Associations of Testosterone and Related Hormones With All-Cause and Cardiovascular Mortality and Incident Cardiovascular Disease in Men : Individual Participant Data Meta-analyses
Authors' conclusion
Men with low testosterone, high LH, or very low estradiol concentrations had increased all-cause mortality. SHBG concentration was positively associated and DHT concentration was nonlinearly associated with all-cause and CVD mortality.
Study context
- Population
- Community-dwelling men in prospective cohort studies9 individual participant data (IPD) studies (255,830 participant-years)
- Comparison
- Baseline sex hormone concentrations and mortality and cardiovascular disease (CVD) risk
- Outcome
- All-cause mortality, CVD death and incident CVD events
Methodological detailstwo-stage random-effects IPD meta-analysis, mass spectrometry hormone measurement, ≥5 years follow-up, Literature search to July 2019, bridge searches to March 2024, Adjusted for age, BMI, marital status, alcohol, smoking, physical activity, hypertension, DM, creatinine, total/HDL cholesterol ratio, lipid medication, Limitations: observational design, heterogeneity, imputation of missing data
- Two-stage random-effects IPD meta-analysis
- Mass spectrometry hormone measurement
- ≥5 years follow-up
- Literature search to July 2019, bridge searches to March 2024
- Adjusted for age, BMI, marital status, alcohol, smoking, physical activity, hypertension, DM, creatinine, total/HDL cholesterol ratio, lipid medication
- Limitations: observational design, heterogeneity, imputation of missing data
Pooled result
As reported in the abstract
Adjusted hazard ratio (95% CI)
SHBG Q1 (median 20.6 nmol/L)vs SHBG Q5 (median 68.3 nmol/L)all-cause mortality
0.85(0.77–0.95)
Lower SHBGCVD mortality
0.81(0.65–1.00)
DHT Q1 (median 0.69 nmol/L)vs DHT Q5 (median 2.45 nmol/L)all-cause mortality
1.19(1.08–1.30)
Lower DHTCVD mortality
1.29(1.03–1.61)
Original publication
Associations of Testosterone and Related Hormones With All-Cause and Cardiovascular Mortality and Incident Cardiovascular Disease in Men : Individual Participant Data Meta-analyses. Ann Intern Med. Published 14 May 2024. doi:10.
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