OR08-01 Serum Testosterone, Age, Waist Circumference and Glycaemia and Risk of Incident Type 2 Diabetes in an Urban Community of Middle Aged and Older Men.

Abstract M. Umapathysivam: None. A. Vincent: None. J. Tan: None. A. Ashagre: None. D. Jesudason: None. G. Wittert: Consulting Fee; Self; I-Nova. Grant Recipient; Self; Bayer, Inc., Eli Lilly & Company, Weight Watchers, Lawley Pharmaceutical. Speaker; Self; Besin Health Care, Bayer, Inc., Amgen Inc. Background: Obesity causes reduction in serum testosterone concentration (T) and low T is an independent risk for the development of type 2 diabetes (T2D). The relationship between T and diabetes risk across the range of T remains unclear, as does the interaction between T and age, waist circumference (WC) and baseline glycemia. Aim: To determine the relationship between T and incident T2D risk across the range of T and to examine interactions between T and WC, age, and baseline glycemia on incident T2D risk in middle aged and older men. Methods: Men without diabetes, cancer, testosterone treatment, and both baseline and 5-yr follow-up assessments in the MAILES Cohort were included. The MAILES cohort comprises 2563 North West Adelaide, community dwelling men aged 35-85 years at enrolment. Multivariate logistic regressions assessed the association between baseline T and incident T2D risk with/out pairwise interactions and non-linear associations (splines). The covariates adjusted for were baseline age, WC, HbA1c, family history, smoking, alcohol intake, self-reported physical activity and medication affecting T2D risk. Incident diabetes was assessed 5 years after baseline assessment and was defined as HbA1c ≥6.5%, medication to lower blood glucose, or self-reported diagnosis of T2D.Results: 1315 men met the inclusion criteria. There were 110 cases of incident T2D (8.4%). T at recruitment was an independent risk factor for incident T2D (OR=0.93, 95%CI=[0.89, 0.98], p=0.003). There was no detectable interactions between T and WC (p = 0.72), WC and baseline HbA1c (p=0.38). There was an interaction between T and age (p = 0.001), with a T effect in men <65 years (OR=0.85, 95%CI=[0.81, 0.92], p<0.001) and not in men >65 years (OR=1.03, 95%CI=[0.95, 1.11], p=0.51). In both the entire cohort and in men <65 years there was no evidence of non-linearity on the logit scale, with higher T being associated with lower T2D risk across the spectrum of T. Conclusions: Higher baseline T was protective against incident diabetes independent of traditional risk factors at all levels of T in men aged ≤65. This is consistent with the recent observation that, treatment with exogenous testosterone of individual with normal T, reduces risk of incident T2D. We were unable to detect effects of baseline T concentration on incident diabetes in older individuals (>65 years). Saturday, June 1, 2024