Men with type 2 diabetes are at higher risk of developing atherosclerosis if they have low rather than normal levels of testosterone, according to a study published in the Journal of Clinical Endocrinology & Metabolism (JCEM).
The study included 115 men younger than 70 years who had type 2 diabetes and no history of cardiovascular events.
Compared with men who had normal testosterone levels (3.5 ng/mL or higher), those with low total testosterone levels (less than 3.5 ng/mL) had a significantly higher proportion of patients with a carotid artery intima-media thickness (IMT) of 0.1 cm or greater (80% vs. 39%), atherosclerotic plaques (68.5% vs. 44.8%), and endothelial dysfunction (80.5% vs. 42.3%).
They also had significantly higher levels of highly sensitive C-reactive protein (2.74 vs. 0.89 mg/dL). Results were similar for free testosterone.
The researchers identified the presence of atherosclerotic plaques using high resolution ultrasound and assessed endothelial function with brachial artery flow-mediated dilation.
In adjusted analyses, low total testosterone was independently associated with 8.4 times increased odds of greater IMT and 5.2 times increased odds of endothelial dysfunction, but not atherosclerotic plaques.
“The results of our study advance our understanding of the interplay between low testosterone and cardiovascular disease in patients with diabetes,” study author Javier Mauricio Farias, MD, of the Hospital Universitario Sanatorio Guemes in Buenos Aires, Argentina, said in a press release issued by the Endocrine Society, which publishes JCEM.