Prevalence of hypogonadism among males with type 2 diabetes mellitus in a Malaysian tertiary hospital: A cross-sectional study.

Kang WAYE HANN; Nor Azmi KAMARUDDIN; Norlela SUKOR

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Prevalence of hypogonadism among males with type 2 diabetes mellitus in a Malaysian tertiary hospital: A cross-sectional study.

Author: Kang WAYE HANN ¹ ; Nor Azmi KAMARUDDIN ² ; Norlela SUKOR ³
Author Information

1. Department of Medicine, M. Kandiah Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Malaysia;Endocrinology Unit, Department of Medicine, Hospital Canselor Tuanku Muhriz, Malaysia;Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia
2. Institute Jantung Negara, Malaysia
3. Endocrinology Unit, Department of Medicine, Hospital Canselor Tuanku Muhriz, Malaysia;Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia
Publication Type:Journal Article, Original
MeSH: Human; Hypogonadism; Diabetes Mellitus, Type 2; Testosterone; Prevalence
From: Journal of the ASEAN Federation of Endocrine Societies 2025;40(2):47-55
CountryPhilippines
Abstract: OBJECTIVE
Previous studies have indicated that clinical hypogonadism is common among males with type 2 diabetes mellitus (T2DM). However, the reported prevalence varies due to the diverse diagnostic criteria used in these studies. This study aims to determine the prevalence of clinical hypogonadism among Malaysian T2DM males and their associated factors.
METHODOLOGY
A total of 360 participants who fulfilled the inclusion criteria were included in this study. Their socio-demographic and clinical parameters were documented and a total testosterone level was sampled from a morning fasting serum. Patients with serum total testosterone of 8-12 nmol/L had their serum total testosterone repeated and their symptoms assessed with the Aging Male Symptoms (AMS) scale. Clinical hypogonadism was diagnosed with total testosterone 26.
RESULTS
The prevalence of clinical hypogonadism among Malaysian T2DM males was 17.5% (n = 63), with 55.6% of them having hypogonadotropic hypogonadism. There is a significant association between clinical hypogonadism with waist circumference > 94 cm (p < 0.001), obesity (p < 0.001), hypertension (p = 0.010), coronary artery disease (p = 0.014) and peripheral artery disease (p = 0.022). There is a significant difference in the weight (p = 0.001), BMI (p < 0.001), waist circumference P < 0.001), serum HDL-C levels (p < 0.001), serum triglycerides levels (p = 0.001) and serum TyG index (p < 0.001). Diabetic males with increasing age (adjusted OR = 1.070, 95% CI 1.004-1.146, p = 0.038), presence of coronary artery diseases (adjusted OR = 2.08, 95% CI 1.220-10.219, p = 0.020) and low total testosterone (adjusted OR = 2.451, 95% CI 1.908-3.155, p < 0.001) are at higher risk of developing clinical hypogonadism.
CONCLUSION
This study is the first in the Asian region to use stricter criteria for diagnosing hypogonadism. Despite these stringent criteria, the prevalence of hypogonadism remains significantly high among Malaysian T2DM males. It is particularly common in diabetic males over 35 years old with coronary artery disease, regardless of A1c control and the duration of diabetes.