Lauren C Chasland1, Matthew W Knuiman2, Mark L Divitini2, Kevin Murray2, David J Handelsman3, Leon Flicker4,5,6, Graeme J Hankey4,7, Osvaldo P Almeida4,5,8, Jonathan Golledge9,10, Nicola D Ridgers11, Louise H Naylor1, Daniel J Green1, Bu B Yeap4,12. 1. School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Western Australia, Australia. 2. School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia. 3. ANZAC Research Institute, Sydney, New South Wales, Australia. 4. Medical School, University of Western Australia, Perth, Western Australia, Australia. 5. WA Centre for Health & Ageing, Harry Perkins Institute of Medical Research, Perth, Western Australia, Australia. 6. Department of Geriatric Medicine, Royal Perth Hospital, Perth, Western Australia, Australia. 7. Department of Neurology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. 8. Department of Psychiatry, Royal Perth Hospital and Bentley Hospital, Perth, Western Australia, Australia. 9. Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia. 10. Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Queensland, Australia. 11. Institute for Physical Activity and Nutrition, School of Exercise and Nutrition, Deakin University, Geelong, Victoria, Australia. 12. Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia.
Abstract
OBJECTIVE: Low endogenous sex hormones and low physical activity (PA) levels have been associated with CVD risk. Whether these interact to influence CVD outcomes remains unclear. We assessed whether sex hormone concentrations and PA were additively associated with lower central adiposity and CVD risk. PATIENTS: 3351 community-dwelling men, mean age 77 years. MEASUREMENTS: Baseline testosterone (T), dihydrotestosterone (DHT) and oestradiol (E2) were assayed. Levels of PA were ascertained by questionnaire. Men were stratified using median splits into high hormone + high PA (H/H), high hormone + low PA (H/L); low hormone + high PA (L/H) and low hormone + low PA (L/L) groups. RESULTS: A total of 865 CVD events and 499 CVD deaths occurred during 10-year mean follow-up. Men with higher T, DHT or SHBG and higher PA had the lowest BMI, waist circumference and risk of metabolic syndrome. Men with higher T had the lowest risk of incident CVD events, irrespective of PA level. Men with higher T or DHT and higher PA had the lowest risk of dying from CVD (eg, hazard ratios for T/PA H/H 0.76 P = 0.031; H/L 0.85 P = 0.222; L/H 0.80 P = 0.075; L/L 1.00). CONCLUSION: Higher circulating androgens and higher PA were associated with less central adiposity at baseline and fewer CVD deaths during follow-up. These findings are consistent with a potential additive effect of androgens and PA on cardiometabolic outcomes in older men.
OBJECTIVE: Low endogenous sex hormones and low physical activity (PA) levels have been associated with CVD risk. Whether these interact to influence CVD outcomes remains unclear. We assessed whether sex hormone concentrations and PA were additively associated with lower central adiposity and CVD risk. PATIENTS: 3351 community-dwelling men, mean age 77 years. MEASUREMENTS: Baseline testosterone (T), dihydrotestosterone (DHT) and oestradiol (E2) were assayed. Levels of PA were ascertained by questionnaire. Men were stratified using median splits into high hormone + high PA (H/H), high hormone + low PA (H/L); low hormone + high PA (L/H) and low hormone + low PA (L/L) groups. RESULTS: A total of 865 CVD events and 499 CVD deaths occurred during 10-year mean follow-up. Men with higher T, DHT or SHBG and higher PA had the lowest BMI, waist circumference and risk of metabolic syndrome. Men with higher T had the lowest risk of incident CVD events, irrespective of PA level. Men with higher T or DHT and higher PA had the lowest risk of dying from CVD (eg, hazard ratios for T/PA H/H 0.76 P = 0.031; H/L 0.85 P = 0.222; L/H 0.80 P = 0.075; L/L 1.00). CONCLUSION: Higher circulating androgens and higher PA were associated with less central adiposity at baseline and fewer CVD deaths during follow-up. These findings are consistent with a potential additive effect of androgens and PA on cardiometabolic outcomes in older men.