7579 Testicular Volume in Children and Adolescents with Type 1 Diabetes Mellitus: A Retrospective Controlled Study
Authors: Cannarella Rossella , Crafa Andrea , Curto Roberto , Costanza Giuseppe , Presti Donatella Lo , La Vignera Sandro , Caruso Manuela C M , Calogero Aldo E 
Published: October 2024

Disclosure: R. Cannarella: None. A. Crafa: None. R. Curto: None. G. Costanza: None. D. Lo Presti: None. S. La Vignera: None. M.C. Caruso: None. A.E. Calogero: None.

Background: The impact of type 1 diabetes mellitus (T1DM) and glycemic control on testicular growth in childhood and adolescence is unknown. Understanding this is important as impaired testicular growth during childhood could negatively influence reproductive potential in adulthood. Objective: This retrospective cross-sectional study was undertaken to evaluate the impact of T1DM and glucose control on testicular volume (TV) in prepubertal (&lt;9 years), peri-pubertal (9-14 years), and post-pubertal (14-16 years) ages. Patients and Methods: We recruited children and adolescents aged between 2 and 18 years, referred to the Unit of Pediatric Endocrinology, University of Catania, for T1DM. Data on TV, age, and glycated hemoglobin (HbA1c) were collected. A cohort of healthy normal-weight children/adolescents in whom TV data were available served as controls. Exclusion criteria were: genetic abnormalities, drug intake (except for insulin in the patient group), radiotherapy, chemotherapy, head or testicular trauma, systemic disorders (i.e., kidney and/or liver diseases), endocrine disorders such as hypogonadism, hyperprolactinemia, Cushing syndrome, acromegaly, hypopituitarism, hypostaturalism, and puberty disorders. The primary outcome was TV (measured with the Prader orchidometer by the same operator), which was analyzed in age-matched subgroups (age &lt;9 years, 9 years ≤ age &lt; 14 years, and age ≥14 years). Between-group analysis was performed using the Student’s t-test for independent samples or the Mann-Whitney test for normally or non-normally distributed variables, respectively. To further understand the impact of glycemic control on testicular growth, TV was analyzed by HbA1c value (≥7% or &lt;7%) among age-related patient subgroups, with one-way analysis of variance or Kruskal-Wallis tests, for normally or non-normally distributed variables, respectively. Results: Seventy-three T1DM patients (11.2±4.2 years) and 95 age-matched controls (9.7±3.3 years) were recruited. Patients showed a mean HbA1c of 8.2±2.0%. TV was not significantly different between patients and controls in the &lt;9 years subgroup (2.3±0.8 mL vs. 2.0±0.6 mL; p=0.07), as well as in the 9-to-14-year (6.6±5.5 mL vs. 7.8±5.5 mL; p=0.12), and ≥14-year (18.7±2.6 mL vs. 15.0±5.6 mL; p=0.09) subgroups. HbA1c values were found to influence testicular growth of patients younger than 9 years, with significantly lower TV for HbA1c values &gt;7% compared to those ≤7% (1.8±0.6 mL vs. 2.8±0.6 mL; p=0.003). No differences were found in the other age subgroups. Conclusion: This study provides the first evidence of the effects of T1DM on testicular growth in childhood and adolescence. Poor glucose control appears to negatively influence testicular growth in prepubertal children with T1DM, in line with preclinical evidence showing the effect of insulin on the proliferation of immature Sertoli cells.

Presentation: 6/2/2024