title: Low serum testosterone levels are associated with increased risk of mortality in a population-based cohort of men aged 20-79.
abstract: OBJECTIVE
  Although the association of low serum testosterone levels with mortality has gained strength in recent research, there are few population-based studies on this issue. This study examined whether low serum testosterone levels are a risk factor for all-cause or cause-specific mortality in a population-based sample of men aged 20-79.
  
  
  RESULTS
  We used data from 1954 men recruited for the prospective population-based Study of Health in Pomerania, with measured serum testosterone levels at baseline and 195 deaths during an average 7.2-year follow-up. A total serum testosterone level of less than 8.7 nmol/L (250 ng/dL) was classified as low. The relationships of low serum testosterone levels with all-cause and cause-specific mortality were analysed by Cox proportional hazards regression models. Men with low serum testosterone levels had a significantly higher mortality from all causes than men with higher serum testosterone levels (HR 2.24; 95% CI 1.41-3.57). After adjusting for waist circumference, smoking habits, high-risk alcohol use, physical activity, renal insufficiency, and levels of dehydroepiandrosterone sulfate, low serum testosterone levels continued to be associated with increased mortality (HR 2.32; 95% CI 1.38-3.89). In cause-specific analyses, low serum testosterone levels predicted increased risk of death from cardiovascular disease (CVD) (HR 2.56; 95% CI 1.15-6.52) and cancer (HR 3.46; 95% CI 1.68-6.68), but not from respiratory diseases or other causes.
  
  
  CONCLUSIONS
  Low serum testosterone levels were associated with an increased risk of all-cause mortality independent of numerous risk factors. As serum testosterone levels are inversely related to mortality due to CVD and cancer, it may be used as a predictive marker.
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, Ernst Moritz Arndt University Greifswald, Germany. robin.haring@uni-greifswald.de
authors.forename: Robin
authors.initials: R
authors.lastname: Haring
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.forename: Antje
authors.initials: A
authors.lastname: Steveling
authors.forename: Alexander
authors.initials: A
authors.lastname: Krebs
authors.forename: Stephan B
authors.initials: SB
authors.lastname: Felix
authors.forename: Christof
authors.initials: C
authors.lastname: Schöfl
authors.forename: Marcus
authors.initials: M
authors.lastname: Dörr
authors.forename: Matthias
authors.initials: M
authors.lastname: Nauck
authors.forename: Henri
authors.initials: H
authors.lastname: Wallaschofski
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D004812:Epidemiologic Methods; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000401:mortality*; D012140:Respiratory Tract Diseases / Q000097:blood / Q000401:mortality*; D013739:Testosterone / Q000172:deficiency*; D055815:Young Adult
chemical_list: D013739:Testosterone