Sarah K Holt1, Natalya Lopushnyan, James Hotaling, Aruna V Sarma, Rodney L Dunn, Patricia A Cleary, Barbara H Braffett, Patricia Gatcomb, Catherine Martin, William H Herman, Hunter Wessells. 1. Department of Urology (S.K.H., N.L., H.W.), University of Washington, Seattle, Washington 98195; Department of Surgery/Urology (J.H.), University of Utah, Salt Lake City, Utah 84112; Departments of Urology (A.V.S., R.L.D.), Internal Medicine (C.M., W.H.H.), and Epidemiology (W.H.H.), University of Michigan, Ann Arbor, Michigan 48109; Biostatistics Center (P.A.C., B.H.B.), George Washington University, Washington DC 20052; and Department of Medicine (P.G.), Yale University, New Haven, Connecticut 06520.
Abstract
CONTEXT: Previous studies have demonstrated lower testosterone concentrations in men with type 2 diabetes mellitus. Data in men with type 1 diabetes mellitus (T1DM) are limited. OBJECTIVE: Our objective was to determine the prevalence of low testosterone in men with T1DM and identify predisposing factors. DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional study of men with T1DM participating in UroEDIC (n = 641), an ancillary study of urologic complications in the Epidemiology of Diabetes Interventions and Complications (EDIC). MAIN OUTCOME MEASURES: Total serum testosterone levels were measured using mass spectrometry, and SHBG levels were measured using sandwich immunoassay on samples from EDIC year 17/18. Calculated free testosterone was determined using an algorithm incorporating binding constants for albumin and SHBG. Low testosterone was defined as total testosterone <300 mg/dL. Multivariate regression models were used to compare age, body mass index, factors related to diabetes treatment and control, and diabetic complications with testosterone levels. RESULTS: Mean age was 51 years. Sixty-one men (9.5%) had testosterone <300 mg/dL. Decreased testosterone was significantly associated with obesity (P < .01), older age (P < .01) and decreased SHBG (P < .001). Insulin dose was inversely associated with calculated free testosterone (P = .02). Hypertension retained a significant adjusted association with lower testosterone (P = .05). There was no observed significant relationship between lower testosterone and nephropathy, peripheral neuropathy, and autonomic neuropathy measures. CONCLUSION: The men with T1DM in the EDIC cohort do not appear to have a high prevalence of androgen deficiency. Risk factors associated with low testosterone levels in this population are similar to the general population.
CONTEXT: Previous studies have demonstrated lower testosterone concentrations in men with type 2 diabetes mellitus. Data in men with type 1 diabetes mellitus (T1DM) are limited. OBJECTIVE: Our objective was to determine the prevalence of low testosterone in men with T1DM and identify predisposing factors. DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional study of men with T1DM participating in UroEDIC (n = 641), an ancillary study of urologic complications in the Epidemiology of Diabetes Interventions and Complications (EDIC). MAIN OUTCOME MEASURES: Total serum testosterone levels were measured using mass spectrometry, and SHBG levels were measured using sandwich immunoassay on samples from EDIC year 17/18. Calculated free testosterone was determined using an algorithm incorporating binding constants for albumin and SHBG. Low testosterone was defined as total testosterone <300 mg/dL. Multivariate regression models were used to compare age, body mass index, factors related to diabetes treatment and control, and diabetic complications with testosterone levels. RESULTS: Mean age was 51 years. Sixty-one men (9.5%) had testosterone <300 mg/dL. Decreased testosterone was significantly associated with obesity (P < .01), older age (P < .01) and decreased SHBG (P < .001). Insulin dose was inversely associated with calculated free testosterone (P = .02). Hypertension retained a significant adjusted association with lower testosterone (P = .05). There was no observed significant relationship between lower testosterone and nephropathy, peripheral neuropathy, and autonomic neuropathy measures. CONCLUSION: The men with T1DM in the EDIC cohort do not appear to have a high prevalence of androgen deficiency. Risk factors associated with low testosterone levels in this population are similar to the general population.
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