing hormone (LH), follicle stimulating hormone (FSH), a complete blood count and haemoglobin electrophoresis were measured. Eugonadism was defined as T≥300ng/dL and LH≤9.4mUI/mL; primary hypogonadism as T< 300 ng/dL and LH>9.4mUI/mL; secondary hypogonadism as T<300ng/dL and LH≤9.4mUI/mL; and compensated hypogonadism as T≥300ng/dL and LH>9.4mUI/mL. Median age was 33 (26-41) years, and SS genotype was the most frequent (73.5%). The prevalence of eugonadism, compensated hypogonadism and secondary hypogonadism was 67.5%, 26.4% and 5.88%, respectively. No men with primary hypogonadism were identified in our sample. Those with compensated hypogonadism had also higher FSH levels (>7.8mUI/mL, P<.0001). In our study population of men with SCD, a high prevalence of compensated hypogonadism was identified, which is a controversial and distinct clinical entity that warrants monitoring and further research.

Decreased serum testosterone level was not significantly correlated with lipid indices in elderly men.

Background:Aging in men causes a gradual decline in endogenous testosterone levels, which may have detrimental effects on their health status. Testosterone deficiency is thought to promote atherosclerosis by modulating lipid metabolism. Therefore, this study was conducted to evaluate the serum testosterone level and its correlation with lipid profile in men aged ≥60 years old.Methods: All elderly men aged ≥60, residing in Amirkola and participating in a phase of the comprehensive project on "investigating the health status of the elderly in Amirkola" were entered into this descriptive cross-sectional study. After fasting over 12 hours, the venous blood samples were taken. Serum concentration of testosterone was determined using ELISA method. Moreover, HDL-LDL, total cholesterol, triglyceride and fasting blood glucose were measured.Results:The prevalence of hypogonadism was 91.28% among the 792 participants of this study with a cut-off point of 9.72 nmol/L (95% confidence interval, 93.25-89.31) and the prevalence of severe hypogonadism with a cut-off point of 5.2 nmol/L was reported 71.59% (95% confidence interval, 74.73-68.44%). Based on the results, there was no significant statistical correlation between the serum level of testosterone and triglyceride (r=0.03, P=0.34). Furthermore, there was a negative correlation between testosterone and HDL, which was not statistically significant(r=-0.05, P=0.13). No significant statistical correlation was found between testosterone and LDL (P=0.98). There was a negative correlation between testosterone and cholesterol, which was not statistically significant (r=-0.02, P=0.49).Conclusion:According to the study results, 91% of men aged ≥60 years old had hypogonadism, no correlation was found between testosterone and lipid indices.

Impact of primary medical or surgical therapy on prolactinoma patients’ BMI and metabolic profile over the long-term

ObjectivesHigh prolactin levels have been associated with weight gain and impaired metabolic profiles. While treatment with dopamine agonists (DAs) has been shown to improve these parameters, there is a lack of surgical series on its comparative effect in prolactinoma patients. MethodsIn this retrospective, comparative study, consecutive patients with a prolactinoma were enrolled if treated with first-line transsphenoidal surgery (TSS) or with DAs. Patients with prolactinomas of Knosp grade >2 and those with a follow-up <24 months were excluded, as were patients with missing laboratory metabolic parameters at baseline and over the long-term. Effects of either treatment on BMI and the metabolic profile were analyzed, and independent risk factors for long-term obesity were calculated. ResultsPrimary treatment was TSS for 12 patients (40%) and DAs for 18 patients (60%). At diagnosis, no significant differences between the two cohorts were observed with regard to adenoma size, Knosp grading, baseline prolactin (PRL) levels, prevalence of hypogonadism, or laboratory metabolic parameters. Mean follow-up was 51.9 months (range, 24–158). Over the long-term, both TSS and DAs led to the control of hyperprolactinemia (92% vs. 72%) and hypogonadism (78% vs. 83%) in the majority of patients. While a significant decrease in patients’ BMI and fasting glucose were observed, changes in the lipid profile were marginal and independent of the treatment modality. At baseline, increased BMI—but not the primary treatment strategy—was an independent predictor of long-term obesity. ConclusionsOver the long-term, patients’ BMI and FG improve, but changes in the metabolic profile are marginal and independent of the primary treatment. It is presumable that not DAs per se, but rather the control of hyperprolactinemia plays a role in patients’ metabolic profile alterations.

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.

Design and Conduct of a Real-World Single-Center Registry Study on Testosterone Therapy of Men with Hypogonadism

Aims: Despite the prevalence of hypogonadism (testosterone deficiency [TD]) and widespread use of testosterone therapy (TTh), the effectiveness and safety of long-term testosterone use remains highly contested. Over the past 15 years, we have conducted a registry study of men with TD with a focus on several health outcomes associated with TTh. Design: Observational patient disease registry study. Materials and Methods: Noninterventional disease registry with prospective longitudinal data on a large sample of adult hypogonadal men (n = 858) who were treated in a single Urology Clinic. The registry evaluates men with symptomatic TD during a urological exam of patients who have not been previously treated with TTh. There were no inclusion/exclusion criteria. All hormone assays are carried out in a single laboratory. Standard-of-care treatment of each patient is the sole responsibility of the attending clinician. The registry data consist of comprehensive medical records and questionnaire data collected during patient visits. The registry has a dedicated statistician to ensure adequate statistical analyses of all outcome measures assessed. Main Outcome Measures: We measured the following parameters: height, weight, waist circumference, hemoglobin, hematocrit, fasting glucose, glycated hemoglobin, insulin, systolic and diastolic blood pressure, heart rate, lipids (total cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides), highly sensitive C-reactive protein, and total testosterone (T). We assessed quality of life, erectile and urinary function. Clinical parameters were measured two to four times a year. Data are analyzed in regular intervals. Results: As of 2019, 858 men have been enrolled, of whom 85 patients exhibited primary hypogonadism, and the remaining 773 exhibited secondary or functional hypogonadism. Findings from this registry study on the benefit of TTh on anthropometric parameters, cardiometabolic function, diabetes, and prostate health have been reported. Conclusions: This registry study has provided real-world clinical evidence and produced new important findings regarding the effectiveness and safety of long-term TTh in hypogonadal men.

Impact of Allogeneic Stem Cell Transplantation on Testicular and Sexual Function

High-dose chemotherapy and radiotherapy, administered as a conditioning regimen before stem cell transplantation, are known to negatively impact testicular function and sexuality. However, to date, only a few studies have simultaneously analyzed the real prevalence of these complications in this clinical setting. Therefore, this study aimed to assess the prevalence of testicular dysfunction and sexual impairment in a cohort of males who underwent allogeneic stem cell transplantation in adulthood. This observational, cross-sectional, single-center study consecutively enrolled 105 subjects on outpatient follow-up. Testicular function and sexuality were evaluated through a hormonal profile (testosterone, follicle-stimulating hormone, luteinizing hormone, and inhibin B) and the IIEF-15 questionnaire, respectively. We found a higher prevalence of hypogonadism (21%), impaired spermatogenesis (87%), and erectile dysfunction (72%) compared with the general population. Chronic graft-versus-host disease, especially of moderate/severe grade, was associated with an increased risk of developing erectile dysfunction (odds ratio, 6.338). Moreover, a high proportion of patients presented with alterations in all domains of sexual function, even after complete clinical remission of hematologic disease. Our data confirm both testicular function and sexuality alterations as frequent complications after allogeneic stem cell transplantation. A multidisciplinary approach is advisable for early diagnosis and adequate treatment.

Advanced Chronic Kidney Disease is a Strong Predictor of Hypogonadism and is Associated with Decreased Lean Tissue Mass.

PurposeIn patients with chronic kidney disease (CKD), hypogonadism is more frequent than in the general population and its prevalence ranges between 40% and 60%. The aim of the study was to investigate the prevalence of hypogonadism and its association with kidney function, body composition, inflammatory markers and lipid disorders in patients with CKD.Materials and MethodsThe study population consisted of 112 men aged ≥40 years in different stages of CKD: 33 participants with eGFR ≥60 mL/min/1.73 m2, 27 men with eGFR 30–59 mL/min/1.73 m2, 17 predialysis patients with eGFR <30 mL/min/1.73 m2, and 35 men on hemodialysis therapy three times a week for more than 3 months (G5D stage). Total testosterone (TT) levels were measured and free testosterone (FT) levels were calculated. Body composition was assessed using bioimpedance spectroscopy (Body Composition Monitor, FMC). Statistical analysis was performed using Statistica version 13.1.ResultsCKD stage was a strong predictor of hypogonadism (providing an information value of 0.83). The weight of evidence technique allowed us to differentiate the high-risk group, which was a group of patients with advanced CKD, defined as eGFR <30 mL/min/1.73 m2. In this group, the likelihood of hypogonadism was 69.23%. Another significant predictor of hypogonadism was lean tissue index (LTI). TT and FT levels were significantly lower in the advanced CKD group in comparison to the control group, whereas prolactin, luteinizing hormone and C-reactive protein levels were significantly higher in the advanced CKD group. The LTI was significantly lower in advanced CKD and was positively correlated with TT and FT.ConclusionDecreased eGFR and decreased LTI are predictors of hypogonadism associated with CKD. The study results suggest that hypogonadism screening should be carried out when eGFR deceases below 30 mL/min/1.73 m2.

TREATING HYPERPROLACTINEMIA DOESN’T IMPROVE SEXUAL FUNCTION IN END STAGE RENAL DISEASE PATIENTS

Chronic kidney disease is associated with gonadal dysfunction. Patient usually present with deceased libido, erectile dysfunction & defective ejaculation. Significant derangements of the hypothalamic pituitary axes is commonly identified in uremic patients with reduced total & free serum testosterone levels and increased LH & FSH levels. Elevated levels of prolactin is usually seen in ESRD & is thought to contribute to the high prevalence of hypogonadism & sexual dysfunction. This study aims to evaluate the effect of treatment of hyperprolactinemia on sexual function in ESRD patients.

Prevalence of and Risk Factors for Low Free Testosterone Levels in Japanese Men with Well-controlled Human Immunodeficiency Virus Infection.

The change in the prevalence of hypogonadism with age in men with human immunodeficiency virus (HIV) infection is subject to debate. To address this issue, we diagnosed hypogonadism based on serum levels of free testosterone (fTST) rather than total testosterone which is thought to be an inaccurate indicator. We also determined the relationship between age and fTST levels and identified risk factors for hypogonadism in men with HIV infection. We retrospectively reviewed fTST levels and associated clinical factors in 71 wellcontrolled HIV-infected men who were treated at Teikyo University Hospital between April 2015 and March 2016 and who had data available on serum fTST levels, measured >6 months after starting antiretroviral therapy. fTST was measured using radioimmunoassay on blood samples collected in the morning. Risk factors for hypogonadism were identified using Welch's t-test and multiple regression analysis. The men had a mean (± standard deviation) age of 47.4 ± 13.6 years, and mean (± standard deviation) serum fTST level of 13.0 ± 6.1 pg/mL. Fifteen (21.1%) men had hypogonadism based on a fTST <8.5 pg/mL. Serum fTST levels significantly decreased with age (-0.216 pg/mL/year). Older age and low hemoglobin levels were identified as risk factors for hypogonadism. The men in the study experienced a more rapid decline in fTST levels with age than men in the general population (-0.161 pg/mL/year). Serum fTST levels in men with HIV infection should be monitored, especially in older men and those with low hemoglobin levels.

Prevalence of hypogonadism in patients with type 2 diabetes mellitus among the Indian population

ObjectivesTo determine the prevalence of hypogonadism among Indian men with and without type 2 diabetes mellitus (T2DM) and evaluate its association with various metabolic parameters. MethodsOne hundred fifty consecutive men with T2DM, aged 25–70 years, and one hundred age-matched healthy men without diabetes were included. The free testosterone (FT) level was calculated using the total testosterone (TT), sex hormone-binding globulin (SHBG), and albumin levels in serum. Patients with a calculated FT level <6.35 ng/dL and a positive response on the androgen deficiency in aging male questionnaire (ADAM) were diagnosed with hypogonadism. ResultsThe prevalence of hypogonadism was 17.3% and 10% in men with and without T2DM, respectively. The body mass index (BMI) and the mean levels of follicle-stimulating hormone (FSH), TT, SHBG, Triglycerides (TG), and FT were significantly different between the groups. The mean BMI and TG levels were significantly higher in patients with T2DM than in those without. Both groups showed a significant negative correlation between the BMI and SHBG level. ConclusionThe hypogonadism prevalence was higher in patients with T2DM than in those without, although the difference did not reach statistical significance.