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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

Abstract

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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Data availability

All data generated or analyzed in this study was provided by the National Center for Health Statistics (NCHS) of the US Centers for Disease Control and Prevention (CDC)- https://www.cdc.gov/nchs/nhanes/index.htm. For further data inquiries, please contact the corresponding author of this paper (DSL).

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Funding

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.

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DSL, ST, and KKT contributed to the study design, interpretation of the data, writing and critical discussion of the paper draft. ST and SG contributed to the statistical analysis of the study. All other authors contributed to the interpretation, discussion and editing of the paper draft.

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Correspondence to David S. Lopez.

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The protocols for the conduct of the NHANES were approved by the Institutional Review Board. Informed consent was obtained from all participants.

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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

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