Abstract
Objective To investigate the association between serum total testosterone(TT)levels and type 2 diabetes(T2DM)and any gender differences in elderly patients. Methods Based on the Aging Health database built from 2008 to 2012, 935 elderly individuals over 60 years old with a mean age of 65.8 years receiving physical examinations were included.According to the 1999 WHO criteria for diabetes, participants were assigned into four groups: a T2DM group(n=298), an impaired fasting glucose(IFG)group(n=26), an impaired glucose tolerance(IGT)group(n=121), and a normal glucose regulation(NGR)group(n=490). We measured serum TT by ELISA and analyzed the distribution patterns in the groups.Furthermore, we examined the gender-specific correlation of TT with T2DM and homeostasis model assessment of insulin resistance(HOMA-IR). Results The prevalence of T2DM in the participants was 31.9%(298/935). One-way ANOVA analysis showed that the TT level was higher in the NGR group than in the T2DM and IGT groups (PANOVA=0.001). Logistic regression analysis indicated a significant protective association between TT and T2DM in the elderly.Every one unit of increase in the SD of the TT level was accompanied by a 23% reduction in the risk for T2DM (P=0.001). Further gender-stratification analysis suggested that the protective role of TT against T2DM only existed in males (OR=0.55, 95%CI: 0.44-0.68; P<0.001). After adjustment for age, blood pressure, blood lipids, and waist circumference, the protective role of TT against T2DM in males still remained (OR=0.68, 95%CI: 0.53-0.86; P=0.002). Pearson correlation analysis also indicated a significant negative correlation between TT and HOMA-IR in older males(P=0.002). As for older females, no significant correlation of TT with T2DM and HOMA-IR was found. Conclusions The serum TT level might be an independent protective factor for T2DM in older males, as evidenced by its correlation with improved insulin resistance status, which is not present in older females. Key words: Diabetes mellitus, type 2; Testosterone
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