Nelson Vergel
Founder, ExcelMale.com
Effect of Testosterone Therapy on Cardiovascular and Thrombotic Events in Hypogonad Men with T2DM
Program: Abstracts - Orals, Poster Previews, and Posters
Session: SAT 134-160-Male Reproductive Endocrinology and Male Reproductive Tract (posters)
Bench to Bedside
ENDO 2016 Meeting. Saturday, April 2, 2016: 1:15 PM-3:15 PM
Exhibit/Poster Hall (BCEC)
Poster Board SAT 154
Maria Escobar Vasco[SUP]*[/SUP][SUP]1[/SUP], Devjit Tripathy[SUP]2[/SUP], Sheila Pinkson[SUP]3[/SUP] and Maureen Koops[SUP]4[/SUP]
[SUP]1[/SUP]University of Texas Health Science Center, San Antonio, TX, [SUP]2[/SUP]South Texas Veteran's Health Care System, San Antonio, TX, [SUP]3[/SUP]South Texas Veterans Health Care System, San Antonio, TX, [SUP]4[/SUP]University of Texas Health Science Center San Antonio, San Antonio, TX
Introduction: Approximately 25-40% of men with type 2 diabetes have low testosterone concentrations. The data on risk of cardiovascular events in patients on testosterone replacement in Veterans is controversial. While one study showed reduced mortality and cardiovascular (CV) events, a recent study suggests that testosterone replacement therapy was associated with increased cardiovascular events. Since there are also isolated reports of increased thrombotic events with testosterone therapy, the aim of this study was to evaluate the incidence of venous thromboembolism (deep venous thrombosis (DVT) and pulmonary embolism (PE), and acute coronary syndromes (ACS) in patients with T2DM on testosterone replacement therapy.
Methods: We reviewed the records of 140 veterans attending the VA Diabetes clinic (South Texas Veterans Heath Care System) who had total and free testosterone, LH, FSH, and prolactin levels measured. Data on incidence of DVT, PE and ACS was analyzed in all subjects who were followed for at least 6 months.
Results: The mean age was 55 ± 0.5 years (range 23-82yrs), BMI was 33 ± 0.5 kg/m[SUP]2[/SUP] and mean HbA[SUB]1c[/SUB] was 8.2 ± 0.2%. Sixty nine percent (98/140) of men with T2DM were hypogonadal (T testosterone <300ng/dl). Sixty two individuals with T2DM had received testosterone therapy while 78 (37 hypogonad and 41 eugonad) were not on testosterone therapy. The mean duration of follow-up for patients on testosterone was 4.5± 1.5 years (range 6months- 16 years) and for those not on testosterone, the duration was 3.5 ± 0.5 years (range 6 months - 6 years). Of the 62 hypogonadal men on testosterone replacement therapy, 1 individual had a DVT diagnosed during therapy. Of note this subject also had a diagnosis of active malignancy at the time of the event. There were no reports of ACS, or PE in patients on testosterone replacement therapy. There were no CV events or DVT in hypogonadal or eugonadal subjects with T2DM who were not on testosterone therapy.
Conclusion: Although the number of events was low, our study did not show increased CV events or VTE with testosterone replacement in hypogonadal men with T2DM followed for 3.5 years. Randomized controlled trials with longer follow-up are needed to examine the effect of testosterone replacement on CV events in T2DM.
Program: Abstracts - Orals, Poster Previews, and Posters
Session: SAT 134-160-Male Reproductive Endocrinology and Male Reproductive Tract (posters)
Bench to Bedside
ENDO 2016 Meeting. Saturday, April 2, 2016: 1:15 PM-3:15 PM
Exhibit/Poster Hall (BCEC)
Poster Board SAT 154
Maria Escobar Vasco[SUP]*[/SUP][SUP]1[/SUP], Devjit Tripathy[SUP]2[/SUP], Sheila Pinkson[SUP]3[/SUP] and Maureen Koops[SUP]4[/SUP]
[SUP]1[/SUP]University of Texas Health Science Center, San Antonio, TX, [SUP]2[/SUP]South Texas Veteran's Health Care System, San Antonio, TX, [SUP]3[/SUP]South Texas Veterans Health Care System, San Antonio, TX, [SUP]4[/SUP]University of Texas Health Science Center San Antonio, San Antonio, TX
Introduction: Approximately 25-40% of men with type 2 diabetes have low testosterone concentrations. The data on risk of cardiovascular events in patients on testosterone replacement in Veterans is controversial. While one study showed reduced mortality and cardiovascular (CV) events, a recent study suggests that testosterone replacement therapy was associated with increased cardiovascular events. Since there are also isolated reports of increased thrombotic events with testosterone therapy, the aim of this study was to evaluate the incidence of venous thromboembolism (deep venous thrombosis (DVT) and pulmonary embolism (PE), and acute coronary syndromes (ACS) in patients with T2DM on testosterone replacement therapy.
Methods: We reviewed the records of 140 veterans attending the VA Diabetes clinic (South Texas Veterans Heath Care System) who had total and free testosterone, LH, FSH, and prolactin levels measured. Data on incidence of DVT, PE and ACS was analyzed in all subjects who were followed for at least 6 months.
Results: The mean age was 55 ± 0.5 years (range 23-82yrs), BMI was 33 ± 0.5 kg/m[SUP]2[/SUP] and mean HbA[SUB]1c[/SUB] was 8.2 ± 0.2%. Sixty nine percent (98/140) of men with T2DM were hypogonadal (T testosterone <300ng/dl). Sixty two individuals with T2DM had received testosterone therapy while 78 (37 hypogonad and 41 eugonad) were not on testosterone therapy. The mean duration of follow-up for patients on testosterone was 4.5± 1.5 years (range 6months- 16 years) and for those not on testosterone, the duration was 3.5 ± 0.5 years (range 6 months - 6 years). Of the 62 hypogonadal men on testosterone replacement therapy, 1 individual had a DVT diagnosed during therapy. Of note this subject also had a diagnosis of active malignancy at the time of the event. There were no reports of ACS, or PE in patients on testosterone replacement therapy. There were no CV events or DVT in hypogonadal or eugonadal subjects with T2DM who were not on testosterone therapy.
Conclusion: Although the number of events was low, our study did not show increased CV events or VTE with testosterone replacement in hypogonadal men with T2DM followed for 3.5 years. Randomized controlled trials with longer follow-up are needed to examine the effect of testosterone replacement on CV events in T2DM.
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