title: Prevalence of low testosterone and predisposing risk factors in men with type 1 diabetes mellitus: findings from the DCCT/EDIC.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Holt
authors.forename: Natalya
authors.initials: N
authors.lastname: Lopushnyan
authors.forename: James
authors.initials: J
authors.lastname: Hotaling
authors.forename: Aruna V
authors.initials: AV
authors.lastname: Sarma
authors.forename: Rodney L
authors.initials: RL
authors.lastname: Dunn
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Cleary
authors.forename: Barbara H
authors.initials: BH
authors.lastname: Braffett
authors.forename: Patricia
authors.initials: P
authors.lastname: Gatcomb
authors.forename: Catherine
authors.initials: C
authors.lastname: Martin
authors.forename: William H
authors.initials: WH
authors.lastname: Herman
authors.forename: Hunter
authors.initials: H
authors.lastname: Wessells
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000378:metabolism*; D004700:Endocrine System Diseases / Q000453:epidemiology* / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology / Q000378:metabolism; D015995:Prevalence; D012307:Risk Factors; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood / Q000172:deficiency*
chemical_list: D006442:Glycated Hemoglobin; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; C517652:hemoglobin A1c protein, human