title: Androgen Deficiency and Erectile Dysfunction in Patients with Type 2 Diabetes.
abstract: BACKGROUND
  The association between type 2 diabetes mellitus (T2DM) and low total serum testosterone (LST) has been identified in several cross-sectional studies.
  
  
  OBJECTIVE
  To assess the prevalence of androgen deficiency and erectile dysfunction (ED) and their relation to glycemic control within a sample of Egyptian men with T2DM.
  
  
  METHODS
  A cross-sectional study including 70 men having T2DM. Their ages ranged from 30 to 50 years. They were evaluated for symptoms of androgen deficiency and ED, using a validated Arabic-translated Androgen Deficiency in Aging Males questionnaire and five-items version of the International Index of Erectile Function-5, respectively. Total testosterone (TT), glycated hemoglobin (HbA1c), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin were measured for all study subjects. Penile hemodynamics was assessed using penile duplex study for subjects who gave history of ED.
  
  
  RESULTS
  LST was found in 40% of studied men, and 92.9% of them reported overt symptoms of androgen deficiency. ED was detected in 85.7% of those with LST, as opposed to 31.0% of those with normal TT (P < 0.000). TT was lower in diabetic men with ED compared to those without ED (12.04 ± 5.36 vs 17.11 ± 7.11 nmol/L, P < 0.001). Significant negative correlation was found between TT and age, body mass index, waist circumference, systolic and diastolic blood pressures, and HBA1c (P < 0.00). FSH, LH, and prolactin levels were within the normal reference range in all subjects. HbA1c was higher in patients who had LST with ED, compared to those with normal TT and without ED. However, multivariate logistic regression analysis did not reveal a significant association between HBA1c and LST levels.
  
  
  CONCLUSIONS
  LST, symptoms of androgen deficiency, and ED are common in the studied sample of Egyptian men with T2DM. Inappropriately normal FSH and LH in face of LST may denote a state of hypogonadotropic hypogonadism. HBA1c was found to be more significantly associated with ED than with LST.
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine for Girls, Al-Azhar University, Egypt.
authors.forename: Entesar Oa
authors.initials: EO
authors.lastname: El Saghier
authors.affiliation: Department of Urology, Faculty of Medicine for Girls, Al-Azhar University, Egypt.
authors.forename: Salah E
authors.initials: SE
authors.lastname: Shebl
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine for Girls, Al-Azhar University, Egypt.
authors.forename: Olfat A
authors.initials: OA
authors.lastname: Fawzy
authors.affiliation: Department of Endocrinology, Dar EL Shefa Hospital, Al-Azhar University, Egypt.
authors.forename: Ihab M
authors.initials: IM
authors.lastname: Eltayeb
authors.affiliation: Department of Diagnostic Radiology, Faculty of Medicine for Girls, Al-Azhar University, Egypt.
authors.forename: Lamya Ma
authors.initials: LM
authors.lastname: Bekhet
authors.affiliation: Department of Diagnostic Radiology, Faculty of Medicine for Boys, Al-Azhar University, Egypt.
authors.forename: Abdelnasser
authors.initials: A
authors.lastname: Gharib
keywords: androgen; diabetes; erectile dysfunction