Diabetic Men With Low Levels of Testosterone are at a Higher Risk of Developing Atherosclerosis

A latest study shows that men with type-2 diabetes and low testosterone levels are more likely to suffer from atherosclerosis.

Atherosclerosis, also known as vascular disease, takes a huge toll on our society. It is a condition that is characterized by hardening of the arteries. This disease builds up inside the arteries and become clogged up by fatty substances called plaques or atheroma. This is a slow progressive disease that begins in childhood and progresses rapidly in the 30s. This is the most common cause for heart attack and stroke.

In the latest study, led by researchers at the Hospital Universitario Sanatorio Guemes in Buenos Aires, Argentina, it was found that men with low levels of testosterone as well as type-2 diabetes, face a higher risk of developing atherosclerosis as compared to those who have diabetes and normal testosterone levels.

"Our study indicates a strong association between low testosterone concentration and the severity of atherosclerotic plaques as well as other key atherosclerotic markers in middle-aged men with type-2 diabetes," said one of the study authors, Javier Mauricio Farias, MD, of the Hospital Universitario Sanatorio Guemes in Buenos Aires. "The results of our study advance our understanding of the interplay between low testosterone and cardiovascular disease in patients with diabetes."

Studies conducted in the past have highlighted concerns regarding the safety of testosterone therapy as well as the risk of cardiovascular complications. This has a significant public health implication as the number of the older men receiving testosterone replacement therapy had increased in the past decade.

However, the Endocrine Society recommends that the testosterone therapy should be reserved for those men with clinical symptoms of hypogonadism and low levels of testosterone.

In this cross-sectional prospective study, the researchers evaluated the levels of testosterone and the key atherosclerotic markers that included intimal media thickening of layers in the carotid artery, the presence of atherosclerotic plaques, functions of the endothelial cells that line the heart and blood vessels, inflammatory markers in 115 men with type-2 diabetes.

The study participants were younger than 70 years and had no history of cardiovascular disease. The researchers also measured the levels of testosterone in the blood sample. Among the participants, more than half of them with diabetes were found to have low testosterone levels.

The researchers observed that men with low testosterone and type-2 diabetes had a six fold increased risk of having thick carotid artery and endothelium dysfunction. Nearly 54 percent of the men with low testosterone and 10 percent of the men with normal testosterone had a higher risk of vascular disease.

"We still need to determine whether testosterone is directly involved in the development of atherosclerosis or if it is merely an indicator of advanced disease," Farias said. "This study is a stepping stone to better understanding the risks of cardiovascular events in men who have both low testosterone and type-2 diabetes."

The study was documented in the Journal of Clinical Endocrinology & Metabolism.