Testosterone deficiency and the risk of anemia: A propensity score-matched analysis

There are little data on the endogenous testosterone effect on hemoglobin or hematocrit. Moreover, these data are limited by a cross-sectional study design, a small participant number, and no adjustment for confounding factors. Therefore, the present study was conducted to address the aforementioned limitations of previous studies using a large dataset and propensity score matched analysis.

Men who underwent health check-up were analyzed. Participants were divided into two groups using the cut-off testosterone value of 3.5 or 3.0 ng/ml according to a previous definition of testosterone deficiency. Using the cutoff testosterone value of 3.5 ng/ml, 966 cases (testosterone levels <3.5 ng/ml) and 7402 controls (testosterone level ≥3.5 ng/ml) were included, but following propensity score matching, there were 966 cases and 1932 controls. Using the cutoff testosterone value of 3.0 ng/ml, 444 cases (testosterone levels <3.0 ng/ml) and 7924 controls (testosterone level ≥3.0 ng/ml) were included, but following propensity score matching, there were 444 cases and 888 controls.

After matching, the groups were evenly distributed with respect to age, body mass index, estimated glomerular filtration rate, hypertension, and diabetes in both data sets. After matching, the mean Hb and Hct were significantly lower and the incidence of anemia was significantly greater in the case compared to the control in both data sets. The relative risk of anemia in the case was 2.4 compared to the control in both data sets.

Screening for anemia in patients with testosterone deficiency would be needed and vice versa.