Evaluation of atherosclerosis and cardiovascular risk markers in male patients with type 2 diabetes with normal and low testosterone levels

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 758-779-Cardiometabolic Risk & Vascular Biology
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-764
Karina Miragaya*, Marcia Gabriela Jimenez, Miguel Walter Vasquez Cayoja, Ana Paula Lisdero, Marina Khoury, Matias Tinetti and Javier Mauricio Farias
Sanatorio GŁemes, Buenos Aires, Argentina
Low serum testosterone and Type 2 Diabetes (T2D) are associated with increased risk of cardiovascular morbidity(1). The magnitude of such association; however, in middle-aged patients with T2D has not been determined. Accordingly, we evaluated atherosclerosis and cardiovascular risk markers in patients with T2D with normal and low total testosterone. We report preliminary data of 148 male patients <70 years without previous cardiovascular events with normal (≥ 3,5 ng⁄ml) and low (<3,5 ng⁄ml, n=36) total testosterone (TT). We measured serum C reactive protein (CRP), carotid artery intima-media thickness (IMT), presence carotid atherosclerotic plaque (Plaque) by high-resolution B-mode ultrasound, and endothelial dysfunction (ED) by brachial artery flow mediated dilation. Data were analyzed using simple calculation, Spearman correlation coefficient, Mann Whitney U tests and x2test.Odds ratio [OR] and 95% confidence intervals (CI) were calculated using simple and multiple logistic regression. Results: There were no difference in age 56.68±76.7, DM duration: 6.67±3yrs, BMI 30.1±3.6 kg⁄m2, LDL 119.3±23mg⁄dl, HDL 39.9±7mg⁄dl, HbA1c 6.9±0.6%, between normal and low TT groups, p= NS. Frequencies of Low TT was 31.3% (n=36); ED 53.91% (n=62) and plaque 52.17% (n=60). IMT, plaque and ED was present in 54% of low TT group and 10.13% in normal TT group (p<0,001). In all patients, mean IMT (0,100±0,014 mm) was negatively correlated with TT, r: -0.39 (p <0.0001). Compared to patients with normal TT, those with low TT have higher IMT ≥0.100 (80% vs 39%), odds ratio (OR) 6.41(CI95%: 2.5-16.4), p<0,001 and atherosclerotic plaques 68.5% vs. 45%, OR 2.60 (1.12-6.03), p<0.0001; ED (80.5 vs 42.5%), OR 5.77 (2.77-14.77), p <0.001, and higher CRP (2.74±582 vs 0.89±0.88mg⁄L, p<0.0001). Using multiple logistic regression analyses adjusted for age, diabetes duration, HbA1c, lipids, treatment effect, and BMI, we found that low TT levels were associated with greater IMT [OR: 8.43 (2.5-25.8)] and ED [OR: 4.98 (1.72-14.37)], but not with the presence of atherosclerotic plaques (p=NS). In summary, male T2D patients with low total testosterone have greater  IMT, ED and CRP compared to diabetic patients with normal TT. Low testosterone in middle age T2D is associated with more advanced cardiovascular risk markers (IMT, CRP and ED).

(1)Corona G et al., Eur J Endocrinol 2011; 165:687.

Nothing to Disclose: KM, MGJ, MWV, APL, MK, MT, JMF

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm