Assessment of Hypogonadism and Associated Risk factors among Male Patients with type 2 Diabetes Mellitus Attending Diabetic Clinic of Tikur Anbessa Specialized Teaching Hospital in Addis Ababa, Ethiopia
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Date
2017-06
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Addis Ababa University
Abstract
Background: Global estimate of world health organization (WHO) indicated that 422 millionadults aged over 18 years were living with diabetes in 2016. Type 2 diabetes Mellitus (T2DM)accounts for 90 to 95% of the incidence of diabetes. The increased prevalence of T2DM hasresulted in increased prevalence of hypogonadism which is proved to be linked to it by many
researchers. This in turn creates a substantial public health burden in terms of inadequate sexualfunction, potential infertility and poor quality of life. However, hypogonadism is underrecognized and under treated in sub-Saharan African countries including Ethiopia. Therefore, thefinding of this research regarding prevalence and risk factors of hypogonadism will alert
clinicians and health policy makers to give attention to this problem and initiate the need forfurther research and appropriate intervention.
Objectives: To assess hypogonadism and its associated risk factors in men with T2DM attendingDiabetic Clinic at TASTH, Addis Ababa, Ethiopia.
Method: A cross-sectional study was conducted among 115 male patients with T2DM fromFebruary to April 2017 at Diabetic Clinic of TASTH in Addis Ababa, Ethiopia. Demographicdata were collected using a structured questionnaire. Clinical data were obtained from medicalrecords. Anthropometric indices were determined. Clinical assessment of androgen deficiencywas done using ADAM questionnaire. TT, LH, and FSH were determined by ECLIA methodwith Cobas e 411, Elecsys® 2010 analyzer. HDL-C, LDL-C, TC and TRIG were determined byenzymatic colorimetric method with Cobas 6000 module 501whereas FBG was determined by
glucose oxidase method with Mindray-200E.
Results: Among the total 115 male study participants with T2DM, 104 (90.4%) had androgendeficiency symptoms but only 29(25.2%) had testosterone deficiency [TT≤12.1nmol/L].However, hypogonadism was observed in 27(23.5%) of which 20(74.1%) and 7(25.9%) were
with secondary (HH) and primary hypogonadism, respectively. Age, duration of diabetes,monthly income, alcohol consumption, and diabetic complications were not statisticallyassociated with TT level except hypertension. BMI, WC, FBG, TRIG were negatively andsignificantly correlated with TT with (r=-0.363, p<0.001) ;(-0.465, p<0.001); (rho=-0.328,p=0.001) ;( rho=-0.357, p<0.001), respectively whereas HDL-C was positively and significantlycorrelated with TT with (r=0.339, p<0.001). However, SBP, DBP, TC, LDL-C, LH and FSH
were not significantly correlated with TT. BMI, WC, FBG, TRIG are significantly increased inhypogonadal group but HDL-C was significantly decreased in hypogonadal group with p value<0.05. WC and FBG were identified as independent risk factors for hypogonadism.
Conclusion: Though symptoms of hypogonadism are highly prevalent among men with T2DMin this tertiary care, testosterone deficiency were less prevalent. Visceral obesity andhyperglycemia are independent risk factors for hypogonadism.
Keywords: T2DM, low serum testosterone, hypogonadism, prevalence, risk factors
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Keywords
T2DM Low serum testosterone Hypogonadism Prevalence