Low Testosterone Levels Increase Mortality Risk in MenJune 18, 2008 (San Francisco) — A population-based cohort study has demonstrated a link between low levels of testosterone and increased risk for mortality from all causes in adult men of all ages.
Robin Haring, a doctoral candidate with the Institute for Community Medicine and the Department of Internal Medicine at Ernst-Moritz-Arndt University in Greifswald, Germany, presented the results here at the ENDO 2008, the Endocrine Society 90th Annual Meeting.
"When we compared survival times of men with low testosterone levels to men with higher testosterone levels, we found that men with low testosterone had significantly lower survival," Mr. Haring told Medscape Diabetes & Endocrinology. "From our analysis, we concluded that men with testosterone levels lower than 8.7 nmol/L had a 2-fold increased risk of death."
Mr. Haring and colleagues at the university recruited 1954 men aged 20 to 89 years through the Study of Health in Pomerania initiative and followed the participants for an average of 7.2 years through August 2007. Participants were classified as having low (<8.7 nmol/L) or high (≥8.7 nmol/L) testosterone levels, and the researchers compared all-cause and cause-specific mortality between the 2 groups.
During the follow-up period, 226 deaths occurred in the study population. After adjusting for age and other risk factors, the researchers determined that participants with low testosterone had a significantly higher risk for all-cause mortality than their normal-testosterone counterparts (hazard ratio, 2.6; 95% confidence interval, 1.6 – 4.1; P < .001).
In a more specific analysis of causes of mortality, the researchers found that men with low testosterone levels were at increased risk for death from cancer and cardiovascular disease but not respiratory disease. The men in the low testosterone group tended to be older and had higher prevalence of diabetes, hypertension, and metabolic syndrome, and Mr. Haring acknowledged the challenge in determining whether low testosterone was a cause or effect of the cardiovascular risk factors.
Hugh Jones, MD, lead investigator of a study presented in a related session and a consultant physician and endocrinologist in the Barnsley Hospital Center for Diabetes & Endocrinology at the University of Sheffield, United Kingdom, said that the study by Mr. Haring and colleagues underscores the importance of treating men with low testosterone levels even in the absence of symptoms.
"A large proportion of younger men with obesity and low testosterone don't have symptoms," Dr. Jones explained. "What we're doing now is treating classical hypogonadism by definition according to the published international guidelines."
Mr. Haring and Dr. Jones have disclosed no relevant financial relationships.
ENDO 2008: The Endocrine Society 90th Annual Meeting: Abstract OR35-1. Presented June 17, 2008.
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