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Impact of Low Concentration of Serum Testosterone on Acute Myocardial Infarction in T2 Patients

More trials needed to determine cardiovascular outcomes…

Testosterone decreases with age. Previous studies show that low concentration can predict obesity and diabetes independently. Other studies showed that a decrease in testosterone can be linked with cardiovascular mortality in elderly populations. Recent studies show that testosterone replacement treatment in patients with type 2 diabetes decreases insulin resistance and LDL cholesterol. These studies show the correlation between low testosterone concentration, type 2 diabetes and LDL cholesterol. However, there is lack of investigation on the correlation between testosterone concentrations and acute myocardial infarction in patients with diabetes.

The purpose of the present study is to observe the correlation between serum testosterone concentrations and the occurrence of acute myocardial infarction in patients with and without type 2 diabetes. The study consisted of 1,109 participants >40 years of age. Serum concentrations of testosterone and sex hormone were recorded at baseline and at first cardiovascular event or death. Serum concentrations of testosterone and sex hormone was measured using immunoassay. The data collected was analyzed using Cox proportional Hazards Regression to determine a correlation between sex hormone at baseline and outcomes.

The results showed that decrease in testosterone levels was associated with acute myocardial infarction mortality in men with type 2 diabetes (HR = 0.86 CI (0.75–0.98). In women, the trends were not statistically significant for the association between testosterone and acute myocardial infarction (HR = 0.722. 95% CI 0.52–1.00, p = 0.046). The results also showed that in a final model also including waist-to-hip ratio, systolic blood pressure, total cholesterol and active smoking, the association still remained statistically significant (HR = 0.754 CI (0.61–0.92).

To conclude, low concentrations of testosterone can predict acute myocardial infarction in men with type 2 diabetes. The results are still lacking regarding cardiovascular outcomes and more trials needs to be conducted to clear the uncertainty.

Practice Pearls:

  • Men with low concentration of testosterone may be at risk of an acute myocardial infarction.
  • Low concentration of testosterone is linked with insulin resistance and LDL cholesterol.
  • This study showed no association of low testosterone concentration and acute myocardial infarction in women with and without diabetes.

Daka B, Langer RD, Larsson CA, et al. “Low concentrations of serum testosterone predict acute myocardial infarction in men with type 2 diabetes mellitus.” BMC Endocr Disord. 2015;15:35.