Table 2.
Relationship between chronic disease score and low total or free testosterone with sexual and psychological symptoms and with penile color Doppler parameters
| Symptom | Total patients | Patients with TT and SHBG available | ||
|---|---|---|---|---|
| Effect size (n=3862) | P | Effect size (n=1988) | P | |
| Reduced spontaneous erections, OR (95% CI) | ||||
| CDS score | 1.38 (1.29; 1.48) | <0.0001 | 1.37 (1.25; 1.50) | <0.0001 |
| Total testosterone | 1.13 (1.06; 1.21) | <0.0001 | NI | NI |
| Free testosterone | NI | NI | 1.12 (1.03; 1.23) | 0.020 |
| Severe ED, OR (95% CI) | ||||
| CDS score | 1.25 (1.13; 1.37) | <0.0001 | 1.29 (1.13; 1.46) | <0.0001 |
| Total testosterone | 1.11 (1.00; 1.23) | 0.047 | NI | NI |
| Free testosterone | NI | NI | 1.26 (1.06; 1.48) | 0.007 |
| Hypoactive sexual desire, OR (95% CI) | ||||
| CDS score | 0.91 (0.84; 0.97) | 0.008 | 0.84 (0.77; 0.93) | 0.001 |
| Total testosterone | 1.21 (1.13; 1.30) | <0.0001 | NI | NI |
| Free testosterone | NI | NI | 1.24 (1.12; 1.37) | <0.0001 |
| Flaccid PSV, β (95% CI) | ||||
| CDS score | −0.91 (−1.18; −0.65) | <0.0001 | −0.90 (−1.20; −0.61) | <0.0001 |
| Total testosterone | −0.28 (−0.54; −0.02) | 0.033 | NI | NI |
| Free testosterone | NI | NI | −0.40 (−0.74; −0.05) | 0.024 |
| Dynamic PSV, β (95% CI) | ||||
| CDS score | −3.85 (−4.64; −3.06) | <0.0001 | −4.15 (−5.11; −3.20) | <0.0001 |
| Total testosterone | −1.39 (−2.17; −0.61) | 0.001 | NI | NI |
| Free testosterone | NI | NI | −1.46 (−2.55; −0.36) | 0.009 |
| Flaccid acceleration, β (95% CI) | ||||
| CDS score | −0.19 (−0.25; −0.14) | <0.0001 | −0.21 (−0.27; −0.14) | <0.0001 |
| Total testosterone | −0.07 (−0.13; −0.01) | 0.016 | NI | NI |
| Free testosterone | NI | NI | −0.09 (−0.17; −0.02) | 0.014 |
| Phobic anxiety (MHQ-P), β (95% CI) | ||||
| CDS score | 0.23 (0.12; 0.34) | <0.0001 | 0.08 (−0.05; 0.21) | 0.225 |
| Total testosterone | 0.09 (−0.01; 0.19) | 0.066 | NI | NI |
| Free testosterone | NI | NI | 0.03 (−0.10; 0.16) | 0.674 |
| Obsessive symptoms (MHQ-O), β (95% CI) | ||||
| CDS score | 0.18 (0.02; 0.33) | 0.028 | −0.08 (−0.27; 0.10) | 0.368 |
| Total testosterone | −0.02 (−0.16; 0.12) | 0.797 | NI | NI |
| Free testosterone | NI | NI | −0.12 (−0.30; 0.06) | 0.195 |
| Somatized anxiety (MHQ-S), β (95% CI) | ||||
| CDS score | 0.25 (0.14; 0.37) | <0.0001 | 0.16 (0.01; 0.32) | 0.034 |
| Total testosterone | 0.11 (0; 0.22) | 0.042 | NI | NI |
| Free testosterone | NI | NI | 0.13 (−0.02; 0.28) | 0.099 |
| Depressive symptoms (MHQ-D), β (95% CI) | ||||
| CDS score | 0.12 (−0.02; 0.26) | 0.083 | −0.06 (−0.23; 0.11) | 0.487 |
| Total testosterone | 0.13 (0.01; 0.26) | 0.036 | NI | NI |
| Free testosterone | NI | NI | 0.05 (−0.12; 0.22) | 0.529 |
Data are derived from age-adjusted ordinal logistic regressions or linear regressions using CDS (increasing levels) and total or free testosterone (decreasing levels) transformed into Z values (number of s.d. from the mean value) in order to make the results comparable. TT: total testosterone; SHBG: sex hormone-binding globulin; NI: not introduced in the model as covariate; CDS: chronic disease score; ED: erectile dysfunction; PSV: peak systolic velocity; OR: odds ratio; CI: confidence interval; MHQ: Middlesex Hospital Questionnaire; P: phobic anxiety; O: obsessive symptoms; S: somatization; D: depressive symptoms; s.d.: standard deviations