Huang Feng
Institute of Cardiovascular Diseases and Guangxi Key Laboratory Base of Precision Medicine in Cardio-cerebrovascular Diseases Control and Prevention, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
Diabetes Ther. 2018 Jun;9(3):1061-1072. doi: 10.1007/s13300-018-0415-3. Epub 2018 Apr 4.
We aimed to systematically investigate the association between testosterone level and cardiovascular risk in male patients with type 2 diabetes mellitus (T2DM) by comparing male T2DM patients with low testosterone levels to male T2DM patients with normal testosterone levels at baseline in terms of the number of cases of coronary artery disease (CAD).
Online databases were carefully searched for studies relating to testosterone, diabetes mellitus, and cardiovascular risk by using the search terms 'testosterone,' 'diabetes mellitus,' and 'coronary artery/cardiovascular disease.' The only endpoint in this analysis was CAD/atherosclerosis/coronary plaque/major adverse coronary event prior to or following testosterone reduction at baseline. The analytical parameters used in this analysis were the risk ratio (RR) with the 95% confidence interval (CI), as obtained using the RevMan 5.3 software.
3467 male patients with T2DM (1079 patients with a low testosterone level versus 2388 patients with a normal testosterone level) were included. The results of this analysis showed that when a random effects model was used, a higher risk of CAD/cardiovascular disease was observed in diabetic patients with a low testosterone level than in those with a normal testosterone level (RR 1.24, 95% CI 0.94-1.63; P = 0.13). However, the difference in risk was not statistically significant. Similarly, with a fixed effects model, a low testosterone level was associated with a higher CAD/cardiovascular risk of disease (RR 1.12, 95% CI 0.98-1.34; P = 0.08); in this case, the difference in risk between the T2DM patients with low and normal testosterone levels approached statistical significance.
A previously or currently reduced testosterone level was not found to be statistically significantly associated with a high risk of CAD/cardiovascular disease in male patients with T2DM. However, the difference in risk between the T2DM patients with low and normal testosterone levels was observed to approach statistical significance.
我们旨在通过比较基线时睾酮水平低的男性2型糖尿病（T2DM）患者和睾酮水平正常的男性T2DM患者的冠状动脉疾病（CAD）病例数，系统地研究睾酮水平与男性T2DM患者心血管风险之间的关联。
通过使用搜索词“睾酮”、“糖尿病”和“冠状动脉/心血管疾病”，在在线数据库中仔细搜索与睾酮、糖尿病和心血管风险相关的研究。该分析的唯一终点是基线时睾酮降低之前或之后的CAD/动脉粥样硬化/冠状动脉斑块/主要不良冠状动脉事件。本分析中使用的分析参数是使用RevMan 5.3软件获得的风险比（RR）及其95%置信区间（CI）。
纳入了3467例男性T2DM患者（1079例睾酮水平低的患者与2388例睾酮水平正常的患者）。该分析结果表明，当使用随机效应模型时，睾酮水平低的糖尿病患者患CAD/心血管疾病的风险高于睾酮水平正常的患者（RR 1.24，95%CI 0.94-1.63；P = 0.13）。然而，风险差异无统计学意义。同样，在固定效应模型中，低睾酮水平与较高的CAD/心血管疾病风险相关（RR 1.12，95%CI 0.98-1.34；P = 0.08）；在这种情况下，睾酮水平低和正常的T2DM患者之间的风险差异接近统计学意义。
在男性T2DM患者中，未发现既往或当前降低的睾酮水平与CAD/心血管疾病的高风险存在统计学显著关联。然而，观察到睾酮水平低和正常的T2DM患者之间的风险差异接近统计学意义。
