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Biomarkers in Cardiovascular Disease pp 425–447Cite as

Plasma Testosterone and Dihydrotestosterone as Markers of Heart Disease and Mortality in Older Men

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Abstract

Testosterone (T) is the primary male sex hormone, exerting its effects directly or following conversion to dihydrotestosterone (DHT) which is a more potent ligand for the androgen receptor. Circulating concentrations of T are lower in older compared to younger men, and lower T is associated with a range of poorer health outcomes. Several studies have identified lower circulating T as a predictor of cardiovascular disease (CVD) risk. Concentrations of DHT are preserved in older men, but associations of DHT with health outcomes in this expanding demographic group are relatively unexplored. Recent studies have utilized mass spectrometry to accurately measure circulating T and DHT in large population-based cohorts of older men. Lower T has been associated with CVD events and all-cause mortality. Lower DHT concentrations are associated with higher mortality from ischemic heart disease. However, interventional studies of T supplementation have not been powered for the outcome of CVD events or mortality. Therefore, while reduced T and DHT are robust biomarkers for heart disease and related mortality, additional studies are required to determine causality and assess the role of T therapy in older men without proven androgen deficiency.

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Abbreviations

ARIC study:

Atherosclerosis Risk in Communities study

BMI:

Body mass index

CHD:

Coronary heart disease

CHS:

Cardiovascular Health Study

CI:

Confidence interval

CVD:

Cardiovascular disease

DHT:

Dihydrotestosterone

E2:

Estradiol

EMAS:

European Male Aging Study

GC:

Gas chromatography

HIMS:

Health In Men Study

HR:

Hazard ratio

IHD:

Ischemic heart disease

LC:

Liquid chromatography

LH:

Luteinizing hormone

MrOS:

Osteoporotic fractures in men

MS:

Mass spectrometry

Q:

Quartile

RCT:

Randomized controlled trial

SHBG:

Sex hormone-binding globulin

T:

Testosterone

WHR:

Waist/hip ratio

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Authors and Affiliations

  1. School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia

    Bu B. Yeap

  2. Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA, Australia

    Bu B. Yeap

  3. Harry Perkins Institute of Medical Research, Fiona Stanley Hospital, 102-118 Murdoch Drive, Murdoch, WA, 6150, Australia

    Bu B. Yeap

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  1. Bu B. Yeap
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Correspondence to Bu B. Yeap .

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Editors and Affiliations

  1. Department of Biomedical Science, Faculty of Science & Technology , University of Westminster, London, United Kingdom

    Vinood B. Patel

  2. Department of Nutrition and Dietetics, Division of Diabetes and Nutritional Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom

    Victor R. Preedy

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Yeap, B.B. (2016). Plasma Testosterone and Dihydrotestosterone as Markers of Heart Disease and Mortality in Older Men. In: Patel, V., Preedy, V. (eds) Biomarkers in Cardiovascular Disease. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7678-4_38

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