Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep 16.
doi: 10.1111/andr.70122. Online ahead of print.

Low testosterone levels in men at age 31 associates with future risk of prediabetes and type 2 diabetes: A birth cohort study

Tuomisto A  1   2 , Pinola P  1   2 , Pesonen P  2 , Franks S  3 , Martikainen H  1   2 , Tapanainen Js  4 , Niinimäki M  1   2 , Morin-Papunen L  1   2
Affiliations

Low testosterone levels in men at age 31 associates with future risk of prediabetes and type 2 diabetes: A birth cohort study

Tuomisto A et al. Andrology. .

Abstract

Objective: We aimed to investigate the association of a low serum testosterone concentration with the risk of abnormal glucose metabolism (i.e., prediabetes and type 2 diabetes) in men at a 15-year follow-up.

Study population and methods: In a population birth cohort, men with low testosterone (testosterone < 12.1 nmol/L, n = 136) and normal testosterone concentration (testosterone ≥ 12.1 nmol/L, n = 2555) at age 31 were followed up until age 46. Blood samples were drawn at ages 31 and 46, and an oral glucose tolerance test (n = 1409) was performed at age 46.

Results: Men with low testosterone had significantly greater body mass index and waist circumference than men with normal testosterone at ages 31 and 46 (p < 0.001 in all comparisons). In men with low testosterone, the association with abnormal glucose metabolism was mainly driven by adiposity (p = 0.4 after adjusting for waist circumference). However, the risk remained increased, independently of waist circumference, when comparing the lowest and highest quartiles of testosterone (odds ratio:1.8 [95% confidence interval 1.3-2.7]) or when using testosterone as a continuous variable (odds ratio: 0.97 [95% confidence interval 0.95-0.99]). Between ages 31 and 46, body mass index increased more in men with normal testosterone at age 31 and low testosterone at age 46 than in men with normal testosterone or low testosterone at both ages (p < 0.001). Higher sex hormone binding globulin levels were associated with a lower risk for abnormal glucose metabolism independently of waist circumference (p < 0.001).

Conclusion: Low levels of testosterone and sex hormone binding globulin at age 31 associated with an increased risk of developing abnormal glucose metabolism after 15 years' follow-up. This association was partly independent of adiposity but was linked to waist circumference and weight gain.

Keywords: abnormal glucose metabolism; low testosterone; male; prediabetes; type 2 diabetes.

PubMed Disclaimer

References

REFERENCES

    1. Hackett G, Kirby M, Rowland W, et al. British Society for Sexual Medicine guidelines on adult testosterone deficiency, with statements for practice. World J Mens Health. 2023;41(3):508‐537. doi:10.5534/wjmh.221027
    1. Gambineri A, Pelusi C. Sex hormones, obesity and type 2 diabetes: is there a link?. Endocr Connect. 2019;8(1):R1‐R9. doi:10.1530/EC‐18‐0450
    1. Vermeulen A, Verdonck L, Kaufman JM. A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab. 1999;84(10):3666‐3672. doi:10.1210/jcem.84.10.6079
    1. Salminen M, Vahlberg T, Räihä I, Niskanen L, Kivelä SL, Irjala K. Sex hormones and the risk of type 2 diabetes mellitus: a 9‐year follow up among elderly men in Finland. Geriatr Gerontol Int. 2015;15(5):559‐564. doi:10.1111/ggi.12312
    1. Tully PJ, Baumeister H, Martin S, et al. Elucidating the biological mechanisms linking depressive symptoms with type 2 diabetes in men: the longitudinal effects of inflammation, microvascular dysfunction, and testosterone. Psychosom Med. 2016;78(2):221‐232. doi:10.1097/PSY.0000000000000263