With Low T, Metabolic Syndrome Could Raise Mortality Risk

Men with low testosterone levels and metabolic syndrome could have a higher risk of mortality, according to a new study. These findings shed light on the potential role of testosterone in all-cause mortality in men which, until now, has remained controversial.

For their study, the researchers assessed 3650 men older than age 65 years. Of these, 444 men who underwent hormone measurements and were included in the final analysis. Follow-up lasted 12 years.
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International Diabetes Federation criteria was consulted to determine the presence of metabolic syndrome. Hazard ratios (HRs) were estimated using inverse-probability-weighted Cox regression.

A total of 106 (23.9%) men had metabolic syndrome at baseline, and 166 men died over the course of follow-up. Results revealed a significant interaction between testosterone levels and all-cause mortality.

Specifically, the researchers observed a higher mortality risk per 1 SD decrease in testosterone among men with metabolic syndrome (HRs 1.78 and 1.83 for total and bioavailable testosterone, respectively).

However, they noted, no association was observed between testosterone and mortality risk among men without metabolic syndrome.

“Our results suggest that [metabolic syndrome] modifies the association between testosterone and mortality in older men,” the researchers concluded. “If confirmed, these findings could contribute to improve risk stratification and better manage the health of older men.”

—Christina Vogt

Reference:

Laouali N, Brailly Tabard S, Helmer C, et al. Testosterone and all-cause mortality in older men:  the role of metabolic syndrome. J Endocr Soc. 2018;2(4):322-335. https://doi.org/10.1210/js.2018-00005.