TY - JOUR
T1 - Sociodemographic, lifestyle and medical influences on serum testosterone and sex hormone–binding globulin in men from UK Biobank
AU - Yeap, Bu B.
AU - Marriott, Ross J.
AU - Antonio, Leen
AU - Bhasin, Shalender
AU - Dobs, Adrian S.
AU - Dwivedi, Girish
AU - Flicker, Leon
AU - Matsumoto, Alvin M.
AU - Ohlsson, Claes
AU - Orwoll, Eric S.
AU - Raj, Suchitra
AU - Reid, Christopher M.
AU - Vanderschueren, Dirk
AU - Wittert, Gary A.
AU - Wu, Frederick C.W.
AU - Murray, Kevin
N1 - Funding Information:
This study was supported by Western Australian Health Translation Network (WAHTN) Medical Research Future Fund (MRFF) Rapid Applied Research Translation Grant. The funding source had no role in the conduct of the analysis or interpretation of results, nor in the preparation and submission of this manuscript
Publisher Copyright:
© 2020 John Wiley & Sons Ltd
PY - 2021/2
Y1 - 2021/2
N2 - Objective: Serum testosterone concentrations are affected by factors unrelated to hypothalamo-pituitary-testicular axis pathology. We evaluated the impact of sociodemographic, lifestyle and medical factors, on serum testosterone and sex hormone–binding globulin (SHBG) in men aged 40-69 years. Design: Cross-sectional analysis of 208,677 community-dwelling men from the UK Biobank. Measurements: We analysed associations of different factors with serum testosterone and SHBG (immunoassays) and calculated free testosterone (cFT), using smoothed centile plots, linear mixed models and effect size estimates. Results: Median (interquartile range) for serum testosterone was 11.6 (9.4-14.1) nmol/L, SHBG 36.9 (27.9-48.1) nmol/L and cFT 213 (178-255) pmol/L. Age and BMI were inversely associated with testosterone and cFT, while SHBG was associated with age and inversely with BMI (all P <.001). Living with a partner, (South) Asian ethnicity, never or previous smoker and some medical conditions were associated with lower testosterone. Poultry or fish eater, and higher physical activity were associated with higher testosterone (all P <.001). Testosterone was lowered by ~0.5 nmol/L across ages, ~1.5 nmol/L for BMI 30 vs 25 kg/m2, ~2 nmol/L for (South) Asian ethnicity, living with partner, college/university qualifications, low red meat eater, insufficient physical activity and 0.3-1.0 nmol/L with cardiovascular disease or diabetes. Different combinations of these factors varied serum testosterone by ~4 nmol/L, SHBG by ~30 nmol/L and cFT by ~60 pmol/L. Conclusions: The identified modifiable risk factors support lifestyle-based interventions in men with low testosterone concentrations. Considering sociodemographic, lifestyle and medical factors facilitates more personalized interpretation of testosterone testing results with respect to existing reference ranges.
AB - Objective: Serum testosterone concentrations are affected by factors unrelated to hypothalamo-pituitary-testicular axis pathology. We evaluated the impact of sociodemographic, lifestyle and medical factors, on serum testosterone and sex hormone–binding globulin (SHBG) in men aged 40-69 years. Design: Cross-sectional analysis of 208,677 community-dwelling men from the UK Biobank. Measurements: We analysed associations of different factors with serum testosterone and SHBG (immunoassays) and calculated free testosterone (cFT), using smoothed centile plots, linear mixed models and effect size estimates. Results: Median (interquartile range) for serum testosterone was 11.6 (9.4-14.1) nmol/L, SHBG 36.9 (27.9-48.1) nmol/L and cFT 213 (178-255) pmol/L. Age and BMI were inversely associated with testosterone and cFT, while SHBG was associated with age and inversely with BMI (all P <.001). Living with a partner, (South) Asian ethnicity, never or previous smoker and some medical conditions were associated with lower testosterone. Poultry or fish eater, and higher physical activity were associated with higher testosterone (all P <.001). Testosterone was lowered by ~0.5 nmol/L across ages, ~1.5 nmol/L for BMI 30 vs 25 kg/m2, ~2 nmol/L for (South) Asian ethnicity, living with partner, college/university qualifications, low red meat eater, insufficient physical activity and 0.3-1.0 nmol/L with cardiovascular disease or diabetes. Different combinations of these factors varied serum testosterone by ~4 nmol/L, SHBG by ~30 nmol/L and cFT by ~60 pmol/L. Conclusions: The identified modifiable risk factors support lifestyle-based interventions in men with low testosterone concentrations. Considering sociodemographic, lifestyle and medical factors facilitates more personalized interpretation of testosterone testing results with respect to existing reference ranges.
KW - calculated free testosterone
KW - men
KW - sex hormone–binding globulin
KW - testosterone
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U2 - 10.1111/cen.14342
DO - 10.1111/cen.14342
M3 - Article
C2 - 32979890
AN - SCOPUS:85092300476
VL - 94
SP - 290
EP - 302
JO - Clinical Endocrinology
JF - Clinical Endocrinology
SN - 0300-0664
IS - 2
ER -