Higher circulating androgens and higher physical activity levels are associated with less central adiposity and lower risk of cardiovascular death in older men

Abstract

Objective Low endogenous sex hormones and low physical activity (PA) levels have been associated with CVD risk. Whether these interact to influence CVD outcomes remains unclear. We assessed whether sex hormone concentrations and PA were additively associated with lower central adiposity and CVD risk. Patients 3351 community‐dwelling men, mean age 77 years. Measurements Baseline testosterone (T), dihydrotestosterone (DHT) and oestradiol (E2) were assayed. Levels of PA were ascertained by questionnaire. Men were stratified using median splits into high hormone + high PA (H/H), high hormone + low PA (H/L); low hormone + high PA (L/H) and low hormone + low PA (L/L) groups. Results A total of 865 CVD events and 499 CVD deaths occurred during 10‐year mean follow‐up. Men with higher T, DHT or SHBG and higher PA had the lowest BMI, waist circumference and risk of metabolic syndrome. Men with higher T had the lowest risk of incident CVD events, irrespective of PA level. Men with higher T or DHT and higher PA had the lowest risk of dying from CVD (eg, hazard ratios for T/PA H/H 0.76 P = 0.031; H/L 0.85 P = 0.222; L/H 0.80 P = 0.075; L/L 1.00). Conclusion Higher circulating androgens and higher PA were associated with less central adiposity at baseline and fewer CVD deaths during follow‐up. These findings are consistent with a potential additive effect of androgens and PA on cardiometabolic outcomes in older men.

The Effects of Androgens on Cardiometabolic Syndrome: Current Therapeutic Concepts

“…68 Higher circulating androgens and physical activity were linked to lower central adiposity at baseline and fewer CVD deaths in the recent follow-up study. 69 A potential synergic effect of androgens and physical activity on cardiometabolic outcomes in aging males is consistent with previous data. 69 Males with both hypogonadism and moderate-to-severe lower urinary tract symptoms possess a more severe cardiometabolic risk profile and benefit more from T treatment than males with mild lower urinary tract symptoms.…”

“…69 A potential synergic effect of androgens and physical activity on cardiometabolic outcomes in aging males is consistent with previous data. 69 Males with both hypogonadism and moderate-to-severe lower urinary tract symptoms possess a more severe cardiometabolic risk profile and benefit more from T treatment than males with mild lower urinary tract symptoms. 70 T therapy is a highly effective treatment for ameliorating lower urinary tract symptoms in hypogonadal men.…”

Analysis of biomarkers and metabolic pathways in patients with unstable angina based on ultra‑high‑performance liquid chromatography‑quadrupole time‑of‑flight mass spectrometry

“…Previous studies have demonstrated that low testosterone levels can lead to an increased risk of cardiovascular disease ( 60 – 62 ). Dihydrotestosterone is an important hemostatic steroid with inhibitory effects on platelets ( 63 ). Dihydrotestosterone cannot be converted to estrogen by aromatase, but a previous study has indicated that testosterone can be converted to estradiol and act through estrogen receptors ( 64 ).…”

Testosterone Therapy for Prevention and Treatment of Obesity in Men

“…49 A prospective study of 3351 community-dwelling men showed that men with low T had higher BMI, WC, and risk of metabolic syndrome (MetS) after a 10-year follow-up. 50 Interestingly, men with higher baseline T levels not only had the lowest BMI, WC, and risk of MetS, but they also had the lowest risk of incident CVD Caliber and Saad; Androgens: Clinical Research and Therapeutics, 1.1 http://online.liebertpub.com/doi/10.1089/andro.2020.0010 events-irrespective of physical activity level-and had the lowest risk of dying from CVD. 50 Low T is a particularly strong predictor of the development of central adiposity 51 with visceral fat accumulation.…”

“…50 Interestingly, men with higher baseline T levels not only had the lowest BMI, WC, and risk of MetS, but they also had the lowest risk of incident CVD Caliber and Saad; Androgens: Clinical Research and Therapeutics, 1.1 http://online.liebertpub.com/doi/10.1089/andro.2020.0010 events-irrespective of physical activity level-and had the lowest risk of dying from CVD. 50 Low T is a particularly strong predictor of the development of central adiposity 51 with visceral fat accumulation. 52 Another prospective study specifically examined the association between baseline T levels and visceral fat accumulation (measured by computed tomography) after a follow-up of 7.5 years.…”