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Lower Testosterone Levels Among Some Diabetic Patients May Lead to Increased Risk of Cardiovascular Disease: Presented at AACE

By John Otrompke

CHICAGO, IL -- April 27, 2006 -- Men with type 2 diabetes should have their testosterone monitored, because one third of them may have low testosterone that could be related to a significantly higher risk of cardiovascular disease, according to a poster presented here at the annual meeting of the American Association of Clinical Endocrinologists (AACE).

"Diabetes itself is a state of increased inflammation," said Vishal Bhatia, MD, endocrinology fellow and assistant professor of medicine, Southern University of New York (SUNY), Buffalo, New York, United States. "It is also possible that testosterone deficiency may lead to abdominal obesity and the generation of an excess of pro-inflammatory factors," the researchers stated in their poster.

The study, which involves 125 men, is a collaboration between SUNY and Midland Medical Center in Texas. Their median age is 35, Dr. Bhatia said.

"It has previously been shown that 33% of males with type 2 diabetes have low testosterone," Dr. Bhatia said. He noted that semen analysis performed as part of the study indicated reduced sperm motility, but the question remains to be answered until final results are available in another 8 to 11 months. Among the men in the study, 36.8% were found to have low testosterone, he said.

Seven percent of American men have diabetes, so 7 million men in the U.S. may have low testosterone levels, Dr. Bhatia said.

In the study, the diabetic men who had low testosterone levels had C-reactive protein measurements of 6.12, while among all male diabetic patients the average level was 3.1, the poster said.

"These patients have more than double the risk of vascular inflammation or cardiovascular disease, including heart attack or stroke," Dr. Bhatia said. Nonetheless, even those diabetic men with normal testosterone levels have a high risk of cardiovascular disease.

Dr. Bhatia said that two theories may explain the apparent correlation between reduced levels of testosterone and increased inflammation in these patients. "It is possible that the inflammation is decreasing signaling from the insulin receptor in the hypothalamic-pituitary axis, leading to decreased testosterone," he said, noting that the reduced testosterone may also cause the increased vascular inflammation.


[Presentation title: Impact of Hypogonadotrophic Hypogonadism on Inflammation and Hemoglobin in Patients with Type 2 Diabetes. Abstract 200]

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