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The genetics of testosterone contributes to “femaleness/maleness” of cardiometabolic traits and type 2 diabetes

Abstract

The genetic architecture of testosterone is highly distinct between sexes. Moreover, obesity is associated with higher testosterone in females but lower testosterone in males. Here, we ask whether male-specific testosterone variants are associated with a male pattern of obesity and type 2 diabetes (T2D) in females, and vice versa. In the UK Biobank, we conducted sex-specific genome-wide association studies and computed polygenic scores for total (PGSTT) and bioavailable testosterone (PGSBT). We tested sex-congruent and sex-incongruent associations between sex-specific PGSTs and metabolic traits, as well as T2D diagnosis. Female-specific PGSBT was associated with an elevated cardiometabolic risk and probability of T2D, in both sexes. Male-specific PGSTT was associated with traits conferring a lower cardiometabolic risk and probability of T2D, in both sexes. We demonstrate the value in considering polygenic testosterone as sex-related continuous traits, in each sex.

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Fig. 1: Testosterone polygenic scores and cardiometabolic traits.

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References

  1. Sinnott-Armstrong N, Naqvi S, Rivas M, Pritchard JK. GWAS of three molecular traits highlights core genes and pathways alongside a highly polygenic background. Elife. 2021. https://doi.org/10.7554/elife.58615.

  2. Ruth KS, Day FR, Tyrrell J, Thompson DJ, Wood AR, Mahajan A, et al. Using human genetics to understand the disease impacts of testosterone in men and women. Nat Med. 2020;26:252–8.

    Article  CAS  Google Scholar 

  3. Flynn E, Tanigawa Y, Rodriguez F, Altman RB, Sinnott-Armstrong N, Rivas MA. Sex-specific genetic effects across biomarkers. Eur J Hum Genet. 2021;29:154–63.

    Article  CAS  Google Scholar 

  4. Sudlow C, Gallacher J, Allen N, Beral V, Burton P, Danesh J, et al. UK biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age. PLoS Med. 2015;12:1–10.

    Article  Google Scholar 

  5. R Core Team (2020). R: a language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing. 2020.

  6. Mazer NA. A novel spreadsheet method for calculating the free serum concentrations of testosterone, dihydrotestosterone, estradiol, estrone and cortisol: With illustrative examples from male and female populations. Steroids 2009;74:512–9.

  7. Holmes D. Determine the CV of a calculated lab reportable—bioavailable testosterone. https://labrtorian.com/2017/08/07/determine-the-cv-of-a-calculated-lab-reportable-bioavailable-testosterone/.

  8. Vermeulen A, Verdonck L, Kaufman JM. A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab. 1999;84:3666–72.

    Article  CAS  Google Scholar 

  9. Choi SW, Mak TSH, O’Reilly PF Tutorial: a guide to performing polygenic risk score analyses. Nat Protoc. 2020. https://doi.org/10.1038/s41596-020-0353-1.

  10. Pasquali R. Obesity and androgens: facts and perspectives. Fertil Steril. 2006;85:1319–40.

    Article  CAS  Google Scholar 

  11. Zeng X, Xie Yjie, Liu Yting, Long Slian, Mo Zcheng. Polycystic ovarian syndrome: Correlation between hyperandrogenism, insulin resistance and obesity. Clin Chim Acta. 2020;502:214–21.

    Article  CAS  Google Scholar 

  12. Kelly DM, Jones TH. Testosterone and obesity. Obes Rev. 2015;16:581–606.

    Article  CAS  Google Scholar 

  13. https://www.who.int/news-room/fact-sheets/detail/diabetes. 2020.

  14. Betancourt-Albrecht M, Cunningham GR. Hypogonadism and diabetes. Int J Impot Res. 2003;15:14–20.

    Article  Google Scholar 

  15. Andersson B, Marin P, Lissner L, Vermeulen A, Bjorntorp P. Testosterone concentrations in women and men with NIDDM. Diabetes Care. 1994. https://doi.org/10.2337/diacare.17.5.405.

  16. Haider A, Yassin A, Haider KS, Doros G, Saad F, Rosano GMC. Men with testosterone deficiency and a history of cardiovascular diseases benefit from long-term testosterone therapy: observational, real-life data from a registry study. Vasc Health Risk Manag. 2016;12:251–61.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Traish AM, Haider A, Haider KS, Doros G, Saad F. Long-term testosterone therapy improves cardiometabolic function and reduces risk of cardiovascular disease in men with hypogonadism. J Cardiovasc Pharmacol Ther. 2017;22:414–33.

    Article  CAS  Google Scholar 

  18. Haider KS, Haider A, Saad F, Doros G, Hanefeld M, Dhindsa S, et al. Remission of type 2 diabetes following long-term treatment with injectable testosterone undecanoate in patients with hypogonadism and type 2 diabetes: 11-year data from a real-world registry study. Diabetes, Obes Metab. 2020;22:2055–68.

    Article  CAS  Google Scholar 

  19. Wittert G, Bracken K, Robledo KP, Grossmann M, Yeap BB, Handelsman DJ, et al. Testosterone treatment to prevent or revert type 2 diabetes in men enrolled in a lifestyle programme (T4DM): a randomised, double-blind, placebo-controlled, 2-year, phase 3b trial. Lancet Diabetes Endocrinol. 2021;9:32–45.

    Article  CAS  Google Scholar 

  20. Vosberg DE, Syme C, Parker N, Richer L, Pausova Z, Paus T. Sex continuum in the brain and body during adolescence and psychological traits. Nat Hum Behav. 2021;5:265–72.

    Article  Google Scholar 

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Acknowledgements

This research has been funded by the Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, Canadian Foundation for Innovation, and National Institutes for Health. The research has been conducted using the UK Biobank Resource under Application Number 43688. The corresponding author, Dr. Tomáš Paus, is the guarantor.

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DEV contributed to the project conception, analyses, figure, and manuscript writing and revision. NP and JS contributed to the analyses and manuscript revision. ZP and TP contributed to the project conception and manuscript writing and revision. All authors approved the final version and are accountable for the work.

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Correspondence to Tomáš Paus.

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Vosberg, D.E., Parker, N., Shin, J. et al. The genetics of testosterone contributes to “femaleness/maleness” of cardiometabolic traits and type 2 diabetes. Int J Obes 46, 235–237 (2022). https://doi.org/10.1038/s41366-021-00960-w

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