Abstract
We sought to establish the interplay of metabolic syndrome (MetS) and/or sexual dysfunction (SD) on hypogonadism. Sexual functioning was assessed using Golombok Rust Inventory of Sexual Satisfaction in 274 consecutive diabetic men visiting the diabetic clinic of the Tema General Hospital between November 2010 and March 2011. MetS was assessed employing the criteria of World Health Organization, International Diabetic Federation and the National Cholesterol Education Program Adult Treatment Panel III while testosterone levels were estimated. The mean ages and duration of diabetes from this study were 59.9±11.3 and 6.8±5.9 years, respectively. The prevalence of hypogonadism was 7.3%, with the −SD/+MetS subjects showing the highest prevalence of hypogonadism, irrespective of the criteria used. Additionally, subjects with MetS and its components had a significantly lower level of testosterone compared with those without MetS and its components. Using standard nine-point scale, it was observed that subjects who avoided sexual act had significantly (P=0.0410) lower testosterone values (5.8±2.3 ng ml−1) than subjects who did not avoid sexual act (6.4±2.6 ng ml−1). MetS alone impacted more on hypogonadism than SD alone or both conditions altogether.
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References
Grundy SM . Metabolic syndrome: a multiplex cardiovascular risk factor. J Clin Endocrinol Metab 2007; 92: 399–404.
Laaksonen DE, Niskanen L, Punnonen K, Nyyssonen K, Tuomainen TP, Salonen R et al. Sex hormones, inflammation and the metabolic syndrome: a population-based study. Eur J Endocrinol 2003; 149: 601–608.
Guay AT . The emerging link between hypogonadism and metabolic syndrome. J Androl 2009; 30: 370–376.
Traish AM, Guay A, Feeley R, Saad F . The dark side of testosterone deficiency: I. Metabolic syndrome and erectile dysfunction. J Androl 2009; 30: 10–22.
Traish AM, Saad F, Guay A . The dark side of testosterone deficiency: II. Type 2 diabetes and insulin resistance. J Androl 2009; 30: 23–32.
Amidu N, Owiredu WK, Alidu H, Sarpong C, Gyasi-Sarpong CK, Quaye L . Association between metabolic syndrome and sexual dysfunction among men with clinically diagnosed diabetes. Diabetol Metab Syndr 2013; 5: 42.
McVary KT . Erectile dysfunction and lower urinary tract symptoms secondary to BPH. Eur Urol 2005; 47: 838–845.
Bajos N, Wellings K, Laborde C, Moreau C, Group CSF. Sexuality and obesity, a gender perspective: results from French national random probability survey of sexual behaviours. BMJ 2010; 340: c2573.
Larsen SH, Wagner G, Heitmann BL . Sexual function and obesity. Int J Obes 2007; 31: 1189–1198.
Kupelian V, Page ST, Araujo AB, Travison TG, Bremner WJ, McKinlay JB . Low sex hormone-binding globulin, total testosterone, and symptomatic androgen deficiency are associated with development of the metabolic syndrome in nonobese men. J Clin Endocrinol Metab 2006; 91: 843–850.
Bal K, Oder M, Sahin AS, Karatas CT, Demir O, Can E et al. Prevalence of metabolic syndrome and its association with erectile dysfunction among urologic patients: metabolic backgrounds of erectile dysfunction. Urology 2007; 69: 356–360.
Malavige LS, Levy JC . Erectile dysfunction in diabetes mellitus. J Sex Med 2009; 6: 1232–1247.
Wu FC, Tajar A, Beynon JM, Pye SR, Silman AJ, Finn JD et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med 2010; 363: 123–135.
Diaz-Arjonilla M, Schwarcz M, Swerdloff RS, Wang C . Obesity, low testosterone levels and erectile dysfunction. Int J Impot Res 2009; 21: 89–98.
Corona G, Rastrelli G, Vignozzi L, Mannucci E, Maggi M . How to recognize late-onset hypogonadism in men with sexual dysfunction. Asian J Androl 2012; 14: 251–259.
Saad F, Yassin A, Doros G, Haider A . Effects of long-term treatment with testosterone on weight and waist size in 411 hypogonadal men with obesity classes I-III: observational data from two registry studies. Int J Obes 2015; 40: 162–170.
Corona G, Giagulli VA, Maseroli E, Vignozzi L, Aversa A, Zitzmann M et al. Testosterone supplementation and body composition: results from a meta-analysis of observational studies. J Endocrinol Invest 2016; 39: 967–981.
Wang C, Jackson G, Jones TH, Matsumoto AM, Nehra A, Perelman MA et al. Low testosterone associated with obesity and the metabolic syndrome contributes to sexual dysfunction and cardiovascular disease risk in men with type 2 diabetes. Diabetes Care 2011; 34: 1669–1675.
Kupelian V, Shabsigh R, Araujo AB, O'Donnell AB, McKinlay JB . Erectile dysfunction as a predictor of the metabolic syndrome in aging men: results from the Massachusetts Male Aging Study. J Urol 2006; 176: 222–226.
Corona G, Mannucci E, Forti G, Maggi M . Hypogonadism, ED, metabolic syndrome and obesity: a pathological link supporting cardiovascular diseases. Int J Androl 2009; 32: 587–598.
Vignozzi L, Morelli A, Filippi S, Ambrosini S, Mancina R, Luconi M et al. Testosterone regulates RhoA/Rho‐kinase signaling in two distinct animal models of chemical diabetes. J Sex Med 2007; 4: 620–632.
Kirkendall WM, Burton AC, Epstein FH, Freis ED . Recommendations for human blood pressure determination by sphygmomanometers. Circulation 1967; 36: 980–988.
Rust J, Golombok S . The GRISS: a psychometric instrument for the assessment of sexual dysfunction. Arch Sex Behav 1986; 15: 157–165.
Rust J, Golombok S . the Golombok Rust Inventory of Sexual Satisfaction (GRISS) [manual]. NFER: Nelson: Windsor, England, 1986.
Rust J, Golombok S . The Golombok-Rust Inventory of Sexual Satisfaction (GRISS). Br J Clin Psychol 1985; 24 (Pt 1): 63–64.
NCEP. Executive summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486–2497.
Alberti KG, Zimmet P, Shaw J . Metabolic syndrome—a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med 2006; 23: 469–480.
Mills TM, Reilly CM, Lewis RW . Androgens and penile erection: a review. J Androl 1996; 17: 633–638.
Shabsigh R . Testosterone therapy in erectile dysfunction. Aging Male 2004; 7: 312–318.
Traish AM, Goldstein I, Kim NN . Testosterone and erectile function: from basic research to a new clinical paradigm for managing men with androgen insufficiency and erectile dysfunction. Eur Urol 2007; 52: 54–70.
Greenstein A, Mabjeesh NJ, Sofer M, Kaver I, Matzkin H, Chen J . Does sildenafil combined with testosterone gel improve erectile dysfunction in hypogonadal men in whom testosterone supplement therapy alone failed? J Urol 2003; 173: 530–532.
Ford ES, Li C, Sattar N . Metabolic syndrome and incident diabetes Current state of the evidence. Diabetes Care 2008; 31: 1898–1904.
WHO. 1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. J Hypertens 1999; 17: 151–183.
Jones TH . Testosterone associations with erectile dysfunction, diabetes and the metabolic syndrome. Eur Urol Suppl 2007; 6: 847–857.
Laaksonen DE, Niskanen L, Punnonen K, Nyyssonen K, Tuomainen TP, Valkonen VP et al. Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-aged men. Diabetes Care 2004; 27: 1036–1041.
Muller M, Grobbee DE, den Tonkelaar I, Lamberts SW, van der Schouw YT . Endogenous sex hormones and metabolic syndrome in aging men. J Clin Endocrinol Metab 2005; 90: 2618–2623.
Blouin K, Despres JP, Couillard C, Tremblay A, Prud'homme D, Bouchard C et al. Contribution of age and declining androgen levels to features of the metabolic syndrome in men. Metabolism 2005; 54: 1034–1040.
Dandona P, Dhindsa S, Chandel A, Chaudhuri A . Hypogonadotropic hypogonadism in men with type 2 diabetes. Postgr Med 2009; 121: 45–51.
Saad F, Gooren LJ . The role of testosterone in the etiology and treatment of obesity, the metabolic syndrome, and diabetes mellitus type 2. J Obes 2011; 2011: 1–10.
Svartberg J, von Muhlen D, Sundsfjord J, Jorde R . Waist circumference and testosterone levels in community dwelling men. The Tromso study. Eur J Epidemiol 2004; 19: 657–663.
Rosmond R, Wallerius S, Wanger P, Martin L, Holm G, Bjorntorp P . A 5-year follow-up study of disease incidence in men with an abnormal hormone pattern. J Intern Med 2003; 254: 386–390.
Stellato RK, Feldman HA, Hamdy O, Horton ES, McKinlay JB . Testosterone, sex hormone-binding globulin, and the development of type 2 diabetes in middle-aged men: prospective results from the Massachusetts male aging study. Diabetes Care 2000; 23: 490–494.
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; 295: 1288–1299.
Selvin E, Feinleib M, Zhang L, Rohrmann S, Rifai N, Nelson WG et al. Androgens and diabetes in men: results from the Third National Health and Nutrition Examination Survey (NHANES III). Diabetes Care 2007; 30: 234–238.
Corona G, Monami M, Boddi V, Cameron‐Smith M, Fisher AD, De Vita G et al. Low testosterone is associated with an increased risk of MACE lethality in subjects with erectile dysfunction. J Sex Med 2010; 7: 1557–1564.
Bhattacharya RK, Khera M, Blick G, Kushner H, Nguyen D, Miner MM . Effect of 12 months of testosterone replacement therapy on metabolic syndrome components in hypogonadal men: data from the Testim Registry in the US (TRiUS). BMC Endocr Disord 2011; 11: 18.
Jones TH . Effects of testosterone on Type 2 diabetes and components of the metabolic syndrome. J Diabetes 2010; 2: 146–156.
Tan K, Shiu S, Pang R, Kung A . Effects of testosterone replacement on HDL subfractions and apolipoprotein A‐I containing lipoproteins. Clin Endocrinol 1998; 48: 187–194.
Makhsida N, Shah J, Yan G, Fisch H, Shabsigh R . Hypogonadism and metabolic syndrome: implications for testosterone therapy. J Urol 2005; 174: 827–834.
Allan CA, McLachlan RI . Androgens and obesity. Curr Opin Endocrinol Diabetes Obes 2010; 17: 224–232.
MacDonald AA, Herbison GP, Showell M, Farquhar CM . The impact of body mass index on semen parameters and reproductive hormones in human males: a systematic review with meta-analysis. Hum Reprod Update 2010; 16: 293–311.
Brand JS, van der Tweel I, Grobbee DE, Emmelot-Vonk MH, van der Schouw YT . Testosterone, sex hormone-binding globulin and the metabolic syndrome: a systematic review and meta-analysis of observational studies. Int J Epidemiol 2011; 40: 189–207.
Laaksonen DE, Niskanen L, Punnonen K, Nyyssonen K, Tuomainen TP, Valkonen VP et al. The metabolic syndrome and smoking in relation to hypogonadism in middle-aged men: a prospective cohort study. J Clin Endocrinol Metab 2005; 90: 712–719.
Corona G, Vignozzi L, Sforza A, Mannucci E, Maggi M . Obesity and late-onset hypogonadism. Mol Cell Endocrinol 2015; 418: 120–133.
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Conception and design: NA and WKBAO; acquisition of data: NA, WKBAO, CKGS and CS; analysis and interpretation of data: NA, HA and BBA; drafting the article: NA, BBA and HA; revising it for intellectual content: NA, WKBAO, CKGS and BBA; final approval of the completed article: NA, WKBAO, CKGS, HA, BBA and CS.
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Amidu, N., Owiredu, W., Gyasi-Sarpong, C. et al. The inter-relational effect of metabolic syndrome and sexual dysfunction on hypogonadism in type II diabetic men. Int J Impot Res 29, 120–125 (2017). https://doi.org/10.1038/ijir.2017.6
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DOI: https://doi.org/10.1038/ijir.2017.6
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