April 25, 2014
2 min read

Screening questionnaire helps to identify testosterone deficiency

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Several health factors identified by researchers as significant predictors of testosterone deficiency have been folded into a simplified tool that physicians may use for screening purposes, according to an article in the Journal of Men’s Health.

In a community-based screening program, Nelson N. Stone, MD, of the department of urology at the Icahn School of Medicine at Mount Sinai, and colleagues determined testosterone levels in 5,071 men. Participants completed a questionnaire to determine lifestyle, coexisting diseases and BMI. Associations were determined by analysis of variance (ANOVA) and chi-square analyses for testosterone deficiencies (testosterone <300 ng/dL). The effect of multiple variables on testosterone levels was determined by linear regression.

The researchers used significant variables (P<.001) to model the male androgen deficiency syndrome questionnaire; it includes queries on diabetes, race, obesity, exercise frequency and erectile dysfunction.

Results showed the average testosterone level was 378.6 ng/dL, and 1,950 men (38.5%) had testosterone deficiency. Certain areas showed a high degree of predictability and potential to screen for testosterone deficiency:

  • Black patients had higher levels (406.6, P<.001).
  • Nonsmokers had lower levels compared with smokers (377.4 vs. 418, P<.001).
  • Men who exercised more than five times per week had higher levels than men who did not exercise (391.9 ng/dL vs. 360.4 ng/dL, P<.001).
  • Men who were overweight by 30 lb had lower levels than normal weight (293.3 ng/dL vs. 421.8 ng/dL, P<.001).

Based on regression analysis, significant associations were seen with overweight status (P<.001), adult-onset diabetes (P<.001), race (P<.001), heart disease (P=.05) and exercise frequency (P=.001).

The risk for testosterone deficiency in men with adult-onset diabetes who were more than 20 lb overweight increased from 49.1% to 62.6% (P=.01). Men without adult-onset diabetes, who were not black, showed increased risk based on overweight status, exercise frequency and erectile dysfunction — 31.1% to 39.3% for one, to 48.2% for two, and to 61.7% for three of the significant conditions (P<.001).

“While aging men have decreasing testosterone levels, low testosterone is more highly associated with obesity, type 2 diabetes mellitus, low exercise frequency, and poor erection confidence,” the researchers wrote. “Further studies must be completed to demonstrate the validity, sensitivity, and specificity of this questionnaire, but we believe that it will be beneficial in identification of those men at greatest risk for the sequelae of untreated testosterone deficiency.”

Disclosure: The researchers report no relevant financial disclosures.