Late-onset hypogonadism among old and middle-aged males with prediabetes in Polish population

Objectives: Around 40% of diabetic men have lowered testosterone and symptoms of hypogonadism but the prevalence of hypogonadism among prediabetic men is unknown. The aim of this study was to investigate the prevalence of late-onset hypogonadism (LOH) in population of Polish men with prediabetes. Methods: This study was performed in 196 prediabetic men and in 184 normoglycemic, control group. Prediabetes was defined as impaired fasting glucose, impaired glucose tolerance and/or HbA1c 5.7-6.4%. LOH was defined as low libido, diminished frequency of morning erections and erectile dysfunctions in men with total testosterone <12 nmol/l. Results: Total testosterone (TT) level in prediabetes group was 11.78 +/- 1.76 and 16.37 +/- 1.6 nmol/l in control group (p<0.001). LOH was diagnosed in 30% prediabetic men and in 13.6% control men. There were negative relationships between calculated free testosterone (cFT) and HbA1c (r = -0.3856; p<0.005). In prediabetic group, TT and cFT levels were lower in patients with impaired glucose tolerance than impaired fasting glucose (p<0.05 and p<0.02, respectively). We showed inverse relationships between IIEF-5 score and cFT (r = -0.414, p<0.005) and between IIEF-5 and HbA1c (r = -0.395, p<0.002). Conclusions: In population of Polish men with prediabetes we observed high prevalence of LOH. Routine testosterone screening should be performed in all prediabetic men.