Associations of total testosterone (T) and calculated free T with cardiovascular disease (CVD) remain poorly understood. Particularly how these associations vary according to race and ethnicity in a nationally representative sample of men. Data included 7058 men (≥20 years) from NHANES. CVD was defined as any reported diagnosis of heart failure (HF), coronary artery disease (CAD), myocardial infarction (MI), and stroke. Total T (ng/mL) was obtained among males who participated in the morning examination. Weighted multivariable-adjusted logistic regression models were conducted. We found associations of low T (OR = 1.57, 95% CI = 1.17–2.11), low calculated free T (OR = 1.53, 95% CI = 1.10–2.17), total T (Q1 vs Q5), and calculated free T (Q1 vs Q5) with CVD after adjusting for estradiol and SHBG. In disease specific analysis, low T increased prevalence of MI (OR = 1.72, 95% CI = 1.08–2.75) and HF (OR = 1.74, 95% CI = 1.08–2.82), but a continuous increment of total T reduced the prevalence of CAD. Similar inverse associations were identified among White and Mexican Americans, but not Blacks (OR = 0.93, 95% CI = 0.49–1.76). Low levels of T and calculated free T were associated with an increased prevalence of overall CVD and among White and Mexican Americans. Associations remained in the same direction with specific CVD outcomes in the overall population.
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DSL was supported by the National Institutes of Health (NIH) and National Institute on Aging, Grant #: P30 AG059301; and the Cancer Prevention and Research Institute of Texas (CPRIT), Grant #: RP210130.
The authors declare no competing interests.
The protocols for the conduct of the NHANES were approved by the Institutional Review Board. Informed consent was obtained from all participants.
We conducted a secondary data analysis using data from NHANES. NHANES obtained informed consents from participants that also included consent for publication.
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Association of Total and Free Testosterone with Cardiovascular Disease in a Nationally Representative Sample of White, Black, and Mexican American men
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Lopez, D.S., Taha, S., Gutierrez, S. et al. Association of total and free testosterone with cardiovascular disease in a nationally representative sample of white, black, and Mexican American men. Int J Impot Res (2022). https://doi.org/10.1038/s41443-022-00660-7