Title: Hypogonadism and Erectile Dysfunction in Male Patients of Type 2 DM without CAD and With CAD in Indian Scenario
Authors: Dr Piyush Kumar, Dr Dharam Prakash Bansal, Dr Prashant Pathak, Dr Ankit Manglunia, Dr Ritvik Agrawal
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.175
Abstract
AIM-: The present study is carried out to investigate hypogonadism using serum testosterone levels in male Type 2 diabetes mellitus (T2DM) subjects with and without coronary artery disease (CAD) and prevalence of erectile dysfunction in type 2 DM with and without CAD
MATERIAL AND METHODS: This was a cross-sectional study, conducted among 80 men (aged 30-70 years) with type 2 diabetes and 40 nondiabetic (aged 30-70 years) who visited medicine OPD of mahatma Gandhi hospital, Jaipur between Feb 2015 to March 2016. The patients’ demographic characteristics were collected using a pre structured questionnaire. Duration of diabetes, smoking habits, family history, drug history, trauma history, any tumour or radiation history or history of chronic liver and kidney disease were collected. Venous blood sample was collected to test for total testosterone (TT), free testosterone (FT), serum lipids, and glycosylated haemoglobin (HbA1c).. In all men, the morning (08.00–10.00 hours) TT and FT levels were measured after an overnight fast. Normal levels of TT were taken as 300-1000 ng/dl and normal levels of FT as 9-40 pg/ml. Presence and degree of ED was assessed by the validated international index of erectile Function-5 (IIEF-5) questionnaire. Erectile dysfunction was considered present when the IIEF–5 score was ≤ 21.
RESULTS: 36.11 % of type 2 DM with CAD subjects had low total testosterone as compared to type 2 DM without CAD (22.72%) subjects. 61.11% type 2 DM with CAD subjects had low free testosterone than 54.54% type 2 DM without CAD subjects. Total testosterone (298.63±24.75) in patients with type 2 DM were significantly lower as compared to control (383.81±58.36) p<0.001. Free testosterone (7.61±2.12) in patients with type 2 DM were significantly lower as compared to control (11.17±2.34) p<0.001.
CONCLUSION: We observed hypogonadism as indicated by low testosterone levels in a significant proportion of male T2DM subjects with CAD.
Erectile dysfunction was found to be more severe in DM2 with CAD. Thus erectile dysfunction can be a indicator of CAD in type 2 DM and correcting them early may prevent coronary artery disease .
KEYWORDS: Cardiovascular risk, coronary artery disease, diabetes, hypogonadism, testosterone
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