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Association of Testosterone and Sex Hormone-Binding Globulin With All-Cause and Cardiovascular Disease Mortality in
Mei Jiao Li1, Chao Qiang Jiang2, Ya Li Jin2
1Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
Summary
Higher testosterone levels (total, free, and bioavailable) were linked to increased all-cause mortality in older men. Higher free testosterone also predicted cardiovascular disease mortality, while lower sex hormone-binding globulin (SHBG) was associated with higher mortality risks.
Area of Science:
- Endocrinology
- Gerontology
- Epidemiology
Background:
- Conflicting data exists regarding testosterone's association with mortality.
- Previous studies have not consistently examined various testosterone forms and SHBG in older men.
Purpose of the Study:
- To investigate the relationship between total testosterone, free testosterone, bioavailable testosterone, and sex hormone-binding globulin (SHBG) with all-cause and cardiovascular disease (CVD) mortality.
- To analyze these associations in older Chinese men.
Main Methods:
- Assayed total testosterone and SHBG; calculated free and bioavailable testosterone using the Vermeulen formula.
- Employed Cox proportional hazards regression to determine hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality risks.
- Analyzed data from 3,948 men aged 50+ years over a 10.5-year follow-up period.
Main Results:
- Higher quartiles of total testosterone and free testosterone were associated with increased all-cause mortality.
- Higher free testosterone levels correlated with increased CVD mortality risk.
- Lower SHBG levels were linked to higher risks of both all-cause and CVD mortality.
- Positive associations were observed between bioavailable testosterone and all-cause mortality.
Conclusions:
- Elevated total, free, and bioavailable testosterone levels are associated with higher all-cause mortality in older men.
- Higher free testosterone is linked to increased CVD mortality, and lower SHBG is associated with higher all-cause and CVD mortality.
- Further mechanistic studies are needed to confirm causality.
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