Erectile dysfunction and lower androgenicity in type 1 diabetic patients.
OBJECTIVE
To analyse the clinical characteristics and relevant hormonal profile in type 1 diabetic patients with and without ED.


METHODS
Fifty one type 1 diabetic patients were studied. ED was assessed by direct interview. Chronic diabetic complications, smoking and alcohol status as well as current use of medications were recorded. Hormonal profile consisted of plasma LH, FSH, prolactin, androstenedione (Delta(4)), dehydroepiandrosterone (DHEA), DHEA-sulfate (DHEA-S), free testosterone (FT), estradiol (E(2)), sex hormone binding globulin (SHBG), dihydrotestosterone (DHT), cortisol, TSH and free thyroxine (FT(4)).


RESULTS
ED was present in 24 patients (47%) (group 1), who were older (P<0.001), had a longer diabetes duration (P<0.001) and a higher systolic blood pressure (P=0.017) when compared to the subjects who did not complain (group 2). ED was positively correlated to all diabetes-related complications (P<0.02). Antidepressive drug(s) were more frequent in group 1 (P=0.007), as well as prokinetics (P=0.043) and ACE-inhibitors (P=0.010). HbA(1)c was comparable. Patients with ED had lower levels of Delta(4) (P=0.003), DHEA (P<0.001), DHEA-S (P=0.002), FT (P=0.08) while SHBG (P=0.010) and LH (P=0.022) were higher compared to group 2. Multiple logistic regression analysis showed an independent association of ED with Delta(4) (P=0.016), DHEA-S (P=0.037), SHBG (P=0.001) and insulin dose (P=0.025). There was no significant difference for all other measured hormones.


CONCLUSIONS
ED is impressively prevalent in type 1 diabetes and is associated with age, diabetes duration, chronic complications and decreased androgens.
Alexopoulou
O
O
Service d'Endocrinologie et Nutrition, Cliniques Universitaires St Luc, Université Catholique de Louvain, B-1200 Bruxelles, Belgique.
Jamart
J
J
Maiter
D
D
Hermans
M P
MP
De Hertogh
R
R
De Nayer
P
P
Buysschaert
M
M
D000367:Age Factors; D000428:Alcohol Drinking; D000728:Androgens / Q000097:blood*; D001794:Blood Pressure; D002096:C-Peptide / Q000097:blood; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000453:epidemiology / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000503:physiopathology; D007172:Erectile Dysfunction / Q000097:blood* / Q000503:physiopathology*; D004958:Estradiol / Q000097:blood; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000097:blood; D012907:Smoking
D000728:Androgens; D002096:C-Peptide; D004958:Estradiol; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D006854:Hydrocortisone