Risk factors of testicular dysfunction in multibacillary leprosy

Objectives: The aim of the study was to observe the risk factors of testicular dysfunction in multibacillary (MB) leprosy. Methods: This cross-sectional study included 111 male MB leprosy affected people [age 42·30 ^ 14·88 years; mean ^ standard deviation (SD)] from urban leprosy clinics of The Leprosy Mission International–Bangladesh, Dhaka program and Danish-Bangla Leprosy Mission hospital in Nilphamari, Bangladesh during August 2015 to August 2016. They were receiving multi-drug therapy (MDT) for leprosy (n ¼ 42; 37·8%) or were released from treatment (RFT, n ¼ 69; 62·2%). Estimation of testosterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH) was done by the use of chemiluminescent and enzyme immunoassay. Results: Testosterone was low in 16·2% (18/111) of the participants while in 36·9% (41/111) testosterone was normal but LH and/or FSH were elevated. In comparison to participants with normal testosterone, participants with low testosterone had no significant difference of age, time since onset of leprosy symptoms, frequency of RFT or reaction [low vs. normal: age 45 (29–61) vs. 40 (30–55) years, p ¼ 0·469; time since onset of symptoms 7 (4–14) vs. 5 (3–10) years, p ¼ 0·147; median (IQR); RFT 66·7% vs. 61·3%, p ¼ 0·667; reaction 72·2% vs. 47·3%, p ¼ 0·053]; but they had higher frequency of positive bacillary index (BI), grade-II disability and lower testicular volume (low vs. normal: positive BI 78·6% vs. 48·5%, p ¼ 0·002; disability 61·1% vs. 30·1%, p ¼ 0·012; testicular volume 13·3 ^ 5·7 vs. 18·2 ^ 5·2 ml, p , 0·001; mean ^ SD). Logistic regression revealed testicular volume #15 ml as an independent predictor of low testosterone level (p ¼ 0·012). Conclusions: Positive BI, disability and low testicular volume may be regarded as risk factors of testicular dysfunction in MB leprosy affected people.