TY - JOUR
T1 - Low testosterone and high cholesterol levels in relation to all-cause, cardiovascular disease, and cancer mortality in White, Black, and Hispanic men
T2 - NHANES 1988–2015
AU - Lopez, David S.
AU - Lee, Wei Chen
AU - Garcia, Carlos Orellana
AU - Downer, Paige Birkelbach
AU - Taha, Shaden
AU - Villasante-Tezanos, Alejandro
AU - Tsilidis, Konstantinos K.
AU - Peek, Kristen
AU - Kyriakos, Markides
AU - Canfield, Steven
N1 - Publisher Copyright:
© 2022, Hellenic Endocrine Society.
PY - 2022/9
Y1 - 2022/9
N2 - Purpose: The role of testosterone (T) deficiency (T ≤ 300 ng/dL) and hypercholesterolemia (total cholesterol ≥ 240 mg/dL) in the risk of all-cause cardiovascular diseases (CVD) and cancer mortality among a nationally representative sample of non-Hispanic White (NHW), non-Hispanic Black (NHB) and Hispanic men remains poorly understood. Methods: Data included a full sample (NHANES 1988–1991, 1999–2004, 2011–2014) and subset sample (excluding 2011–2012, no estradiol and SHBG levels available) of 5379 and 3740 men, respectively. Participants were aged ≥ 20 y with serum T and cholesterol data (median follow-up 7.6 years). Weighted multivariable-adjusted Cox proportional hazards models were used in this study. Results: In the overall population of full and subset samples, hypercholesterolemia was inversely associated with all-cause (HR = 0.76, 95% CI, 0.63–0.91) and cancer mortality (HR = 0.56, 95% CI, 0.34–0.90). Similar findings were observed among NHW men, but higher T levels increased the risk of CVD mortality in the subset sample (T3 vs T1,Ptrend = 0.02). Among NHB men in the full and subset samples, T deficiency increased the risk of CVD mortality, but T3 vs. T1 decreased it (Ptrend = 0.03), and hypercholesterolemia decreased cancer mortality. Among Hispanic men in the full and subset samples, T deficiency increased, and hypercholesterolemia decreased the risk of CVD mortality. Conclusion: Hypercholesterolemia was inversely associated with cancer mortality. However, higher levels of T were positively associated with CVD mortality among NHW and were inversely associated with CVD mortality among NHB and Hispanic men. Larger prospective studies are warranted to clarify the underlying relationship between T and cholesterol with mortality among racial and ethnic groups.
AB - Purpose: The role of testosterone (T) deficiency (T ≤ 300 ng/dL) and hypercholesterolemia (total cholesterol ≥ 240 mg/dL) in the risk of all-cause cardiovascular diseases (CVD) and cancer mortality among a nationally representative sample of non-Hispanic White (NHW), non-Hispanic Black (NHB) and Hispanic men remains poorly understood. Methods: Data included a full sample (NHANES 1988–1991, 1999–2004, 2011–2014) and subset sample (excluding 2011–2012, no estradiol and SHBG levels available) of 5379 and 3740 men, respectively. Participants were aged ≥ 20 y with serum T and cholesterol data (median follow-up 7.6 years). Weighted multivariable-adjusted Cox proportional hazards models were used in this study. Results: In the overall population of full and subset samples, hypercholesterolemia was inversely associated with all-cause (HR = 0.76, 95% CI, 0.63–0.91) and cancer mortality (HR = 0.56, 95% CI, 0.34–0.90). Similar findings were observed among NHW men, but higher T levels increased the risk of CVD mortality in the subset sample (T3 vs T1,Ptrend = 0.02). Among NHB men in the full and subset samples, T deficiency increased the risk of CVD mortality, but T3 vs. T1 decreased it (Ptrend = 0.03), and hypercholesterolemia decreased cancer mortality. Among Hispanic men in the full and subset samples, T deficiency increased, and hypercholesterolemia decreased the risk of CVD mortality. Conclusion: Hypercholesterolemia was inversely associated with cancer mortality. However, higher levels of T were positively associated with CVD mortality among NHW and were inversely associated with CVD mortality among NHB and Hispanic men. Larger prospective studies are warranted to clarify the underlying relationship between T and cholesterol with mortality among racial and ethnic groups.
KW - Cancer
KW - Cardiovascular
KW - Mortality
KW - Serum testosterone
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U2 - 10.1007/s42000-022-00360-3
DO - 10.1007/s42000-022-00360-3
M3 - Article
C2 - 35334099
AN - SCOPUS:85127238753
SN - 1109-3099
VL - 21
SP - 399
EP - 411
JO - Hormones
JF - Hormones
IS - 3
ER -