Low Testosterone and Type-2 Diabetes tied to Higher Vascular Risk

2014-11-06

Doctors have long seen a connection between type-2 diabetes, vascular problems and erectile dysfunction. But this is the first study to connect the other two with low levels of the male hormone. This was a cross-sectional study. All participants had type-2 diabetes, low serum testosterone levels—the kind that freely roams the bloodstream, and had a greater risk of thickening of the carotid artery. This is the one leading to the brain. Blood clots in this blood vessel can cause a stroke. These participants had six times greater risk of what is known as carotid artery intima media thickness (CIMT). 31% of the participants had low testosterone which was linked to a higher risk of vascular disease, known in medical terminology as atherosclerosis. The study was conducted by the Hospital Universitario Sanatorio Guemes in Buenos Aires, Argentina, in conjunction with Emory University in the U.S. The results were published online in the peer-reviewed Journal of Clinical Endocrinology & Metabolism.

Dr. Javier Mauricio Farias was the lead author of the study. Emory’s Dr. Guillermo E. Umpierrez co-authored. Umppierrez said in a statement, “Several cross-sectional studies have reported that about one-third of adult patients with obesity and type 2 diabetes have low serum testosterone.” He added, “Our study indicates a strong association between cardiovascular disease and low testosterone but does not prove causation.” The authors note that few studies have looked at a link between low testosterone, atherosclerosis and type-2 diabetes, before. Doctors say that the choice to administer testosterone replacement therapy, in hopes of saving men with these combined conditions, is controversial and up to their physician’s discretion. The researchers wrote, “Prospective randomized studies are needed to assess the clinical significance of our findings and the clinical impact of testosterone replacement on cardiovascular risk factors in diabetic patients with low total testosterone.” The role of testosterone replacement therapy (TRT) was not included in this study. However Dr. Umpierrez noted, “In elderly patients with evidence of atherosclerosis, testosterone replacement has not been shown to be of benefit and may even increase the risk of cardiovascular events.”