Objectives: Type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) are characterized by insulin resistance and often associated with male hypogonadism. To discriminate the specific contribution of T2DM and MetS to male hypogonadism.
Design and methods: A consecutive series of 1134 (mean age 52.1±13 years) male patients with sexual dysfunction was studied. Several hormonal and biochemical parameters were studied along with ANDROTEST, a 12-item validated structured interview, specifically designed for the screening of hypogonadism (total testosterone TT, <10.4 nmol/l or free-testosterone FT, <37 pmol/l) in a male population with sexual dysfunction.
Results: Irrespective of the criteria used to define hypogonadism, MetS was associated with a significantly higher prevalence of the condition, both in subjects with and without T2DM (41 and 29% vs 13.2% and 77.1 and 58% vs 40.6%; respectively for TT and FT in patients with MetS and with or without T2DM, when compared with subjects without MetS and T2DM; both P<0.0001). Conversely, T2DM was associated with a higher prevalence of hypogonadism in subjects with MetS but not in those without MetS. Patients with MetS, with or without T2DM, also showed a higher ANDROTEST score when compared with patients without MetS. Logistic multivariate regression analysis, incorporating the five components of MetS, identified a significant association of elevated waist circumference and hypertriglyceridaemia with hypogonadism both in patients, with or without T2DM.
Conclusions: Our study demonstrated that MetS and in particular visceral adiposity (as assessed by increased waistline and hypertriglyceridaemia) is specifically associated with hypogonadism in subjects consulting for sexual dysfunction.
03 - 07 May 2008
European Society of Endocrinology