Background: Some evidence has shown that the prevalence of hypoactive sexual desire and erectile dysfunction (ED) is associated with testosterone levels whilst higher levels of testosterone have been reported to increase the frequency of intercourse. Available evidence points towards an etiologic role for hypogonadism in the causation of diabetes, metabolic syndrome (Mets) and sexual dysfunction (SD) even though the exact pathophysiological linkage is yet to be fully elucidated. This study therefore sought to evaluate the impact of testosterone as well as its bioactive components on both the MetS and SD. Method: Diabetic men engaged in a stable heterosexual relationship for at least 2 years were recruited for this study. Participants were at least 18 years and provided an informed and signed consent to partake in this study. Fasting blood samples were taken from the participants for biochemical and hormonal assay. The participants were then evaluated using the Golombok Rust Inventory of Sexual Satisfaction for males (GRISS-M). Metabolic syndrome was assessed using the NCEP-ATP III, IDF and WHO criteria. All data analyses were performed using the SPSS software, version 11.0 systat, Inc. Germany and GraphPad Prism, version 5.0, San Diego California, USA. Results: The mean total, free and bioavailable testosterone as well as SHBG recorded among the participants was 7.10 ± 1.23 ng/ml, 0.10 ± 0.01 ng/ml, 7.01 ± 1.41 ng/ml and 4.33 ± 1.12 nmol/l respectively. Subjects with the MetS showed significantly lower SHBG levels in comparison with subjects without the MetS. Participants with raised triglyceride levels showed significantly lower levels of total, free and bioavailable testosterone when compared to participant without raised triglycerides. Participants with problems of avoidance and infrequency of sexual activity showed significantly lower levels of total, free and bioavailable testosterone when compared to participants without avoidance or infrequency problems. The +SD/+MetS group recorded the lowest SHBG levels. Conclusion: Testosterone and its bioactive components are associated with male libido as well as the metabolic syndrome. Low levels of free and bioavailable testosterone are true determinants of the MetS in men.
Sexuality is a complex process and a multidimensional phenomenon that incorporates biological, psychological, interpersonal and behavioral dimensions [
Recently emerged evidence has suggested that the secretion or activity of NO an important vasodilator necessary for erection to occur is modulated by gona- dal androgens [
Erectile dysfunction (ED; or impotence) and premature ejaculation (PE) are the two most prevalent complaints in male sexual dysfunction (SD) [
Disorders of desire or decreased libido are characterized by a lack or absence of desire for sexual activity or the absence of sexual fantasies [
There is no universal agreement regarding the definition of hypogonadism. However it is generally accepted that hypogonadism is used to refer to the presence of persistently low circulating testosterone levels relative to the normal population [
Testosterone is largely bound to sex hormone binding globulin (SHBG) and this could influence the availability of free testosterone levels in the body. The decreasing levels of SHBG with age [
Androgens have been reported to promote myogenesis and inhibit adipogenesis [
Participants in this study were 130 type II diabetic males who attend the diabetic clinic at the Maamobi General Hospital in Accra and were being managed on oral diabetic medications. Participants were at least 18 years and above and were consecutively sampled if they were actively engaged in a stable heterosexual relationship which was defined as having engaged in a continuous heterosexual relationship for a minimum of two years before enrollment in this study. Each participant was required to sign an informed consent to participate in the study. Patients who were not known type II diabetics or had obvious physical disabilities were excluded from the study. Ethical approval was obtained from the Committee on Human Research Publication and Ethics (CHRPE) of the School of Medical Science and the Komfo Anokye Teaching Hospital (KATH), Kumasi. Sexual function of the participants was evaluated using the Golombok Rust Inventory of Sexual Satisfaction for males (GRISS-M) with participants grouped as having Sexual Dysfunction (SD) when their stanine scores was equal to or greater than five (5). Subscales of Impotence (IMP), Premature Ejaculation (PE), Non-sens- uality (NS) Avoidance (AV), Dissatisfaction (DIS), Non-communication (NC) and Infrequency (INF) was also computed using their stanine scores. The NCEP- ATP III [
All data analyses were performed using the SPSS software, version 11.0 systat, Inc. Germany and Graph Pad Prism, version 5.0, San Diego California, USA. Data presentation was done as the mean ±SD or percentages. In all the statistical analysis, a value of p < 0.05 was considered to be significant.
The mean total testosterone, free testosterone, bioavailable testosterone and SHBG recorded among the participants was 7.10 ± 1.23 ng/ml, 0.10 ± 0.01 ng/ ml, 7.01 ± 1.41 ng/ml and 4.33 ± 1.12 nmol/l respectively. When the study participants were stratified by the presence or absence of the MetS, participants with the MetS recorded significantly lower levels of total testosterone for all criteria of the MetS. Participants with the MetS also recorded significantly lower levels of free (IDF) and bioavailable testosterone (IDF). Furthermore, participants with the MetS also recorded lower levels of SHBG in comparison with those without the MetS (ATP III and WHO) (
There was no significant difference observed in the total testosterone, free testosterone, and bioavailable testosterone levels of participants when participants with 1, 2, 3 and 4 component score of the MetS were compared with regards to the IDF and WHO criteria. However the ATP III criteria recorded significant differences in the levels of total and bioavailable testosterone with decreasing levels of total and bioavailable testosterone along the 1, 2, 3 and 4 MetS score groups. Participants with four components of the MetS recorded hypogonadal levels of total and bioavailable testosterone. There was however no differences in the free testosterone and SHBG levels when the same comparism was done for the 1, 2, 3 and 4 component score groups (
When participants were stratified based on the presence or absence of the various specific MetS components, participants with Abdominal Obesity showed no significant difference in any of the assayed parameters whilst participants with Central Obesity showed significantly lower levels of SHBG as compared to participants without Central Obesity. Participants with raised FBG showed no significant difference in their total, free and bioavailable testosterone levels as
Hormonal Variable | TOTAL | No MetS | MetS | P Value |
---|---|---|---|---|
ATP III | ||||
Total Testosterone (ng/ml) | 7.10 ± 1.23 | 9.07 ± 2.43 | 4.43 ± 1.42 | 0.0410 |
Free Testosterone (ng/ml) | 0.10 ± 0.01 | 1.01 ± 0.65 | 0.06 ± 0.00 | 0.1464 |
Bioavailable Testosterone (ng/ml) | 7.01 ± 1.41 | 9.06 ± 3.42 | 4.36 ± 1.52 | 0.1002 |
SHBG (nmol/l) | 4.33 ± 1.12 | 5.34 ± 1.61 | 3.52 ± 1.03 | 0.02145 |
IDF | ||||
Total Testosterone (ng/ml) | 9.27 ± 2.75 | 4.51 ± 1.64 | 0.0339 | |
Free Testosterone (ng/ml) | 1.17 ± 0.54 | 0.24 ± 0.05 | 0.0394 | |
Bioavailable Testosterone (ng/ml) | 8.08 ± 1.09 | 4.30 ± 1.44 | 0.0483 | |
SHBG (nmol/l) | 5.62 ± 2.43 | 3.89 ± 0.97 | 0.1087 | |
WHO | ||||
Total Testosterone (ng/ml) | 10.83 ± 3.71 | 2.21 ± 0.84 | 0.0392 | |
Free Testosterone (ng/ml) | 1.07 ± 0.50 | 0.22 ± 0.03 | 0.2946 | |
Bioavailable Testosterone (ng/ml) | 10.08 ± 4.66 | 2.01 ± 0.68 | 0.6201 | |
SHBG (nmol/l) | 5.26 ± 1.03 | 3.99 ± 1.11 | 0.0277 |
No MetS-With no metabolic syndrome/MetS = with metabolic syndrome.
Hormonal variables | MetS Score | F Value | P Value | |||
---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | |||
ATP III | ||||||
Total Testosterone (ng/ml) | 10.54 ± 2.61 | 7.46 ± 1.83 | 5.21 ± 1.24 | 2.17 ± 0.46 | F3, 122 = 1.2755 | 0.0434 |
Free Testosterone (ng/ml) | 1.66 ± 0.53 | 1.09 ± 0.64 | 1.04 ± 0.29 | 1.02 ± 0.04 | F3, 122 = 0.7389 | 0.1235 |
Bioavailable Testosterone (ng/ml) | 8.41 ± 2.26 | 6.33 ± 1.39 | 4.13 ± 1.01 | 1.14 ± 0.28 | F3, 122 = 1.1590 | 0.0432 |
SHBG (nmol/l) | 4.59 ± 1.86 | 3.64 ± 1.04 | 4.22 ± 1.61 | 3.45 ± 1.08 | F3, 122 = 1.1194 | 0.1522 |
IDF | ||||||
Total Testosterone (ng/ml) | 5.52 ± 1.43 | 4.95 ± 0.37 | 4.43 ± 1.70 | 2.07 ± 0.89 | F3, 122 = 2.0050 | 0.1227 |
Free Testosterone (ng/ml) | 0.18 ± 0.09 | 0.10 ± 0.01 | 0.20 ± 0.08 | 0.09 ± 0.01 | F3, 122 = 1.9280 | 0.1345 |
Bioavailable Testosterone (ng/ml) | 5.36 ± 1.41 | 4.82 ± 1.33 | 4.22 ± 1.29 | 2.00 ± 0.94 | F3, 122 = 1.9563 | 0.1291 |
SHBG (nmol/l) | 5.15 ± 1.75 | 4.25 ± 1.41 | 4.76 ± 1.95 | 4.00 ± 1.86 | F3, 122 = 0.1228 | 0.8562 |
WHO | ||||||
Total Testosterone (ng/ml) | 4.52 ± 1.43 | 4.30 ± 0.35 | 3.21 ± 1.02 | 2.30 ± 1.98 | F3, 122 =0.2893 | 0.3854 |
Free Testosterone (ng/ml) | 0.18 ± 0.06 | 0.01 ± 0.00 | 0.14 ± 0.03 | 0.12 ± 0.08 | F3, 122 = 0.9876 | 0.4833 |
Bioavailable Testosterone (ng/ml) | 4.36 ± 1.41 | 4.25 ± 1.28 | 3.08 ± 1.06 | 2.15 ± 0.87 | F3, 122 = 0.3852 | 0.3965 |
SHBG (nmol/l) | 5.15 ± 1.74 | 4.68 ± 1.52 | 4.26 ± 1.30 | 4.07 ± 1.54 | F3, 122 = 0.1119 | 0.7492 |
well as SHBG levels in comparison with participants without raised FBG. Participants with raised Triglyceride levels showed significantly lower levels of total, free and bioavailable testosterone when compared to participant without raised Triglyceride levels. There was however no observed differences in the total testosterone, free testosterone, bioavailable testosterone and SHBG levels when participants with or without raised BP, reduced HDL-cholesterol and Dyslipidemia were compared, irrespective of the MetS criteria used (
When the diabetic male participants were stratified based on the presence or absence of SD sub scales, participants who had impotence showed no difference in their total testosterone, free testosterone, bioavailable testosterone and SHBG levels in comparison with participants without difficulties of impotence. Participants with difficulties of premature ejaculation, non-sensuality, dissatisfaction and non-communication also showed no difference in their levels of total, free and bioavailable testosterone as well as SHBG levels in comparison with participants without these difficulties. Participants with difficulties of avoidance and infrequency in sexual activity showed significantly lower hypogonadal levels of total, free and bioavailable testosterone when compared to participants without avoidance problems. They however showed no difference in their SHBG levels (
When the different shades of the SD/MetS groups were compared for their total, bioavailable and free testosterone levels, there was no difference recorded amongst these groups. However, when the same groups were compared for their SHBG levels, significantly decreasing levels of SHBG (p = 0.0205, F3,122 = 1.148) were recorded (ATP III), with SHBG levels being highest among the ?SD/−MetS
Total Testosterone(ng/ml) | Free Testosterone(ng/ml) | |||||
---|---|---|---|---|---|---|
Variable | Absent | Present | P Value | Absent | Present | P Value |
ATP III | ||||||
Abdominal Obesity-WC | 16.75 ± 3.76 | 7.88 ± 1.34 | 0.2339 | 1.87 ± 0.64 | 1.01 ± 0.09 | 0.2273 |
Raised FBG | 11.63 ± 2.21 | 6.66 ± 1.34 | 0.3499 | 1.04 ± 0.00 | 0.92 ± 0.08 | 0.5382 |
Raised TG | 15.24 ± 3.93 | 13.61 ± 4.37 | 0.0115 | 2.33 ± 0.08 | 1.76 ± 0.93 | 0.0485 |
Raised BP | 11.26 ± 2.11 | 7.49 ± 1.96 | 0.5732 | 1.05 ± 0.49 | 0.56 ± 0.07 | 0.5894 |
Reduced HDL-C | 8.38 ± 2.27 | 5.30 ± 1.32 | 0.5812 | 0.72 ± 0.05 | 0.21 ± 0.06 | 0.4968 |
IDF | ||||||
Abdominal Obesity-WC | 10.54 ± 2.33 | 6.54 ± 1.32 | 0.2022 | 0.54 ± 0.00 | 0.34 ± 0.11 | 0.3444 |
Raised FBG | 11.35 ± 2.47 | 6.36 ± 1.82 | 0.3499 | 0.69 ± 0.06 | 0.21 ± 0.06 | 0.5382 |
Raised TG | 15.07 ± 3.22 | 11.65 ± 3.43 | 0.0115 | 1.86 ± 0.08 | 1.32 ± 0.31 | 0.0285 |
Raised BP | 5.92 ± 1.31 | 7.22 ± 2.25 | 0.7216 | 1.03 ± 0.26 | 0.28 ± 0.06 | 0.7305 |
Reduced HDL-C | 8.48 ± 1.99 | 4.32 ± 1.14 | 0.4087 | 0.34 ± 0.08 | 0.15 ± 0.04 | 0.3499 |
WHO | ||||||
Central Obesity-WHR | 9.88 ± 2.53 | 5.21 ± 1.10 | 0.4332 | 0.63 ± 0.09 | 0.40 ± 0.05 | 0.5098 |
Raised FBG | 11.62 ± 4.37 | 6.82 ± 2.04 | 0.3499 | 1.28 ± 0.93 | 0.58 ± 0.13 | 0.5382 |
Dyslipidemia | 6.44 ± 1.34 | 4.64 ± 1.66 | 0.5863 | 1.22 ± 0.27 | 0.43 ± 0.03 | 0.9208 |
Raised BP | 9.47 ± 1.84 | 6.44 ± 2.48 | 0.5578 | 1.82 ± 0.76 | 0.85 ± 0.19 | 0.4422 |
Bioavailable Testosterone(ng/ml) | SHBG (nmol/l) | |||||
---|---|---|---|---|---|---|
Variable | Absent | Present | P Value | Absent | Present | P Value |
ATP III | ||||||
Abdominal Obesity-WC | 13.44 ± 3.12 | 6.65 ± 1.32 | 0.2151 | 3.58 ± 1.07 | 3.10 ± 1.06 | 0.6493 |
Raised FBG | 10.32 ± 2.04 | 6.73 ± 1.51 | 0.3865 | 3.87 ± 1.05 | 3.15 ± 1.02 | 0.3328 |
Raised TG | 15.45 ± 3.22 | 9.88 ± 2.10 | 0.0033 | 3.16 ± 1.19 | 2.29 ± 0.62 | 0.0124 |
Raised BP | 11.38 ± 3.36 | 6.50 ± 2.39 | 0.5395 | 3.45 ± 1.02 | 4.63 ± 1.27 | 0.0762 |
Reduced HDL-C | 7.48 ± 1.33 | 4.53 ± 1.86 | 0.5322 | 3.57 ± 1.06 | 3.68 ± 1.06 | 0.3852 |
IDF | ||||||
Abdominal Obesity-WC | 10.34 ± 2.43 | 5.45 ± 1.33 | 0.4642 | 4.22 ± 1.47 | 3.54 ± 1.08 | 0.1433 |
Raised FBG | 10.25 ± 2.38 | 6.62 ± 1.34 | 0.3865 | 3.78 ± 1.37 | 3.47 ± 1.43 | 0.3562 |
Raised TG | 15.31 ± 4.33 | 10.38 ± 2.19 | 0.0039 | 3.25 ± 1.09 | 2.54 ± 0.63 | 0.0024 |
Raised BP | 5.31 ± 1.66 | 7.29 ± 2.45 | 0.7513 | 3.98 ± 1.01 | 3.87 ± 1.03 | 0.3591 |
Reduced HDL-C | 8.30 ± 2.39 | 4.36 ± 1.48 | 0.3702 | 3.86 ± 1.07 | 3.78 ± 1.06 | 0.6802 |
WHO | ||||||
Central Obesity-WHR | 8.36 ± 2.32 | 5.54 ± 1.75 | 0.4370 | 5.23 ± 1.47 | 4.44 ± 1.34 | 0.0432 |
Raised FBG | 10.37 ± 3.53 | 6.48 ± 1.33 | 0.3865 | 4.15 ± 1.52 | 3.98 ± 1.02 | 0.5722 |
Dyslipidemia | 8.52 ± 2.33 | 6.56 ± 1.54 | 0.7121 | 3.63 ± 1.16 | 2.00 ± 0.43 | 0.1739 |
Raised BP | 9.35 ± 2.73 | 8.78 ± 1.43 | 0.4985 | 4.63 ± 1.58 | 5.25 ± 1.44 | 0.2634 |
group (6.46 ± 1.30), followed by the +SD/−MetS group (5.16 ± 1.45) and the -SD/+MetS group (3.92 ± 1.08). The +SD/+MetS group recorded the lowest SHBG (3.47 ± 1.01) levels (
Variable | Total Testosterone(ng/ml) | Free Testosterone(ng/ml) | ||||
---|---|---|---|---|---|---|
Absent | Present | P Value | Absent | Present | P Value | |
Impotence | 8.37 ± 2.29 | 7.58 ± 2.34 | 0.7825 | 0.79 ± 0.10 | 0.53 ± 0.08 | 0.5978 |
Premature ejaculation | 5.69 ± 2.56 | 9.52 ± 2.38 | 0.4240 | 0.31 ± 0.09 | 0.50 ± 0.13 | 0.4873 |
Non sensuality | 7.43 ± 2.44 | 7.23 ± 2.02 | 0.9523 | 0.38 ± 0.16 | 0.22 ± 0.07 | 0.7114 |
Avoidance | 11.37 ± 4.62 | 2.12 ± 0.33 | 0.0416 | 0.52 ± 0.15 | 0.12 ± 0.09 | 0.0349 |
Dissatisfaction | 8.49 ± 2.62 | 7.36 ± 2.60 | 0.8614 | 0.38 ± 0.12 | 0.18 ± 0.06 | 0.6957 |
Non communication | 5.82 ± 1.29 | 8.45 ± 2.22 | 0.6454 | 0.41 ± 0.14 | 0.38 ± 0.11 | 0.9352 |
Infrequency | 5.43 ± 1.54 | 2.05 ± 0.15 | 0.0445 | 0.69 ± 0.08 | 0.43 ± 0.17 | 0.0481 |
Bioavailable Testosterone (ng/ml) | SHBG (nmol/l) | |||||
Absent | Present | P Value | Absent | Present | P Value | |
Impotence | 7.52 ± 2.33 | 6.92 ± 2.02 | 0.7441 | 5.01 ± 2.02 | 3.11 ± 1.93 | 0.1396 |
Premature ejaculation | 5.36 ± 1.62 | 8.90 ± 1.33 | 0.4064 | 3.91 ± 1.98 | 5.03 ± 2.43 | 0.1734 |
Non sensuality | 7.38 ± 1.97 | 7.04 ± 2.02 | 0.8995 | 3.62 ± 1.87 | 4.02 ± 2.66 | 0.2964 |
Avoidance | 10.81 ± 3.55 | 2.02 ± 0.09 | 0.0463 | 5.01 ± 2.23 | 3.02 ± 1.91 | 0.1836 |
Dissatisfaction | 7.94 ± 1.38 | 7.16 ± 2.52 | 0.9001 | 3.95 ± 1.71 | 4.03 ± 2.88 | 0.2841 |
Non communication | 5.41 ± 1.24 | 7.44 ± 1.67 | 0.6802 | 3.09 ± 1.87 | 4.19 ± 2.48 | 0.1843 |
Infrequency | 3.36 ± 0.37 | 1.36 ± 0.76 | 0.0433 | 4.01 ± 2.21 | 4.66 ± 2.14 | 0.4398 |
Hormonal Variables | −SD/−MetS | +SD/−MetS | −SD/+MetS | +SD/+MetS | F Value | P Value |
---|---|---|---|---|---|---|
ATP III | ||||||
Total Testosterone (ng/ml) | 7.26 ± 2.02 | 6.74 ± 1.01 | 5.89 ± 1.40 | 3.79 ± 1.07 | F3, 122 = 1.4070 | 0.2494 |
Free Testosterone (ng/ml) | 1.01 ± 0.09 | 0.60 ± 0.00 | 0.40 ± 0.00 | 0.10 ± 0.00 | F3, 122 = 1.0760 | 0.3660 |
Bioavailable Testosterone (ng/ml) | 6.23 ± 1.48 | 6.18 ± 1.09 | 5.69 ± 1.73 | 3.65 ± 0.91 | F3, 122 = 1.3040 | 0.2814 |
SHBG (nmol/l) | 6.46 ± 1.30 | 5.16 ± 1.45 | 3.92 ± 1.08 | 3.47 ± 1.01 | F3, 122 = 1.148 | 0.0205 |
IDF | ||||||
Total Testosterone (ng/ml) | 5.48 ± 1.33 | 6.69 ± 1.58 | 8.38 ± 1.54 | 2.44 ± 0.99 | F3, 122 = 1.0930 | 0.3590 |
Free Testosterone (ng/ml) | 0.33 ± 0.00 | 0.30 ± 0.00 | 0.15 ± 0.00 | 0.10 ± 0.00 | F3, 122 = 1.2140 | 0.3123 |
Bioavailable Testosterone (ng/ml) | 5.12 ± 1.48 | 6.36 ± 1.08 | 7.51 ± 1.92 | 2.57 ± 0.72 | F3, 122 = 1.1550 | 0.3342 |
SHBG (nmol/l) | 5.02 ± 1.37 | 4.38 ± 1.03 | 4.08 ± 1.03 | 3.22 ± 1.05 | F3, 122 = 0.7433 | 0.2853 |
WHO | ||||||
Total Testosterone (ng/ml) | 11.49 ± 2.61 | 6.66 ± 1.38 | 5.96 ± 1.52 | 3.48 ± 0.81 | F3,122 = 0.4250 | 0.7357 |
Free Testosterone (ng/ml) | 0.42 ± 0.09 | 0.31 ± 0.00 | 0.20 ± 0.09 | 0.10 ± 0.04 | F3, 122 = 0.3386 | 0.7974 |
Bioavailable Testosterone (ng/ml) | 10.93 ± 2.04 | 6.28 ± 1.29 | 5.85 ± 1.47 | 3.35 ± 0.73 | F3, 122 = 0.4560 | 0.7140 |
SHBG (nmol/l) | 5.83 ± 1.62 | 4.33 ± 1.35 | 4.01 ± 1.86 | 3.18 ± 1.00 | F3, 122 = 0.3266 | 0.3820 |
When the hormonal parameters were considered as determinants with adjustment for confounders, only low levels of free and bioavailable testosterone were significant determinants of the MetS, with an aOR of 1.5 and 4.5 respectively. None of the parameters were determinants of either SD or SD/MetS (Tables 7-9).
It is of interest the observation that participants with the MetS had lower levels of SHBG and lower levels of total, free and bioavailable testosterone in comparison to those without the MetS. Low SHBG and testosterone levels have been reported in some studies as a risk factor of the MetS [
Variable | OR (CI) | Pvalue | aOR (CI) | P Value |
---|---|---|---|---|
Tot. Testosterone | ||||
Normal | ||||
Low | 4.27 (0.91 - 19.9903) | 0.046 | 5.11 (0.31 - 84.00) | 0.2540 |
Free Testosterone | ||||
Normal | ||||
Low | 3.17 (0.91 - 11.06) | 0.0410 | 1.50 (0.43 - 7.72) | 0.0312 |
Bioavailable Testosterone | ||||
Normal | ||||
Low | 3.90 (1.06 - 14.31) | 0.0400 | 4.49 (1.13 - 17.84) | 0.0330 |
SHBG | ||||
Normal | ||||
Low | 2.28 (0.42 - 12.39) | 0.3410 | 2.64 (0.42 - 16.78) | 0.3040 |
Variable | OR (CI) | P Value | aOR (CI) | P Value |
---|---|---|---|---|
Tot. Testosterone | ||||
Normal | ||||
Low | 0.90 (0.20 - 4.17) | 0.8940 | 1.11 (0.22 - 5.67) | 0.8990 |
Free Testosterone | ||||
Normal | ||||
Low | 1.30 (0.35 - 4.78) | 0.6980 | 1.37 (0.35 - 5.34) | 0.6520 |
Bioavailable Testosterone | ||||
Normal | ||||
Low | 1.12 (0.30 - 4.21) | 0.8690 | 1.20 (0.30 - 4.78) | 0.7980 |
SHBG | ||||
Normal | ||||
Low | 2.97 (0.33 - 27.13) | 0.9660 | 2.35 (0.25 - 21.83) | 0.4520 |
Variable | OR (CI) | P Value | aOR (CI) | P Value |
---|---|---|---|---|
Tot. Testosterone | ||||
Normal | ||||
Low | 1.13 (0.20 - 6.27) | 0.8900 | 0.50 (0.03 - 7.57) | 0.6200 |
Free Testosterone | ||||
Normal | ||||
Low | 1.66 (0.43 - 6.41) | 0.4650 | 0.96 (0.16 - 5.89) | 0.9610 |
Bioavailable Testosterone | ||||
Normal | ||||
Low | 1.91 (0.48 - 7.53) | 0.3550 | 1.03 (0.16 - 6.52) | 0.9780 |
SHBG | ||||
Normal | ||||
Low | 1.77(0.29 - 10.76) | 0.5360 | 0.67 (0.06 - 7.31) | 0.7390 |
have been reported in some studies to be associated with the MetS [
Testosterone and its bioactive components have a very strong association with male libido as well as the metabolic syndrome. Low levels of free and bioavailable testosterone are true determinants of the MetS in men. Bioavailable testosterone levels are a stronger determinant of the MetS than free testosterone levels.
The authors declare that they have no competing interests.
WKBAO, NA, HA, ATB and CKGS developed the concept and designed the study. NA, WKBAO, HA, PPMD, EBAP and ATB administered the questionnaire, analysed and interpreted the data.NA, WKBAO, HA, PPMD and ATB performed all the assay procedures. WKBAO, HA, NA, PPMD, ATB and EBAPdrafted the manuscript. NA, HA, WKBAO, PPMD, CKGS and ATB revised the manuscript for intellectual content. All authors read and approved the final manuscript.
Ethical approval was obtained from the Committee on Human Research Publication and Ethics (CHRPE) of the School of Medical Science and the Komfo Anokye Teaching Hospital (KATH), Kumasi. All participants gave an informed and signed consent to partake in this study.
All participants gave an informed and signed consent for the research to be used for publication.
Alidu, H., Amidu, N., Owiredu, W.K.B.A., Gyasi-Sarpong, C.K., Bawah, A.T., Dapare, P.P.M. and Agyemang Prempeh, E.B. (2017) Testosterone and Its Bioactive Components Are Associated with Libido and the Metabolic Syndrome in Men. Advances in Sexual Medicine, 7, 105-119. https://doi.org/10.4236/asm.2017.72008
ADT
AV
Androgen Deprivation Therapy
Avoidance
BP
DIS
Blood Pressure
Dissatisfaction
ED
Erectile Dysfunction
GRISS-M
Golombuk-Rust Inventory for Sexual Satisfaction-Male
IDF
International Diabetes Federation
IMP
Impotence
INF
Infrequency
MetS
Metabolic syndrome
NCEP-ATP III
National Cholesterol Education Programme-Adult Treatment Panel III
NO
Nitric oxides
NPT
NS
Nocturnal Penile Tumescence
Non-sensuality
PE
Premature Ejaculation
SD
Sexual Dysfunction
SHBG
Sex Hormone Binding Globulin
Submit or recommend next manuscript to SCIRP and we will provide best service for you:
Accepting pre-submission inquiries through Email, Facebook, LinkedIn, Twitter, etc.
A wide selection of journals (inclusive of 9 subjects, more than 200 journals)
Providing 24-hour high-quality service
User-friendly online submission system
Fair and swift peer-review system
Efficient typesetting and proofreading procedure
Display of the result of downloads and visits, as well as the number of cited articles
Maximum dissemination of your research work
Submit your manuscript at: http://papersubmission.scirp.org/
Or contact asm@scirp.org