Aruna Sarma

Personal Information
Title Associate Professor
Expertise Uropathy
Institution University of Michigan-Ann Arbor
Data Summary
TypeCount
Grants/SubContracts 1
Progress Reports 1
Publications 3
Protocols 0
Committees 2

SubContract(s)


Testosterone Concentrations and Cardiovascular Disease in Men with Type 1 Diabetes
In men, low endogenous levels of testosterone (T) are associated with increased risk of cardiovascular disease (CVD). It is unclear whether this relationship is independent of age, obesity, and conventional CVD risk factors such as levels of blood pressure and lipids. The majority of studies are cross-sectional and cannot examine changes in T or risk factor levels. Prospective studies of T and CVD risk are needed particularly for men with type 1 diabetes (T1D) for several reasons. Men with T1D may have as much as a 10-fold increased risk for CVD mortality compared to men without diabetes. This risk may be compounded by the lower bioavailable T levels in men with T1D compared to men without diabetes; as many as 1 in 5 men with T1D may have low bioavailable T. The need to understand T and its risks is more urgent due to the tripling in prescriptions for exogenous T over the past decade. We propose to address these important clinical questions by leveraging the extensive resources of DCCT/EDIC, a large randomized trial of intensive glycemic control in T1D and its observational follow-up to complete these aims: 1) to examine how changes in T levels predict changes in CVD risk factors among men with T1D. We hypothesize that decreases in T levels will predict increases in blood pressure, triglycerides, hemoglobin A1c, and decreases in high-density lipoprotein, before and after adjustment for age and obesity; 2) to examine how T levels predict cardiac structure and function on cardiac MRI among men with T1D. We hypothesize that lower T levels will predict lower values of left ventricular mass and end-diastolic volume, before and after adjustment for age, obesity, hemoglobin A1c, blood pressure, and lipid levels; and 3) to examine how changes in Tlevels predict CVD events among men with T1D. We hypothesize that lower T levels will predict a greater incidence of CVD events, before and after adjustment for age, obesity, hemoglobin A1c, blood pressure, and lipid levels. By examining a cohort at high-risk for CVD and which has serial measures of CVD risk factors as well as structure, function, and adjudicated events, we can examine whether T is related to CVD in the type 1 population, as well as illuminating the relationships between T and risk factors generally.


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