Testosterone replacement therapy: association with mortality in high-risk patient subgroups.

Area of Science:

• Endocrinology
• Cardiology
• Gerontology

Background:

• Testosterone deficiency (TD) affects adult men, potentially impacting health outcomes.
• Understanding the association between testosterone therapy (TTh) and mortality is crucial for clinical practice.

Purpose of the Study:

• To determine the association between testosterone therapy (TTh) and mortality in men with adult-onset testosterone deficiency.
• To investigate if this association is independent of cardio-metabolic risk factors and age.

Main Methods:

• Utilized a registry database of 737 men with adult-onset TD over a 10-year follow-up.
• Compared associations between testosterone undecanoate (TU), cardio-metabolic risk factors, and mortality.
• Employed Cox regression models and stratified analyses based on cardio-metabolic risk.

Main Results:

• During follow-up, 94 of 737 men died.
• Testosterone undecanoate (TU) treatment was associated with significantly lower mortality (HR=0.23).
• This association remained independent of age, BMI, lipids, blood pressure, smoking, and type 2 diabetes, and was most evident in high-risk men.

Conclusions:

• Testosterone therapy (TTh) is associated with reduced mortality in men with adult-onset TD.
• The beneficial effect on mortality was more pronounced in men with higher baseline cardio-metabolic risk factors.