OBJECTIVE -There is evidence to suggest that low concentrations of testosterone are associated with an increased risk of cardiovascular disease in men. The aim of this study was to evaluate the relationship between serum testosterone concentration and carotid atherosclerosis as well as major cardiovascular risk factors in men with type 2 diabetes.RESEARCH DESIGN AND METHODS -Serum free and total testosterone concentrations were measured in 253 consecutive men with type 2 diabetes. The relationships between serum testosterone concentration and carotid atherosclerosis, determined by ultrasonographically evaluated intima-media thickness (IMT) and plaque score (PS) in a subgroup of 154 diabetic patients, as well as major cardiovascular risk factors, including age, blood pressure, and lipid concentrations, were evaluated.RESULTS -Inverse correlations were found between free testosterone (F-tes) concentration and IMT (r ϭ Ϫ0.206, P ϭ 0.0103) and between F-tes concentration and PS (r ϭ Ϫ0.334, P Ͻ 0.001). The IMT and PS were significantly greater in patients with lower concentrations of F-tes (Ͻ10 pg/ml) than in patients with higher concentrations of F-tes (1.01 Ϯ 0.29 vs. 0.91 Ϯ 0.26 mm, P ϭ 0.038; 4.5 Ϯ 3.8 vs. 2.4 Ϯ 3.2, P ϭ 0.0003; respectively). An inverse correlation was found between serum F-tes concentration and age (r ϭ Ϫ0.420, P Ͻ 0.0001). A positive correlation was found between serum F-tes and total cholesterol concentrations (r ϭ 0.145, P ϭ 0.0238).CONCLUSIONS -Serum F-tes concentration is inversely associated with carotid atherosclerosis determined by ultrasonographically evaluated IMT and PS in men with type 2 diabetes.
Abstract. Low concentrations of endogenous androgens have been linked with insulin resistance and atherosclerosis. Men with diabetes have been reported to have lower serum testosterone concentration than non-diabetic men; however, there has never been a large study. The aim of this study was to investigate if endogenous androgen concentration is certainly lower in a relatively large number of Japanese patients with type 2 diabetes compared with healthy men, and to identify what factors may be associated with low serum testosterone concentrations in men with type 2 diabetes. Serum free testosterone concentrations were measured in 524 healthy men and in 331 consecutive Japanese men with type 2 diabetes between 40 and 69 years old. In addition, we investigated the relationships between serum free testosterone concentration and luteinizing hormone (LH) concentration as well as major cardiovascular risk factors including age, blood pressure, plasma lipid concentration, glycemic control (HbA 1c ), and BMI. Serum free testosterone concentrations were lower in men with type 2 diabetes than in healthy men in the 40-49 years group (10.9 ± 3.3 vs. 14.0 ± 3.6 pg/ml, P<0.0001), in the 50-59 years group (10.4 ± 3.2 vs. 12.1 ± 2.9 pg/ml, P<0.0001), and in the 60-69 years group (9.5 ± 2.6 vs. 10.5 ± 2.9 pg/ml, P = 0.0104). A negative correlation was found between serum free testosterone and LH concentrations (r = -0.326, P<0.0001). In conclusion, serum free testosterone concentration is certainly lower in a relatively large number of Japanese patients with type 2 diabetes compared with healthy men with each decade of life between 40 and 69 years old.
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