Background: Potential cardiovascular risk as a result of testosterone therapy is controversially discussed.

Methods: In a registry of 823 men with hypogonadism, 324 men (39%) had T2DM. 152 received TU 1000 mg/12 weeks (T-group), 172 opted against treatment (CTRL). Changes over time between groups were compared by mixed effects model for repeated measures with random effect for intercept and fixed effects for time, group and their interaction, and adjusted for age, weight, WC, fasting glucose, blood pressure, lipids and quality of life to account for baseline differences between the two groups.

Results: Mean age: T-group: 61.8±5.1, CTRL: 63.6±4.9 years.

Follow-up: T-group (CTRL): mean: 7.4 (8.3), median: 8 (9) years. T-group: 54 patients (35.5%) had had a previous cardiovascular disease (CVD, defined as myocardial infarction, stroke, or diagnosis of coronary artery disease). CTRL: 68 patients (39.5%) (p=0.4574). 64 men (42.1%) had been smokers at baseline (T-group), 66 (38.4%) in CTRL (p=0.4939). Most classical risk factors were significantly higher at baseline in the T-group compared to CTRL: BMI (36.4±4.5 vs. 33.3±5.3 kg/m²), systolic blood pressure (162.6±13.1 vs. 145.4±14.7 mmHg), diastolic blood pressure (97.2±10.7 vs. 84.7 vs. 10.3 mmHg), LDL (4.6±0.7 vs. 4.0±1.4 mmol/L), with no significant difference in HDL. Glycemic control was worse in the T-group: HbA1c 9.1±1.2 vs. 7.8±0.7%, HOMA-IR 10.2±2.1 vs. 7.5±1.3. Mortality: during the entire observation time, 12 patients (7.8%) died in the T-group and 43 (25%) in CTRL (p<0.0001). MACE: in the T-group, there were no myocardial infarctions or strokes. In CTRL, 49 myocardial infarctions (28.5%) and 42 strokes (24.4%) occurred.

Conclusions: Mortality, myocardial infarctions and strokes were reduced in men with hypogonadism and T2DM receiving long-term testosterone therapy.


K.S. Haider: Speaker's Bureau; Self; Bayer AG. A. Haider: Research Support; Self; Bayer AG. Speaker's Bureau; Self; Bayer AG. F. Saad: Employee; Self; Bayer AG. Stock/Shareholder; Self; AbbVie Inc., Amgen Inc., Bayer AG.


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