The association between serum total testosterone and progression of hyperglycemia: a 15-year prospective cohort study

madman

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ABSTRACT

Background: The association between low testosterone concentration and increased risk of hyperglycemia in men has been demonstrated in observational and interventional studies. However, considering a variety of confounding factors, limited population-based studies have so far been conducted. Also, no information is available regarding the effect of testosterone on progressive development of dysglycemia.

Objective: To examine the effect of total testosterone on development of pre-diabetes/diabetes in normoglycemic middle-aged and older men. Materials and Methods: Data were obtained from the Tehran Lipid and Glucose Study, a community-based prospective cohort of an Iranian population. Analyses were conducted on 903 normoglycemic eligible men aged 30–70 years. An illness-death model was applied to estimate the probabilities of three transitional phases of normoglycemia?diabetes, normoglycemia?pre-diabetes, and pre-diabetes?diabetes.

Results: Over a median follow-up of 12 years, 0.9% individuals developed diabetes. Per unit increase (ng/mL) in testosterone concentration, the transition rate from normoglycemia to pre-diabetes decreased by 6% [hazard ratios (HRs): 0.94 (95% confidence interval (CI): 0.90, 0.99)]. However, no effect for testosterone on the progression of diabetes from normoglycemia or pre-diabetes was observed [HRs: 0.79 (95% CI: 0.44, 1.41) and 0.98 (95% CI: 0.84, 1.16), respectively]. High body mass index was a strong predictor of hyperglycemia within all transitions.

Discussion: Independent of major confounding factors, low testosterone was associated with normoglycemia progression to prediabetes, but not with pre-diabetes to diabetes, which might indirectly highlight the stronger impact of other risk factors after occurrence of pre-diabetes.

Conclusion: Low testosterone concentrations in men are associated with progression from normoglycemia to pre-diabetes, but not from pre-diabetes to diabetes.




CONCLUSION
Our findings show that testosterone’s effect on development of dysglycemia is basically reflected through prevention of prediabetes in normoglycemic men.
Following occurrence of prediabetes, testosterone’s effect is insignificant and stronger risk factors other than testosterone seem to influence diabetes development. These findings may help to diagnose men at risk of pre-/diabetes and provide rationale for replacement therapy in older men.
 

Attachments

ABSTRACT

Background: The association between low testosterone concentration and increased risk of hyperglycemia in men has been demonstrated in observational and interventional studies. However, considering a variety of confounding factors, limited population-based studies have so far been conducted. Also, no information is available regarding the effect of testosterone on progressive development of dysglycemia.

Objective: To examine the effect of total testosterone on development of pre-diabetes/diabetes in normoglycemic middle-aged and older men. Materials and Methods: Data were obtained from the Tehran Lipid and Glucose Study, a community-based prospective cohort of an Iranian population. Analyses were conducted on 903 normoglycemic eligible men aged 30–70 years. An illness-death model was applied to estimate the probabilities of three transitional phases of normoglycemia?diabetes, normoglycemia?pre-diabetes, and pre-diabetes?diabetes.

Results: Over a median follow-up of 12 years, 0.9% individuals developed diabetes. Per unit increase (ng/mL) in testosterone concentration, the transition rate from normoglycemia to pre-diabetes decreased by 6% [hazard ratios (HRs): 0.94 (95% confidence interval (CI): 0.90, 0.99)]. However, no effect for testosterone on the progression of diabetes from normoglycemia or pre-diabetes was observed [HRs: 0.79 (95% CI: 0.44, 1.41) and 0.98 (95% CI: 0.84, 1.16), respectively]. High body mass index was a strong predictor of hyperglycemia within all transitions.

Discussion: Independent of major confounding factors, low testosterone was associated with normoglycemia progression to prediabetes, but not with pre-diabetes to diabetes, which might indirectly highlight the stronger impact of other risk factors after occurrence of pre-diabetes.

Conclusion: Low testosterone concentrations in men are associated with progression from normoglycemia to pre-diabetes, but not from pre-diabetes to diabetes.




CONCLUSION
Our findings show that testosterone’s effect on development of dysglycemia is basically reflected through prevention of prediabetes in normoglycemic men.
Following occurrence of prediabetes, testosterone’s effect is insignificant and stronger risk factors other than testosterone seem to influence diabetes development. These findings may help to diagnose men at risk of pre-/diabetes and provide rationale for replacement therapy in older men.

Thanks for the article..
 

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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