Title: ADAM Questionnaire; Is it a Predictor of Androgen Deficiency in Type 2 Diabetes Mellitus Male Patients?

Authors: Dr Haynes Raja. K, Dr S. Balasubramaniyan, Dr S. Selvamuthukumaran, Dr C. Subathra, Dr I. Balaji

 DOI: https://dx.doi.org/10.18535/jmscr/v6i10.167

Abstract

Background: Diabetes Mellitus is a growing epidemic in the world. It accelerates the aging process and has been proven to reduce Androgen levels in males earlier, through various mechanisms. This study is done to analyse the clinical utility of the ADAM questionnaire in patients with diabetes mellitus in diagnosing androgen deficiency.

Aim: To estimate the prevalence of androgen deficiency among male diabetic patients. To evaluate the efficiency of the ADAM questionnaire, as a tool for diagnosing androgen deficiency, in males with type 2 diabetes mellitus.

Materials and Methods: A prospective study involving 50 type 2 diabetic patients without any other comorbidities was conducted in Rajah Muthiah Medical College. The patients were initially screened with ADAM questionnaire and blood samples were taken for analysing serum testosterone levels.

Results: 28 patients had low androgen levels according to the ADAM questionnaire among which 13 were found to have low serum testosterone levels. There was a statistically significant correlation between ADAM score and Testosterone levels.

Conclusion: ADAM questionnaire can be effectively utilized in male type 2 diabetes mellitus patients. It can be used as a first line investigation for finding androgen deficiency in those patients before subjecting them for serum Testosterone levels.

Keywords: Type 2 diabetes mellitus, Serum Testosterone, ADAM questionnaire.

References

  1. Charlier C, Barr M, Colby S, Greene G, Olfert M, Charlier CM, et al. Correlations of Self-Reported Androgen Deficiency in Ageing Males (ADAM) with Stress and Sleep among Young Adult Males. Healthcare. 2018 Oct 1;6(4):121.
  2. Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, et al. Testosterone Therapy in Men with Androgen Deficiency Syndromes: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2010 Jun 1;95(6):2536–59.
  3. Kalyani RR, Dobs AS. Androgen deficiency, diabetes, and the metabolic syndrome in men: Current Opinion in Endocrinology, Diabetes and Obesity. 2007 Jun;14(3):226–34.
  4. Dhindsa S, Prabhakar S, Sethi M, Bandyopadhyay A, Chaudhuri A, Dandona P. Frequent Occurrence of Hypogonadotropic Hypogonadism in Type 2 Diabetes. J Clin Endocrinol Metab. 2004 Nov 1;89(11):5462–8.
  5. Tancredi A, Reginster J-Y, Schleich Fl, Pire G, Maassen P, Luyckx F, et al. Interest of the androgen deficiency in aging males (ADAM) questionnaire for the identification of hypogonadism in elderly community-dwelling male volunteers. European Journal of Endocrinology [Internet]. 2004 Sep [cited 2018 Oct 15];151(3). Available from: https://orbi.uliege. be/handle/2268/26324
  6. Morley JE, Charlton E, Patrick P, Kaiser FE, Cadeau P, McCready D, et al. Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism - Clinical and Experimental. 2000 Sep 1;49(9):1239–42.
  7. Yeap BB, Alfonso H, Chubb SAP, Handelsman DJ, Hankey GJ, Norman PE, et al. Reference Ranges and Determinants of Testosterone, Dihydrotestosterone, and Estradiol Levels Measured using Liquid Chromatography-Tandem Mass Spectrometry in a Population-Based Cohort of Older Men. J Clin Endocrinol Metab. 2012 Nov 1;97(11):4030–9.
  8. Ding EL, Song Y, Malik VS, Liu S. Sex Differences of Endogenous Sex Hormones and Risk of Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA. 2006 Mar 15;295(11):1288–99.
  9. Oh J-Y, Barrett-Connor E, Wedick NM, Wingard DL. Endogenous Sex Hormones and the Development of Type 2 Diabetes in Older Men and Women: the Rancho Bernardo Study. Diabetes Care. 2002 Jan 1;25(1):55–60.
  10. Yialamas MA, Dwyer AA, Hanley E, Lee H, Pitteloud N, Hayes FJ. Acute Sex Steroid Withdrawal Reduces Insulin Sensitivity in Healthy Men with Idiopathic Hypogonadotropic Hypogonadism. J Clin Endocrinol Metab. 2007 Nov 1;92(11):4254–9.
  11. pdf [Internet]. [cited 2018 Oct 15]. Available from: http://www.aimdrjournal.com/pdf/vol3Issue4/BC1_OA_V3N4.pdf
  12. Rhoden EL, Ribeiro EP, Teloken C, Souto CAV. Diabetes mellitus is associated with subnormal serum levels of free testosterone in men. BJU International. 2005 Oct 1;96(6):867–70.
  13. pdf [Internet]. [cited 2018 Oct 15]. Available from: http://medind.nic.in/iaa/ t12/i7/iaat12i7p92.pdf
  14. Marin P, Holmang S, Gustafsson C, Jonsson L, Kvist H, Elander A, et al. Androgen treatment of abdominally obese men. Obesity research [Internet]. 1993 [cited 2018 Oct 15]; Available from: http://agris.fao.org/agris-search/search.do?recordID=US201301496061
  15. Morales DA, Spevack M, Emerson L, Kuzmarov I, Casey R, Black A, et al. Adding to the controversy: Pitfalls in the diagnosis of testosterone deficiency syndromes with questionnaires and biochemistry. The Aging Male. 2007 Jan 1;10(2):57–65.

Corresponding Author

Dr S. Selvamuthukumaran

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.