TY - JOUR
T1 - High serum testosterone is associated with reduced risk of cardiovascular events in elderly men
T2 - The MrOS (osteoporotic fractures in men) study in Sweden
AU - Ohlsson, Claes
AU - Barrett-Connor, Elizabeth
AU - Bhasin, Shalender
AU - Orwoll, Eric
AU - Labrie, Fernand
AU - Karlsson, Magnus K.
AU - Ljunggren, Östen
AU - Vandenput, Liesbeth
AU - Mellström, Dan
AU - Tivesten, Åsa
N1 - Funding Information:
This study was supported by the Swedish Research Council, the Swedish Foundation for Strategic Research, the Avtal om Läkarutbildning och Forskning research grant in Gothenburg, the Swedish Heart-Lung Foundation, the Marianne and Marcus Wallenberg Foundation, the Lundberg Foundation, the Torsten and Ragnar Söderberg Foundation, the Åke Wiberg Foundation, and the NovoNordisk Foundation. Dr. Ljunggren has received lecture fees and participated in advisory boards and clinical trials for Eli Lilly, Amgen, MSD, Novartis, and AstraZeneca.
PY - 2011/10/11
Y1 - 2011/10/11
N2 - Objectives: We tested the hypothesis that serum total testosterone and sex hormonebinding 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 (<550 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.
AB - Objectives: We tested the hypothesis that serum total testosterone and sex hormonebinding 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 (<550 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.
KW - cardiovascular disease
KW - men
KW - testosterone
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U2 - 10.1016/j.jacc.2011.07.019
DO - 10.1016/j.jacc.2011.07.019
M3 - Article
C2 - 21982312
AN - SCOPUS:80053624962
SN - 0735-1097
VL - 58
SP - 1674
EP - 1681
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 16
ER -