Introduction and objectives: Aim of this study is to evaluate the psycho-biological correlates of DM associated hypogonadism (DMAH).
Methods: The Structured Interview SIEDY was employed along with several biochemical, psychological and instrumental investigations. We defined hypogonadal subjects (HY) those with a circulating total testosterone (T) below 10.4 nM.
Results: We studied 1246 patients. More than 15% resulted affected by type 2 DM and 1/3 of them were also HY. DMAH was associated with a significant reduction of the androgen-dependent marker PSA, as indicating the presence of a biological, more than biochemical, hypogonadism. In addition, DMAH was associated with hypogonadism-related symptoms, such as reduction in libido, leading to a decrease number of sexual attempts. In DMAH, testis size and LH concentrations were significantly reduced, suggesting a central origin of the disease. DMAH was associated with higher prevalence of depression symptoms than the rest of type 2 DM sample. DMAH patients showed a lower duration of disease and lower DM-associated complications, as nephropathy when compared to the rest of type 2 DM sample. However, they were showed higher BMI and higher triglyceride and lower HDL cholesterol than the rest of type 2 DM patients. A negative association was found between BMI and T plasma levels (−0.353; P<0.0001). At penile Duplex ultrasound (PDU), DMAH was associated with a decrease in acceleration rate and basal pick systolic velocity. PDU parameters were inversely related to DMAH, even after adjusting for age and BMI.
Conclusion: Hypogonadism frequently complicates type 2 DM. DMAH might exacerbate sexual dysfunction by reducing libido and mood and further compromising penile vascular reactivity and lipid metabolism. Hence, testing circulating T is strongly recommended in ED subjects with type 2 DM.
01 - 05 Apr 2006
European Society of Endocrinology