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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Addis Ababa University


Background: Global estimate of world health organization (WHO) indicated that 422 million adults 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 has resulted 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 sexual function, potential infertility and poor quality of life. However, hypogonadism is under recognized and under treated in sub-Saharan African countries including Ethiopia. Therefore, the finding 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 for further research and appropriate intervention. Objectives: To assess hypogonadism and its associated risk factors in men with T2DM attending Diabetic Clinic at TASTH, Addis Ababa, Ethiopia. Method: A cross-sectional study was conducted among 115 male patients with T2DM from February to April 2017 at Diabetic Clinic of TASTH in Addis Ababa, Ethiopia. Demographic data were collected using a structured questionnaire. Clinical data were obtained from medical records. Anthropometric indices were determined. Clinical assessment of androgen deficiency was done using ADAM questionnaire. TT, LH, and FSH were determined by ECLIA method with Cobas e 411, Elecsys® 2010 analyzer. HDL-C, LDL-C, TC and TRIG were determined by enzymatic 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 androgen deficiency 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 statistically associated with TT level except hypertension. BMI, WC, FBG, TRIG were negatively and significantly 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 significantly correlated 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 in hypogonadal 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 T2DM in this tertiary care, testosterone deficiency were less prevalent. Visceral obesity and hyperglycemia are independent risk factors for hypogonadism. Keywords: T2DM, low serum testosterone, hypogonadism, prevalence, risk factors



T2DM, Low serum testosterone, Hypogonadism, Prevalence