Testosterone deficiency is associated with increased risk of mortality and testosterone replacement improves survival in men with type 2 diabetes - Abstract

Objective: Men with type 2 diabetes are known to have a high prevalence of testosterone deficiency.

No long term data is available regarding testosterone and mortality in men with type 2 diabetes or any effect of testosterone replacement therapy (TRT). We report a 6 year follow up study to examine the effect of baseline testosterone and TRT on all cause mortality in men with type 2 diabetes and low testosterone.

Research Design and Methods: 581 men with type 2 diabetes who had testosterone levels performed between 2002 and 2005 were followed up for a mean period of 5.8+1.3SD years. Mortality rates were compared between total testosterone (T) >10.4nmol/l (300ng/dl) (n=343) and T < 10.4nmol/L (n=238). The effect of TRT (as per normal clinical practise; 85.9% testosterone gel; 14.1% intramuscular testosterone undecanoate) was assessed retrospectively within the low testosterone group.

Results: Mortality was increased in the low T group (17.2%) compared to the normal T group (9%; p=0.003) when controlled for co-variates. In the Cox regression model multivariate adjusted hazard ratio for decreased survival was 2.02 (p= 0.009, 95%CI 1.2-3.4). TRT (mean duration 41.6+20.7 months; n=64) was associated with a reduced mortality of 8.4% compared to 19.2% (p=0.002) in the untreated group (n=174). The multivariate adjusted hazard ratio for decreased survival in the un-treated group was 2.3(95% CI 1.3 to 3.9, p=0.004).

Conclusions: Low testosterone levels predict an increase in all-cause mortality during long-term follow up. Testosterone replacement may improve survival in hypogonadal men with type 2 diabetes.

Written by:
Muraleedharan V, Marsh H, Kapoor D, Channer KS, Jones TH.   Are you the author?
V Muraleedharan, Diabetes, Barnsley Hospital NHSFT, Barnsley, United Kingdom.

Reference: Eur J Endocrinol. 2013 Sep 2. Epub ahead of print.
doi: 10.1530/EJE-13-0321


PubMed Abstract
PMID: 23999642

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