Testosterone Levels and Type 2 Diabetes—No Correlation with Age, Differential Predictive Value in Men and Women

Abstract

Most studies reporting on the association of circulating testosterone levels with type 2 diabetes in men are of cross-sectional design. Reports on the relevance of altered testosterone levels in women are scarce. Here, we evaluate the role of low serum testosterone levels for incident diabetes in men and women in a population setting of 7706 subjects (3896 females). During a mean follow up time of 13.8 years, 7.8% developed type 2 diabetes. Significant correlations of testosterone with high density lipoprotein (HDL)-cholesterol (R = 0.21, p < 0.001), body-mass-index (R = −0.23, p < 0.001), and waist-to-hip-ratio (R = −0.21, p < 0.001) were found in men. No correlation was found with age in men; in women, the correlation was negligible (R = 0.04, p = 0.012). In men, low testosterone levels predicted high risk of type 2 diabetes, while in women this relationship was opposite. Men with low testosterone levels showed increased risk of future diabetes (hazard ratio (HR) 2.66, 95% confidence interval (CI) 1.91–3.72, p < 0.001 in basic model; HR 1.56 95%, CI 1.10–2.21, p = 0.003). In women, low testosterone levels indicated lower risk with (HR 0.53, 95% CI 0.37–0.77, p = 0.003), while the association lost significance in the fully adjusted model (HR 0.72, 95% CI 0.49–1.05, p = 0.09). Low levels of testosterone predicted future diabetes in men. A borderline opposite association was found in women.

Predictive value of low testosterone concentrations regarding coronary heart disease and mortality in men and women – evidence from the FINRISK97 study

“…By its strict methodological approach and its prospective design with long‐term follow‐up of almost 14 years and large sample size, as well as the inclusion of women, our study delivers very strong evidence on the irrelevance of low testosterone levels regarding future CHD risk and mortality. These results seem surprising in view of two previous reports of the FINRISK97 study, linking low testosterone levels to incident diabetes and also atrial fibrillation and subsequent stroke in men . However, in contrast to CHD, for both entities, distinct testosterone‐based pathomechanisms are well understood.…”

“…Regarding increased risk of diabetes, this might be mediated by obesity: as shown in Table , the strongest (in this case inverse) correlation for testosterone was found for BMI and WHR. Obese men show the enhanced conversion of androstenedione to estrogens by aromatization, which occurs due to adipose tissue‐driven elevated aromatase levels . Other studies in rodents and humans documented that metabolic endotoxemia leads to a decline in gonadal function, and that leptin, which is produced by adipose tissue, inhibits testosterone secretion from the Leydig cells .…”

“…The relevance of low testosterone concentrations has been evaluated in multiple studies . The volume of evidence that links low testosterone levels with coronary heart disease (CHD) and mortality has been steadily growing during the last two decades .…”

Association of serum testosterone with different classes of glucose metabolism and the mediation effect of obesity: The Henan Rural Cohort Study

“…Our findings strengthen these hypotheses only in males instead of females. That might be due to a significant difference in testosterone levels between healthy males and females . Our data indicate that, among female patients, the serum testosterone levels were negatively associated with T2DM and insulin resistance, while obesity played a role in this relationship.…”

Ginger and Testosterone

“…In addition, testosterone is involved in general health and well-being [23]. Insufficient levels of testosterone in men are linked with a wide range of disorders/diseases such as infertility [24], diabetes [25], osteoporosis [26], and bone loss [27]. Therefore, several in vivo studies have investigated various dietary supplements as well as medicinal plants on the level of testosterone in males.…”