title: High serum testosterone is associated with reduced risk of cardiovascular events in elderly men. The MrOS (Osteoporotic Fractures in Men) study in Sweden.
abstract: OBJECTIVE
  We tested the hypothesis that serum total testosterone and sex hormone-binding globulin (SHBG) levels predict cardiovascular (CV) events in community-dwelling elderly men.
  
  
  BACKGROUND
  Low serum testosterone is associated with increased adiposity, an adverse metabolic risk profile, and atherosclerosis. However, few prospective studies have demonstrated a protective link between endogenous testosterone and CV events. Polymorphisms in the SHBG gene are associated with risk of type 2 diabetes, but few studies have addressed SHBG as a predictor of CV events.
  
  
  METHODS
  We used gas chromatography/mass spectrometry to analyze baseline levels of testosterone in the prospective population-based MrOS (Osteoporotic Fractures in Men) Sweden study (2,416 men, age 69 to 81 years). SHBG was measured by immunoradiometric assay. CV clinical outcomes were obtained from central Swedish registers.
  
  
  RESULTS
  During a median 5-year follow-up, 485 CV events occurred. Both total testosterone and SHBG levels were inversely associated with the risk of CV events (trend over quartiles: p = 0.009 and p = 0.012, respectively). Men in the highest quartile of testosterone (≥550 ng/dl) had a lower risk of CV events compared with men in the 3 lower quartiles (hazard ratio: 0.70, 95% confidence interval: 0.56 to 0.88). This association remained after adjustment for traditional CV risk factors and was not materially changed in analyses excluding men with known CV disease at baseline (hazard ratio: 0.71, 95% confidence interval: 0.53 to 0.95). In models that included both testosterone and SHBG, testosterone but not SHBG predicted CV risk.
  
  
  CONCLUSIONS
  High serum testosterone predicted a reduced 5-year risk of CV events in elderly men.
authors: Centre for Bone and Arthritis Research, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
authors: Claes
authors: C
authors: Ohlsson
authors: Elizabeth
authors: E
authors: Barrett-Connor
authors: Shalender
authors: S
authors: Bhasin
authors: Eric
authors: E
authors: Orwoll
authors: Fernand
authors: F
authors: Labrie
authors: Magnus K
authors: MK
authors: Karlsson
authors: Osten
authors: O
authors: Ljunggren
authors: Liesbeth
authors: L
authors: Vandenput
authors: Dan
authors: D
authors: Mellström
authors: Asa
authors: A
authors: Tivesten
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D008401:Gas Chromatography-Mass Spectrometry / Q000379:methods; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000097:blood / Q000150:complications / Q000517:prevention & control*; D011110:Polymorphism, Genetic; D012306:Risk; D012738:Sex Hormone-Binding Globulin / Q000096:biosynthesis*; D013548:Sweden; D013739:Testosterone / Q000097:blood*; D016896:Treatment Outcome
chemical_list: D012738:Sex Hormone-Binding Globulin; D013739:Testosterone