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Diabetes in Men with Low Testosterone Indicates Heart Attack Risk: Study

Men who have low testosterone and Type 2 diabetes are more likely to have atherosclerosis – a condition where plaque builds up in the arteries – than men who have diabetes and normal testosterone levels, according to new findings by researchers.

"The results of our study advance our understanding of the interplay between low testosterone and cardiovascular disease in patients with diabetes," said study co-author Javier Mauricio Farias from Hospital Universitario Sanatorio Guemes in Argentina. However, the magnitude of this association in middle-aged patients with type 2 diabetes (T2D) has not been determined, said the abstract of the paper published in the Journal of Clinical Endocrinology & Metabolism (JCEM).

Atherosclerosis occurs when fats, cholesterol and other substances build up in and on the walls of the body’s arteriesa and restrict blood flow through the vessels. The plaques also can burst and cause blood clots.

"Our study indicates a strong association between low testosterone concentration and the severity of atherosclerotic plaques as well as other key atherosclerotic markers in middle-aged men with Type 2 diabetes," Farias added.

The study involved 115 men with Type 2 diabetes aged below 70years of age and had no history of cardiovascular disease. The results showed that men who had low testosterone and Type 2 diabetes were six times more likely to have increased thickness of the carotid artery and endothelium dysfunction compared to men with normal serum testosterone (T) levels.

The cross-sectional study evaluated atherosclerotic disease markers in patients with normal (≥3.5 ng/mL (≥12.1 nmol/L), n = 79) or low (< 3.5 ng/mL (≤12.1 nmol/L), n = 36) and the total T underwent the measurement of highly sensitive C-reactive protein, carotid artery carotid intima-media thickness (IMT), and atherosclerotic plaque by high-resolution B-mode ultrasound and to asses endothelial function by brachial artery flow-mediated dilation.

The results showed that Carotid IMT was negatively correlated with total T concentration (r = −0.39, P < .0001). Compared with subjects with normal T, a higher proportion of patients with low total T had carotid IMT of 0.1 cm or greater [80% vs 39%, odds ratio (OR) 6.41; 95% CI 2.5–16.4, P < .0001], atherosclerotic plaques (68.5% vs 44.8%, OR 2.60, 95% CI 1.12–6.03, P < .0001); endothelial dysfunction (80.5% vs 42.3%, OR 5.77, 95% CI 2.77–14.77, P < .003), and higher highly sensitive C-reactive protein levels (2.74 ± 5.82 vs 0.89 ± 0.88 mg/L, P < .0001).

Similar results were found when free T was considered. Multiple logistic regression analyses adjusted for age, diabetes mellitus duration, hemoglobin A1c, lipids, treatment effect, and body mass index reported that a low total T level was independently associated with greater IMT [OR 8.43 (95% CI 2.5–25.8)] and endothelial dysfunction [OR 5.21 (95% CI 1.73–15.66)] but not with the presence of atherosclerotic plaques (OR 1.77, 95% CI 0.66–4.74).

(With inputs from IANS)


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