Prevalence of low testosterone and predisposing risk factors in men with type 1 diabetes mellitus: findings from the DCCT/EDIC

J Clin Endocrinol Metab. 2014 Sep;99(9):E1655-60. doi: 10.1210/jc.2014-1317. Epub 2014 Jul 11.

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 1 / metabolism*
  • Endocrine System Diseases / epidemiology*
  • Endocrine System Diseases / metabolism*
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hypertension / epidemiology
  • Hypertension / metabolism
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Obesity / epidemiology
  • Obesity / metabolism
  • Peripheral Nervous System Diseases / epidemiology
  • Peripheral Nervous System Diseases / metabolism
  • Prevalence
  • Risk Factors
  • Sex Hormone-Binding Globulin / metabolism
  • Testosterone / blood
  • Testosterone / deficiency*

Substances

  • Glycated Hemoglobin A
  • Sex Hormone-Binding Globulin
  • hemoglobin A1c protein, human
  • Testosterone