Testosterone levels linked to mortality in postmenopausal diabetic women
Medwire News: Low free testosterone (FT) levels appear to be associated with increased all-cause and cardiovascular (CV) mortality in postmenopausal diabetic women referred for coronary angiography, researchers report.
Their study differs from previous research into the link between androgen levels and mortality in women, as they use the biologically active form of testosterone (FT) rather than total testosterone (TT) alone to assess androgen status, they say.
As reported in the journal Diabetes Care, Elisabeth Wehr (Medical University Graz, Austria) and colleagues assessed FT, total testosterone (TT), and serum hormone-binding globulin (SHBG) levels of 875 postmenopausal women who had been referred to the Ludwigshafen Heart Centre for coronary angiography between July 1997 and January 2000.
The team followed up the patients for a median of 7.7 years. They found that by the end of follow-up, 179 women (21%) had died, with 56.4% of the deaths being due to CV disease.
Overall, high FT levels were associated with CV risk factors including obesity, insulin resistance, and Type 2 diabetes at baseline, write Wehr and team.
However, the researchers found no significant association of FT, TT, or SHBG with all-cause mortality or CV mortality when they analyzed postmenopausal women as a whole.
Interestingly, it was only when they assessed the women separately on the basis of their diabetes status that they noted an association between low FT and increased risk for mortality in the diabetic women. The multivariate-adjusted hazard ratios in the fourth compared with first FT quartile for all-cause and CV mortality were 0.38 and 0.28, respectively.
By contrast, they found no significant association of FT with mortality in postmenopausal women without type 2 diabetes.
"Considering our results showing an inverse association of FT levels with mortality in diabetic postmenopausal women, one might question the postulated negative impact of high androgens on survival in postmenopausal women at high CV risk," say the authors
They add that large prospective studies are warranted to explore the effect of androgens on mortality in women, with a special focus on women with PCOS.
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By Sally Robertson