Relationship Between Testosterone Deficiency and the Cardiovascular Risk Ractors, Diabetes and Hypertension

Abstract

Background and objective Testosterone deficiency (TD) increases the incidence of cardiovascular risk factors such as diabetes and hypertension. Conversely, TD is reported in people with obesity and diabetes. Therefore, this study examines the relationship between TD, diabetes, and hypertension by following a longitudinal design. Material and methods In this study, 2242 (1490 middle-aged and 752 elderly) healthy men were followed up for 8 years and the incidence of hypertension or diabetes was determined. The diagnostic criteria for hypertension were systolic pressure ≥140 mmHg and diastolic pressure ≥90 mmHg, and the criterion for diabetes was a fasting blood glucose level ≥126 mg/dL; the men who took medication for hypertension or diabetes were considered diseased. The threshold for TD was 2.5 ng/mL of serum testosterone. Subsequently, the relative risk (RR) of disease according to the testosterone level was analyzed. In addition, the RR of TD according to glucose and blood pressure levels was analyzed for men with normal testosterone at the initial examination. Results The TD incidence rates were 12.2 and 16.8% for middle-aged and elderly men, respectively. Among the middle-aged men, the diabetes incidence rates were 11.7 and 5.7% in the TD and non-TD (NTD) groups, respectively; the RR of diabetes increased by 1.771 times in the TD group relative to the NTD group (p<0.001). Among the elderly men, the RR of hypertension and diabetes increased by 1.573 and 1.649 times, respectively, in the TD group, compared to the NTD group. Among those with normal testosterone levels at the initial examination, prehypertension (PHTN) increased the RR of TD by 2.421 and 3.091 times for middle-aged and elderly men, respectively, compared to those with normal blood pressure. Moreover, an impaired fasting glucose level at baseline increased the RR of TD by 1.710 times in middle-aged men and 2.187 times in elderly men, compared to those with normal glucose levels. Conclusion In men, TD increased the risk of diabetes and hypertension, which are cardiovascular risk factors.