Raeba Eldhose, (2022) The Prevalence of Hypogonadism and Its Association with Diabetes Mellitus, Hypertension, Cardiovascular Disease, Osteoporosis, Frailty and Obesity in Elderly Men attending Geriatric OPD at a Tertiary Care Centre in South India. Masters thesis, Christian Medical College, Vellore.
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Abstract
BACKGROUND: Male hypogonadism is common in the elderly. Studies have shown a prevalence varying from 10.3%-53%. It is associated with higher prevalence of cardiovascular disease, hypertension, diabetes mellitus, osteoporosis, obesity and frailty. Since these are associated with high morbidity and mortality, identification of any new risk factor and its prevalence will be useful in taking steps for prevention of these diseases. AIM OF THE STUDY: The aim of the this study was to find the prevalence of hypogonadism in elderly males attending Geriatrics OPD and to look for its association with diabetes mellitus, hypertension, cardiovascular disease, osteoporosis, obesity and frailty. SETTING AND DESIGN: This cross sectional observational study was conducted in the Geriatric medicine OPD at Christian Medical College, Vellore. METHOD: The blood samples of patients who presented to geriatrics OPD for any indication were taken to assess for total testosterone levels till the sample size was obtained . Free and total testosterone levels were assessed in all the individuals. History of hypertension, diabetes mellitus, cardiovascular diseases were noted. ADAM questionnaire was asked and short physical performance battery questionnaire was performed. Blood pressure, weight and height were also assessed. Fasting and post prandial glucose levels, ECG changes suggestive of ischemic heart diseases and DEXA scan were obtained from the investigations report of the patient. The prevalence of hypogonadism and the association of hypogonadism with cardiovascular disease, diabetes mellitus, hypertension, osteoporosis, obesity and frailty were assessed. Analysis was done using Statistical Package for Social Services (SPSS) software Version 21.0 (Armonk, NY: IBM Corp) and R. RESULTS: The criteria for hypogonadism in our study was a combination of symptoms of hypogonadism with a total testosterone <300ng/dL. The prevalence of hypogonadism in our study was 47% (n - 74). Total testosterone< 300ng/dL was found in 58% of the participants. When free testosterone <5 ng/dL was considered, the prevalence was even higher at 61%. Age had a significant association with hypogonadism and free testosterone. However, total testosterone, though it showed a downward trend, did not have a significant association with age. Diabetes had a significant association with hypogonadism and total testosterone both on univariate and multivariate analysis, but was not significantly associated with free testosterone level. There was a significant association between BMI and total testosterone and hypogonadism (symptoms + total testosterone <300 ng/dL). BMI was not associated with free testosterone. Frailty was significantly associated with free testosterone but not with total testosterone or hypogonadism. Cardiovascular disease did not have any significant association with hypogonadism, total or free testosterone. On multivariate analysis, however cardiovascular disease had a significant association with free testosterone. We found that the prevalence of osteoporosis was low in those with low testosterone. This contradictory result was thought to be due to the effect BMI had on osteoporosis and total testosterone. Multivariate analysis done however showed osteoporosis had no association with hypogonadism, total testosterone or free testosterone. Hypertension also did not have any significant association with hypogonadism, total testosterone or free testosterone. Adams questionnaire had a sensitivity of 79.57% and specificity of 18.18 % to detect total testosterone less than 300 ng/dl. Its sensitivity and specificity to detect free testosterone < 5 ng/dl was slightly higher at 80.41% and 19.35% respectively. CONCLUSION: The prevalence of hypogonadism (Men with symptoms of hypogonadism along with total testosterone < 300 ng/dl) in our study was 47% (n - 74). 58% had Total testosterone < 300ng/dl and 61% had free testosterone <5 ng/dl. Age, diabetes, obesity and dyslipidaemia had a significant association with hypogonadism (symptoms + testosterone < 300 ng/dl) while diabetes mellitus, BMI and dyslipidaemia had a significant inverse association with total testosterone. Free testosterone had a significant association with age, cardiovascular disease, ischemic heart disease and frailty.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 201826053 |
| Uncontrolled Keywords: | Prevalence, Hypogonadism, Diabetes Mellitus, Hypertension, Cardiovascular Disease, Osteoporosis, Frailty and Obesity, Elderly Men, Geriatric OPD, Tertiary Care Centre, South India. |
| Subjects: | MEDICAL > Geriatrics > MEDICAL > Geriatrics |
| Depositing User: | Subramani R |
| Date Deposited: | 24 Jun 2021 14:39 |
| Last Modified: | 03 Mar 2024 05:38 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/17615 |
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