The Androgen Deficiency in the Aging Male (ADAM) questionnaire is commonly used to screen type 2 diabetes mellitus (T2DM) patients for androgen deficiency symptoms, but the association of low total (TT) and free testosterone (FT) levels with divergent responses to the ADAM questionnaire remains unclear. The aim of this study was to assess the predictive ability of TT and calculated FT (cFT) levels for accurately classifying ADAM status. We recruited 70 patients each with positive (group A) and negative (group B) responses to the ADAM questionnaire and 70 age-matched healthy controls (group C) (mean age, 50.5 years); serum levels of TT were estimated and cFT were estimated using Vermeulen equation. Hypogonadism was defined as the presence of symptoms (positive ADAM score) along with TT level < 300 ng/dL or calculated (cFT) <6.35 ng/dL. BMI was highest in group A (P < 0.05), followed by groups B and C. Group A had longer diabetes durations (P < 0.05) and higher fasting plasma glucose (FPG) and HbA1c levels than group B (P < 0.001). TT levels and cFT were significantly lower in Group A than in the other two groups. In group A, 51 (73%) men had low TT levels (<300 ng/dL) and 48 (69%) had low cFT (<6.35 ng/dL). TT levels < 300 ng/dL had higher sensitivity and specificity (73 and 96%, respectively) than cFT < 6.35 ng/dL (69 and 90%, respectively) for predicting ADAM status. Multivariate-adjusted logistic regression showed that diabetes duration, HbA1c level, and BMI predicted low TT levels, whereas diabetes duration and HbA1c and high-density lipoprotein levels were significant predictors of low cFT. TT levels were a better predictor of ADAM responses than cFT in male T2DM patients. Our results suggest that TT level is better than cFT for diagnosing hypogonadism in T2DM patients when equilibrium dialysis is not feasible.

中文翻译：

---

2型糖尿病患者中总游离睾酮和计算出的游离睾丸激素与雄激素缺乏症状的关联。

男性衰老男性雄激素缺乏症（ADAM）问卷通常用于筛查2型糖尿病（T2DM）患者的雄激素缺乏症状，但低总（TT）和游离睾丸激素（FT）水平与对该疾病的不同反应相关ADAM问卷仍然不清楚。这项研究的目的是评估TT的预测能力和计算的FT（cFT）水平，以准确地分类ADAM状态。我们招募了70例对ADAM问卷呈阳性（A组）和阴性（B组）的患者，以及70名年龄匹配的健康对照组（C组）（平均年龄50.5岁）；使用Vermeulen方程估算TT的血清水平和cFT。性腺功能减退被定义为存在症状（阳性ADAM评分）以及TT水平<300 ng / dL或计算（cFT）<6.35 ng / dL。BMI在A组中最高（P <0.05），其次是B和C组。A组的糖尿病持续时间（P <0.05）和空腹血糖（FPG）和HbA1c水平高于B组（P <0.001）。A组的TT水平和cFT显着低于其他两组。在A组中，有51位（73％）男性的TT水平低（<300 ng / dL），有48位（69％）的cFT低（<6.35 ng / dL）。TT水平<300 ng / dL的敏感性和特异性（分别为73和96％）高于cFT <6.35 ng / dL（分别为69和90％）的ADAM状态预测值。多因素校正logistic回归分析显示，糖尿病持续时间，HbA1c水平和BMI可预测低TT水平，而糖尿病持续时间，HbA1c和高密度脂蛋白水平则是低cFT的重要预测指标。在男性T2DM患者中，TT水平比cFT是ADAM反应的更好预测指标。我们的结果表明，在无法进行平衡透析的情况下，T2DM患者的性腺功能减退的诊断水平要好于cFT。