High Serum Testosterone Is Associated With Reduced Risk of Cardiovascular Events in Elderly Men: The MrOS (Osteoporotic Fractures in Men) Study in Sweden

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• 作者：Claes  ; Ohlsson MD ; PhD^?/sup> ; Elizabeth  ; Barrett-Connor MD^&Dagger ; ; Shalender  ; Bhasin MD ; PhD^§ ; ; Eric  ; Orwoll MD ; PhD^?/sup> ; Fernand  ; Labrie MD ; PhD^¶ ; ; Magnus K.  ; Karlsson MD ; PhD^# ; Ö ; sten  ; Ljunggren MD ; PhD^?? ; Liesbeth  ; Vandenput PharmD ; PhD^?/sup> ; Dan  ; Mellströ ; m MD ; PhD^?/sup> ; Å ; sa  ; Tivesten MD ; PhD^&dagger ; ;   ; ^{asa.tivesten@medic.gu.se}
• 关键词：cardiovascular disease ; men ; testosterone
• 刊名：Journal of the American College of Cardiology
• 出版年：2011
• 出版时间：11 October 2011
• 年：2011
• 卷：58
• 期：16
• 页码：1674-1681
• 全文大小：829 K

文摘

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Objectives

We tested the hypothesis that serum total testosterone and sex hormone¨Cbinding globulin (SHBG) levels predict cardiovascular (CV) events in community-dwelling elderly men.

Background

Low serum testosterone is associated with increased adiposity, an adverse metabolic risk profile, and atherosclerosis. However, few prospective studies have demonstrated a protective link between endogenous testosterone and CV events. Polymorphisms in the SHBG gene are associated with risk of type 2 diabetes, but few studies have addressed SHBG as a predictor of CV events.

Methods

We used gas chromatography/mass spectrometry to analyze baseline levels of testosterone in the prospective population-based MrOS (Osteoporotic Fractures in Men) Sweden study (2,416 men, age 69 to 81 years). SHBG was measured by immunoradiometric assay. CV clinical outcomes were obtained from central Swedish registers.

Results

During a median 5-year follow-up, 485 CV events occurred. Both total testosterone and SHBG levels were inversely associated with the risk of CV events (trend over quartiles: p = 0.009 and p = 0.012, respectively). Men in the highest quartile of testosterone (?50 ng/dl) had a lower risk of CV events compared with men in the 3 lower quartiles (hazard ratio: 0.70, 95 % confidence interval: 0.56 to 0.88). This association remained after adjustment for traditional CV risk factors and was not materially changed in analyses excluding men with known CV disease at baseline (hazard ratio: 0.71, 95 % confidence interval: 0.53 to 0.95). In models that included both testosterone and SHBG, testosterone but not SHBG predicted CV risk.

Conclusions

High serum testosterone predicted a reduced 5-year risk of CV events in elderly men.