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Cited by 389Hormonal and reproductive studiesAdrenal Hormones and DisordersMenopause: Health Impacts and Treatments

Testosterone deficiency is associated with increased risk of mortality and testosterone replacement improves survival in men with type 2 diabetes

Muraleedharan, Vakkat, Marsh, Hazel, Kapoor, Dheeraj, Channer, Kevin S, Jones, T Hugh·2013·European Journal of Endocrinology
DOI 10.1530/eje-13-0321
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Abstract

Objective: Men with type 2 diabetes are known to have a high prevalence of testosterone deficiency. No long-term data are available regarding testosterone and mortality in men with type 2 diabetes or any effect of testosterone replacement therapy (TRT). We report a 6-year follow-up study to examine the effect of baseline testosterone and TRT on all-cause mortality in men with type 2 diabetes and low testosterone. Research design and methods: A total of 581 men with type 2 diabetes who had testosterone levels performed between 2002 and 2005 were followed up for a mean period of 5.8±1.3 s.d . years. Mortality rates were compared between total testosterone >10.4 nmol/l (300 ng/dl; n =343) and testosterone ≤10.4 nmol/l ( n =238). The effect of TRT (as per normal clinical practise: 85.9% testosterone gel and 14.1% intramuscular testosterone undecanoate) was assessed retrospectively within the low testosterone group. Results: Mortality was increased in the low testosterone group (17.2%) compared with the normal testosterone group (9%; P =0.003) when controlled for covariates. In the Cox regression model, multivariate-adjusted hazard ratio (HR) for decreased survival was 2.02 ( P =0.009, 95% CI 1.2–3.4). TRT (mean duration 41.6±20.7 months; n =64) was associated with a reduced mortality of 8.4% compared with 19.2% ( P =0.002) in the untreated group ( n =174). The multivariate-adjusted HR for decreased survival in the untreated group was 2.3 (95% CI 1.3–3.9, P =0.004). Conclusions: Low testosterone levels predict an increase in all-cause mortality during long-term follow-up. Testosterone replacement may improve survival in hypogonadal men with type 2 diabetes.

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Authors
Muraleedharan, V., Marsh, H., Kapoor, D., Channer, K. S., & Jones, T. H.
Affiliations
  • Barnsley Hospital NHS Foundation Trust (GB)
  • Royal Hallamshire Hospital (GB)
Corresponding author
  • Muraleedharan, Vakkat
  • Jones, T Hugh
Venue
European Journal of Endocrinology
Publisher
Oxford University Press (OUP)
Published
2013-12
Volume
169
Issue
6
Pages
725-733
ISSN
  • 0804-4643 (ISSN-L)
  • 1479-683X
DOI
10.1530/eje-13-0321
OpenAlex
W2165819542
Cited by
389
References
42
Citations by year
2026: 9 · 2025: 16 · 2024: 21 · 2023: 26 · 2022: 20 · 2021: 20 · 2020: 27 · 2019: 25 · 2018: 38 · 2017: 44 · 2016: 40 · 2015: 44 · 2014: 57 · 2013: 2
FWCI
37.50
Type
journal article
Language
en
Open access
closed
Locations
  • European Journal of Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Keywords
androgen deficiency, type 2 diabetes, testosterone replacement therapy, all-cause mortality, hypogonadism, men, testosterone gel, testosterone undecanoate, survival
MeSH terms
Aged, Cardiovascular Diseases, Cause of Death, Diabetes Mellitus, Type 2, Follow-Up Studies, United Kingdom, Humans, Hypogonadism, Immunoenzyme Techniques, Luminescent Measurements, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Risk Factors, Testosterone, Time Factors, Multivariate Analysis, Proportional Hazards Models, Odds Ratio, Hormone Replacement Therapy, Diabetes Complications, Kaplan-Meier Estimate

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