Higher serum testosterone concentration was not associated with a reduced risk of developing type 2 diabetes in men older than 65.
Higher serum testosterone concentration may be protective against the development of type 2 diabetes (T2D) in men with overweight or obesity who are 65 years of age or younger, according to recent research presented at the Endocrine Society’s 2024 annual meeting, held June 1 to 4 in Boston, Massachusetts.1
According to data from the CDC, over 40% of adults in the United States have obesity and 9.2% have severe obesity.2 In men, obesity is known to reduce serum testosterone concentrations and low testosterone is a risk factor for the development of type 2 diabetes. However, data on the relationship between testosterone and diabetes risk across a range of testosterone levels is currently lacking.
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“A low blood testosterone concentration is an independent risk factor for developing type 2 diabetes, and high levels of testosterone appear protective against the development of type 2 diabetes,” Mahesh Umapathysivam, lead author on the study, said in a release.1 “We wanted to better understand the relationship between testosterone and type 2 diabetes risk across the range of testosterone levels, and to examine interactions between testosterone and different diabetes risk factors in middle aged and older men.”
Investigators from the University of Adelaide in South Australia conducted a study to determine the relationship between serum testosterone concentration and incident T2D risk and to examine interactions between testosterone and waist circumference, age and baseline glycemia on incident T2D risk. Data for the study was gathered from the men androgen inflammation lifestyle environment and stress (MAILES) study, which assessed the associations of sex steroids, inflammation, environmental and psychosocial factors with cardio-metabolic disease risk in men.3
The study cohort included 1315 men between the ages of 35 and 85 who did not have diabetes or cancer and were not currently on testosterone treatment. Covariates were adjusted for baseline age, waist circumference, HbA1c, family history, smoking, alcohol intake, self-reported physical activity and medication affecting T2D risk. Follow-up was conducted 5 years after baseline.
During the study, there were 110 cases of incident T2D. Investigators found that, after correcting for the covariates, serum testosterone concentration was associated with a risk for developing T2D. While there were no interactions between serum testosterone concentration and waist circumference or waist circumference and HbA1c, there was an interaction between testosterone in men aged 65 years or younger, suggesting that higher levels of testosterone in men among that age group was protective against T2D.
“This implies that higher testosterone blood concentrations are associated with reduced risk of developing type 2 diabetes,” Umapathysivam said in a release.1 “In contrast, there were no detectable effects of blood testosterone levels on diabetes risk in men over age 65. Maintaining a heathy weight, exercising regularly and avoiding alcohol helps maintain a normal testosterone level in most men and also help prevents T2D.”
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