Low free testosterone level as a predictor of cardiovascular events in Japanese men with coronary risk factors

Abstract

Aim: We investigated whether low plasma free testosterone (FT) levels could predict cardiovascular events (CVE) in Japanese men with coronary risk factors. Methods: Male patients with classical coronary risk factors who had undergone serum FT testing were enrolled. New incidences of CVE were retrospectively investigated among all eligible participants based on their medical records. Results: Overall, 466 male outpatients with coronary risk factors without a previous history of CVE were identified. Throughout the follow-up period (median ¼ 92 months), 126 CVE occurred. The Kaplan-Meier survival analysis according to the tertiles of plasma FT levels revealed that patients with the lowest FT tertile (<6.5 pg/mL) had a higher likelihood of developing CVE than those with the highest tertile (>9.3 pg/mL) (p<.01). Multivariate analysis showed that increased frequency of CVE was observed with lower FT tertiles, independent of other coronary risk factors, with hazard ratios of 0.617 (95% CI, 0.389-0.976; p¼.030) and 0.524 (95% CI, 0.309-0.887; p¼.016) for the second and highest tertile relative to the lowest FT tertile, respectively. Conclusion: Among Japanese men with coronary risk factors, a lower FT level was a predictor for the development of cardiovascular diseases independent of other coronary risk factors and age.

Relation between athletic club affiliation from school age and future serum free testosterone levels in Japan: A cross‐sectional study

“…BMI and waist circumference were negatively correlated with testosterone levels, although BMI was not associated with low testosterone levels in this study 24 . Some Japanese studies have found no association between BMI and low‐testosterone, similar to this study 9 . The prevalence of obesity and overweight in Japanese adults is rather low in international comparisons 25 and could explain why BMI was not a significant factor in this study.…”

“…24 Some Japanese studies have found no association between BMI and low-testosterone, similar to this study. 9 The prevalence of obesity and overweight in Japanese adults is rather low in international comparisons 25 and could explain why BMI was not a significant factor in this study.…”

“…In actual clinical practice, researchers have clarified testosterone deficiency is associated with the progression of CVDs in Caucasians and Asians. [8][9][10] Therefore, there is a worldwide clinical interest in whether treatment of metabolic syndrome, which is closely related to testosterone deficiency, could prevent the development of CVDs. Multiple factors may affect testosterone levels, including aging as well as lifestyle element such as smoking, alcohol, and exercise.…”

“…These factors are components of the metabolic syndrome and have been renowned as risk factors for stroke and cardiovascular diseases (CVDs). In actual clinical practice, researchers have clarified testosterone deficiency is associated with the progression of CVDs in Caucasians and Asians 8–10 . Therefore, there is a worldwide clinical interest in whether treatment of metabolic syndrome, which is closely related to testosterone deficiency, could prevent the development of CVDs.…”

Association of testosterone with myocardial infarction and severity of coronary artery disease among male patients

“…Testosterone levels decrease with age, low serum testosterone levels are linked to premature coronary artery disease (CAD) and with increased risk of cardiovascular (CV) mortality. Reduced levels of testosterone are also a risk factor for type 2 diabetes (T2D), inflammation, dyslipidemia and metabolic syndrome (MS) [ [1] , [2] , [3] , [4] , [5] ]. A systematic meta-analysis enrolled 3467 male patients with T2DM (1079 patients with a low testosterone level versus 2388 patients with a normal testosterone level) and investigated the association between testosterone level and cardiovascular risk in male patients with type 2 diabetes mellitus (T2DM).…”