Diabetes Self-Management Blog

Men who have low testosterone levels may be at heightened risk for early death from heart disease and all causes, according to research newly published in the journal Heart. Heart disease is the leading cause of death for people with Type 2 diabetes.

Conventional wisdom holds that testosterone is a risk factor for the development of cardiovascular conditions. To determine the effect of testosterone levels in men with coronary disease and to identify what percentage of men with coronary disease have low testosterone, researchers recruited 930 men with coronary heart disease who had been referred to a heart center between 2000 and 2002. The participants’ heart health was then tracked for about 7 years.

At the start of the study, low testosterone levels were found to be fairly common, occurring in about 25% of the men. According to the measurements of bioavailable testosterone (testosterone available for body tissues to use) and total testosterone, these men had clinically defined testosterone deficiency, as opposed to a tapering of testosterone levels due to age. Over the course of the follow-up period, nearly twice as many men with low testosterone levels died as men with normal testosterone levels (20% versus 12%).

Low, rather than high, levels of testosterone are linked to obesity, dangerous blood fats, and insulin resistance, all of which are risk factors for diabetes and heart disease. (High testosterone levels found in anabolic steroids, however, are known to be harmful.) The researchers suggest that men at high risk of these conditions may stand to benefit the most from testosterone replacement therapy.

In an accompanying editorial, they state, “There has been a marked increase in prescription of testosterone over recent years. While the long-term cardiovascular impact of testosterone supplements in those with low levels remains to be demonstrated, accumulating evidence suggests there is a sound basis for examining this. Recent data suggest that this important pathway warrants a lot more attention.”

The study authors were careful to note that testosterone replacement is not without its risks, including prostate cancer in men. Further study into the effects of testosterone replacement on mortality is warranted, they conclude.

To learn more about the research, read the article “Low Testosterone Linked to Heightened Risk of Early Death” or see the study in the journal Heart.

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