Endocrine Abstracts

Background: In men with type 2 diabetes there is high prevalence of low levels of testosterone. There is accumulating evidence that low testosterone levels are associated with greater morbidity and mortality. There is no published data regarding mortality among men with type 2 diabetes in relation to testosterone levels.

Aim: We report preliminary findings from our 4 to 7 years follow up study to examine the effect of baseline testosterone on all cause mortality in men with type 2 diabetes.

Methods: A total of 587 patients with type 2 diabetes who had testosterone levels done between 2002 and 2004 were followed up for a mean period of 5.8 years (SD1.3).

Patients who died in the first 6 months of screening were excluded. Patients were analysed in three groups: i) with normal TT levels (above 12 nmol/l) ii) with borderline TT (between 8 to 12 nmol/) levels and iii) low TT levels (below 8 nmol/l).

Results: Of the 587 patients 277 (47%) had normal TT levels, 179 (30%) borderline low TT levels and 131 (22%) had low TT levels. Mean age was 60 (SD11) and they were similarly matched in three groups. 72 (12.2%) deaths occurred during the follow up period. The mortality was highest in low TT group compared to that with normal TT (27 out of 131 (21%) versus 26 out of 277 (9.4%)).

In the Kaplan–Meier model, survival was significantly decreased from 49 months (SE 3.8) in normal TT group to 37 months (SE 2) in patients with low TT (P=0.041). In the Cox regression model of the age adjusted survival was significantly lower (Hazard ratio=1.4, P=0.015) in patients with low testosterone in comparison with those with a normal TT levels.

Conclusions: This data shows that in men with type 2 diabetes low levels of testosterone is associated with significant increase in mortality.