Yi X Chan1,2, Matthew W Knuiman3, Joseph Hung1,4, Mark L Divitini3, John P Beilby5,6, David J Handelsman7, Jonathan Beilin2, Brendan McQuillan1,4, Bu B Yeap8,9. 1. School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia. 2. Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA, Australia. 3. School of Population Health, University of Western Australia, Perth, WA, Australia. 4. Department of Cardiovascular Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia. 5. PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia. 6. School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia. 7. ANZAC Research Institute, Concord, NSW, Australia. 8. School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia. bu.yeap@uwa.edu.au. 9. Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA, Australia. bu.yeap@uwa.edu.au.
Abstract
CONTEXT: Lower testosterone (T) is associated with poorer health outcomes in older men, however, the relationship between T, dihydrotestosterone (DHT) and estradiol (E2) with cardiovascular disease (CVD) in younger to middle-aged men remains unclear. OBJECTIVES: We assessed associations between endogenous sex hormones with mortality (all-cause and CVD) and CVD events, in a cohort of men aged 17-97 years. PARTICIPANTS AND METHODS: Sex hormones were assayed using mass spectrometry in 2143 men from the 1994/5 Busselton Health Survey. Outcomes to December 2010 were analysed. RESULTS: Of the 1804 men included in the analysis, mean age was 50·3 ± 16·8 years and 68·9% of men were aged <60. Mean follow-up period was 14·9 years. There were 319 deaths, 141 CVD deaths and 399 CVD events. Compared to the full cohort, men who died had lower baseline T (12·0 ± 4·4 vs 13·6 ± 4·9 nmol/l), free T (181·9 ± 52·9 vs 218·3 ± 63·8 pmol/l) and DHT (1·65 ± 0·64 vs 1·70 ± 0·72 nmol/l), but higher E2 (64·0 ± 32 vs 60·1 ± 30·2 pmol/l). After adjustment for risk factors, T was not associated with mortality (adjusted HR = 0·90, 95% CI 0·79-1·04; P = 0·164 for every increase in 1 SD of T), CVD deaths (adjusted HR = 1·04, 95% CI 0·84-1·29; P = 0·708) or CVD events (adjusted HR = 1·03, 95% CI 0·92-1·15, P = 0·661). No associations were found for free T, DHT or E2. Results were similar for men older and younger than 60 years. CONCLUSIONS: In predominantly middle-aged men, T, DHT and E2 do not influence mortality or CVD outcomes. This neutral association of hormones with CVD contrasts with prior studies of older men.
CONTEXT: Lower testosterone (T) is associated with poorer health outcomes in older men, however, the relationship between T, dihydrotestosterone (DHT) and estradiol (E2) with cardiovascular disease (CVD) in younger to middle-aged men remains unclear. OBJECTIVES: We assessed associations between endogenous sex hormones with mortality (all-cause and CVD) and CVD events, in a cohort of men aged 17-97 years. PARTICIPANTS AND METHODS: Sex hormones were assayed using mass spectrometry in 2143 men from the 1994/5 Busselton Health Survey. Outcomes to December 2010 were analysed. RESULTS: Of the 1804 men included in the analysis, mean age was 50·3 ± 16·8 years and 68·9% of men were aged <60. Mean follow-up period was 14·9 years. There were 319 deaths, 141 CVD deaths and 399 CVD events. Compared to the full cohort, men who died had lower baseline T (12·0 ± 4·4 vs 13·6 ± 4·9 nmol/l), free T (181·9 ± 52·9 vs 218·3 ± 63·8 pmol/l) and DHT (1·65 ± 0·64 vs 1·70 ± 0·72 nmol/l), but higher E2 (64·0 ± 32 vs 60·1 ± 30·2 pmol/l). After adjustment for risk factors, T was not associated with mortality (adjusted HR = 0·90, 95% CI 0·79-1·04; P = 0·164 for every increase in 1 SD of T), CVD deaths (adjusted HR = 1·04, 95% CI 0·84-1·29; P = 0·708) or CVD events (adjusted HR = 1·03, 95% CI 0·92-1·15, P = 0·661). No associations were found for free T, DHT or E2. Results were similar for men older and younger than 60 years. CONCLUSIONS: In predominantly middle-aged men, T, DHT and E2 do not influence mortality or CVD outcomes. This neutral association of hormones with CVD contrasts with prior studies of older men.
Authors: Bu Beng Yeap; Ross James Marriott; Robert J Adams; Leen Antonio; Christie M Ballantyne; Shalender Bhasin; Peggy M Cawthon; David John Couper; Adrian S Dobs; Leon Flicker; Magnus Karlsson; Sean A Martin; Alvin M Matsumoto; Dan Mellström; Paul E Norman; Claes Ohlsson; Eric S Orwoll; Terence W O'Neill; Molly M Shores; Thomas G Travison; Dirk Vanderschueren; Gary A Wittert; Frederick C W Wu; Kevin Murray Journal: BMJ Open Date: 2020-05-11 Impact factor: 2.692
Authors: Nataliya V Yaglova; Dibakhan A Tsomartova; Sergey S Obernikhin; Valentin V Yaglov; Svetlana V Nazimova; Elina S Tsomartova; Elizaveta V Chereshneva; Marina Y Ivanova; Tatiana A Lomanovskaya Journal: Int J Mol Sci Date: 2021-03-19 Impact factor: 5.923