Kota et al performed a follow-up of 260 patients with T1DM for 14 years and found that 5.4% of patients with T1DM developed hypogonadal disease.[19] Autoimmune hypogonadism is common in women, with a male to female ratio of 1:3, which may be related to the male-specific blood testis barrier that protects the testes from autoantibody damage, there are also studies suggesting that this may be related to female pregnancy, ovarian secretion of hormones, and (or) the genetic effect of the second X chromosome.[20] Gonadal-specific antigens include 2 steroidogenic enzymes: 17-α-OH and P450scc. The gene discussed is CYP11A1; the disease is type 1 diabetes mellitus.