title: Screening for hypogonadism in diabetes 2008/9: results from the Cheshire Primary Care cohort.
abstract: OBJECTIVE
  There is increasing awareness of hypogonadism in men with type 2 diabetes but limited data from Primary Care.
  
  
  METHODS
  The anonymised records of 6457 male patients aged 18-80 years with diabetes were accessed. Within the last 2 years 391 men (6.0% of total) underwent measurement of serum testosterone. Data search was performed through the centralised data facility afforded by EMIS®, the majority GP systems provider in Cheshire.
  
  
  RESULTS
  4.4% of type 2 diabetes men screened were frankly hypogonadal with a serum total testosterone of less than 8.0 nmol/l. For borderline hypogonadism (serum total testosterone 8-11.99 nmol/l) the proportion of type 2 diabetes men rose to 32.1%. Age adjusted mean (geometric) testosterone was lower in men with type 2 diabetes (13.6 nmol/l 95%CI: 13.1-14.2) vs type 1 diabetes (17.9 nmol/l; 95%CI 15.2-21.0), F=10.3; p=0.0014. For those screened age adjusted body mass index (BMI) was greater in type 2 diabetes at 30.7 (30.1-31.3) vs 28.4 (26.1-30.6)kg/m(2) in type 1 diabetes (F=4.3; p=0.04). Multiple linear regression analysis indicated that there was a statistically significant interaction (P=0.014) between BMI and diabetes type in their relation with log testosterone. For persons with type 1 DM and type 2 DM, testosterone can be expected to decrease by 6% (P=0.002) and by 1% (P=0.002) respectively, for every one unit increment in BMI.
  
  
  CONCLUSIONS
  There is manifestly a subset of men with diabetes and androgen deficiency who could benefit from testosterone replacement. BMI has an independent influence on androgen status.
authors: Cardiovascular Sciences Research Group, Core Technology Facility, University of Manchester, 46 Grafton Street, Manchester, UK.
authors: Simon George
authors: SG
authors: Anderson
authors: Adrian
authors: A
authors: Heald
authors: Novie
authors: N
authors: Younger
authors: Sumudu
authors: S
authors: Bujawansa
authors: Ram Prakash
authors: RP
authors: Narayanan
authors: Alan
authors: A
authors: McCulloch
authors: Hugh
authors: H
authors: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D004739:England / Q000453:epidemiology; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000378:metabolism; D020249:Hormone Replacement Therapy; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D016018:Least-Squares Analysis; D016014:Linear Models; D008055:Lipids / Q000097:blood; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011320:Primary Health Care; D018570:Risk Assessment; D012307:Risk Factors; D013739:Testosterone / Q000097:blood / Q000172:deficiency* / Q000627:therapeutic use; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D008055:Lipids; D013739:Testosterone; C517652:hemoglobin A1c protein, human