Performance of the Androgen Deficiency in Aging Male questionnaire for the clinical detection of androgen deficiency in black sub-Saharan African men with Type-2 diabetes mellitus

  • Theophilus Ejiofor Ugwu Enugu State University of Technology
  • Rosemary Temitope Ikem Obafemi Awolowo University
Keywords: ADAM, androgen, testosterone, type 2 diabetes, Nigeria, Africa

Abstract

Background: The Androgen Deficiency in Aging Male (ADAM) questionnaire is increasingly popular for evaluation of androgen deficiency (AD) in sub-Saharan African men with type 2 diabetes mellitus (DM). However, its reliability in this population is unknown. Methods: Total testosterone < 8 nmol/L was used as the gold standard for diagnosis of AD in this cross-sectional survey of 200 type 2 DM males aged 30–69 years. Participants also completed the Saint Louis University ADAM questionnaire whereby AD was diagnosed by a ‘yes’ answer to question 1 (reduced libido) or 7 (erectile dysfunction) or any other three questions. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy of the ADAM tool were computed. Results: The mean age of the participants was 58.0 ± 8.8 years. A total of 142 subjects (71.0%) had AD based on the ADAM questionnaire. However, AD was biochemically confirmed in 59 subjects (29.5%). The ADAM questionnaire rendered a sensitivity of 88.1%, specificity of 44.7%, PPV of 50.0%, NPV of 85.7% and accuracy of 61.4%. Conclusion: Despite an impressive sensitivity, the low specificity and overall accuracy of the ADAM questionnaire makes it unreliable for the detection of AD in sub-Saharan African men with type 2 DM. (Full text available online at www.medpharm.tandfonline.com/oemd) Journal of Endocrinology, Metabolism and Diabetes of South Africa 2017; DOI: 10.1080/16089677.2017.1318534

Author Biographies

Theophilus Ejiofor Ugwu, Enugu State University of Technology
Department of Medicine Enugu State University of Technology Enugu
Rosemary Temitope Ikem, Obafemi Awolowo University
Department of Medicine Obafemi Awolowo University Ile Ife
Published
2017-05-05
Section
Original Research