Prediabetic Men Suffer from Depression, Andropausal Syndrome at Higher Rates

A Polish study in Clinical Interventions in Aging suggests that middle-aged men with prediabetes are more likely than healthy peers to suffer from depressive symptoms and signs of andropausal syndrome. Interestingly, the study found no increased risk of depressive symptoms for elderly men with prediabetes.

The study is, in part, a response to the growing body of clinical research around mental health in men. As they age, men lose testosterone at the rate of about 1-2% per year; combined with symptomatic hypogonadism, metabolic disorders and increasing emotional disturbances. This combination of maladies is generally considered andropausal syndrome (AS), which refers to a clinical syndrome with psychological, sexual, and mental health decline; or late-onset hypogonadism (LOH), the diagnosis of which is based on clinical symptoms associated with sexual functions and low testosterone levels only.

Prediabetes (PD) is characterized by a slight increase in blood glucose concentrations than the normal levels, but the patients are not yet said to be diabetic. PD status is considered a risk factor for the further development of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Poland, in particular, has a high prevalence of PD.

It is well known that patients with T2DM have been recognized to have a higher prevalence of major depressive disorders and depressive symptoms than the general population. This study of 196 men with PD and 184 healthy controls used the Self-rating Depression Scale (SDS) and the Aging Males’ Symptoms (AMS) rating scale to determine the differences in depressive symptoms between patients with PD and a control group, as well as to investigate the clinical and hormonal determinants of the severity of these symptoms in middle-aged and elderly men with PD.

The prevalence of andropausal syndrome in men with PD was significantly higher than that in healthy men (35% vs 11%, respectively). In men with PD aged 40—59 years, the severity of sexual, psychological, and all andropausal symptoms was greater than in healthy peers, while in elderly men (60–80 years), only the severity of psychological symptoms was greater than in healthy peers. The severity of depressive symptoms in the middle-aged men with PD was greater than in healthy peers, while the severity of depressive symptoms in elderly men with PD and healthy peers was similar.

“These results clearly indicate that prevalence of testosterone deficiency and hypogonadism among male patients with PD is high and significant,” the study authors note. “However, the prevalence of andropausal symptoms and depression symptoms in the population of men with PD is still unknown.”

The study also provides some insights on the hormonal behaviors that contribute to symptoms of AS and depression. “Hormonal determinants of these symptoms are different in middle-aged and elderly patients,” the researchers conclude. “Further studies are needed to establish whether androgen replacement therapy would be beneficial in prediabetic men.”