Aims: To assess the implications of low testosterone on cardiovascular risk factors, metabolic syndrome (MES) and clinical outcomes in Chinese men with Type 2 Diabetes (T2D).
Methods:
A prospective cohort study carried out in a university hospital involving a consecutive cohort of 1239 Chinese men with T2D (aged 58.61±11.54 years) and a median disease duration of 9 years (inter-quartile-range[IQR] 4-16 years) followed up for 4.8 years (IQR 4.4-5.6 years). Clinical characteristics, frequency of MES, serum total testosterone and clinical events were analyzed.
Results:
More men with low testosterone had cardiovascular-renal disease and MES than those with normal testosterone. The adjusted odds ratio (OR) of low testosterone for MES was 2.63 (95% Confidence Interval [CI] 1.56-4.61). After a median follow-up of 4.8 years, the hazard ratio (HR) of low testosterone was 2.18 (95%CI 1.30-3.64) for all-cause mortality and 2.28 (95%CI 1.28–4.07) for incident all-site cancer. In a multivariate Cox-regression model, these HRs were attenuated but remained significant with adjustment for age and MES but rendered non-significant when renal parameters were included.
Conclusions:
Chinese men with low testosterone had high prevalence of cardiovascular disease and MES with high incidence for premature death and all-site cancer, in part mediated by renal dysfunction.