Racial Differences in Age-Related Variations of Testosterone Levels Among US Males: Potential Implications for Prostate Cancer and Personalized Medication

Hu, Hui; Odedina, Folakemi T.; Reams, R. Renee; Lissåker, Claudia; Xu, Xiaohui

doi:10.1007/s40615-014-0049-8

Cited by 19 publications

(10 citation statements)

References 29 publications

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“…This finding is also in accordance with some epidemiological evidence. According to one study based on National Health and Nutritional Examination Survey (NHANES) data, black males, compared to white males, have significantly higher peak levels of testosterone during young age, but the difference diminishes with aging and completely disappears after age 60. It indicated that the testosterone levels in blacks decrease faster with increasing age compared to that in white.…”

Section: Discussionsupporting

confidence: 92%

“…Based on this knowledge, measures that can slow age-related declines in serum testosterone can potentially be applied to prevent PCa, such as engaging in more physical activity, controlling body weight, supplementing zinc and preventing vitamin D deficiency, et al 30,31 These will be of particular importance from the age of 40, when serum testosterone is about to have an obvious decline. 29,32 Second, this will potentially endow positive significance on testosterone replacement therapy (TRT) in preventing PCa, as TRT can effectively smooth the age-related decline in testosterone if given at appropriate time. This is in line with a recent prospective study reporting that TRT among hypogonadal men had preventive effect against PCa.…”

Section: Discussionmentioning

confidence: 99%

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Association between age‐related reductions in testosterone and risk of prostate cancer—An analysis of patients' data with prostatic diseases

Wang

Chen

Bird

et al. 2017

Intl Journal of Cancer

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The relationship between serum total testosterone and prostate cancer (PCa) risk is controversial. The hypothesis that faster age-related reduction in testosterone is linked with increased PCa risk remains untested. We conducted this study at a tertiary-level hospital in southeast of the US, and derived data from the Medical Registry Database of individuals that were diagnosed of any prostate-related disease from 2001-2015. Cases were those diagnosed of PCa and had one or more measurements of testosterone prior to PCa diagnosis. Controls were those without PCa and had one or more testosterone measurements. Multivariable logistic regression models for PCa risk of absolute levels (one-time measure and 5-year average) and annual change in testosterone were respectively constructed. Among a total of 1559 patients, 217 were PCa cases, and neither one-time measure nor 5-year average of testosterone was found to be significantly associated with PCa risk. Among the 379 patients with two or more testosterone measurements, 27 were PCa cases. For every 10 ng/dL increment in annual reduction of testosterone, the risk of PCa would increase by 14% [adjusted odds ratio, 1.14; 95% confidence interval (CI), 1.03-1.25]. Compared to patients with a relatively stable testosterone, patients with an annual testosterone reduction of more than 30 ng/dL had 5.03 [95% CI: 1.53, 16.55] fold increase in PCa risk. This implies a faster age-related reduction in, but not absolute level of serum total testosterone as a risk factor for PCa. Further longitudinal studies are needed to confirm this finding.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Association between age‐related reductions in testosterone and risk of prostate cancer—An analysis of patients' data with prostatic diseases

Wang

Chen

Bird

et al. 2017

Intl Journal of Cancer

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“…Metastatic patients are treated with systemic therapy only, and that was mainly Androgen Deprivation Treatment (ADT) until recently. There is some evidence to suggest that African American men have higher testosterone and androgen receptor expression compared to white men (21,63,64). These might be contributing to a better response to ADT, which in turn might nullify other socio-economic factors contributing to the disparities in the outcome.…”

Section: Discussionmentioning

confidence: 99%

Lack of Racial Survival Differences in Metastatic Prostate Cancer in National Cancer Data Base (NCDB): A Different Finding Compared to Non-metastatic Disease

et al. 2020

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Background: Inconsistent findings have been reported in the literature regarding racial differences in survival outcomes between African American and white patients with metastatic prostate cancer (mPCa). The current study utilized a national database to determine whether racial differences exist among the target population to address this inconsistency. Methods: This study retrospectively reviewed prostate cancer (PCa) patient data (N = 1,319,225) from the National Cancer Database (NCDB). The data were divided into three groupings based on the metastatic status: (1) no metastasis (N = 318,291), (2) bone metastasis (N = 29,639), and (3) metastases to locations other than bone, such as brain, liver, or lung (N = 952). Survival probabilities of African American and white PCa patients with bone metastasis were examined through parametric proportional hazards Weibull models and Bayesian survival analysis. These results were compared to patients with no metastasis or other types of metastases. Results: No statistically supported racial disparities were observed for African American and white men with bone metastasis (p = 0.885). Similarly, there were no racial disparities in survival for those men suffering from other metastases (liver, lung, or brain). However, racial disparities in survival were observed among the two racial groups with nonmetastatic PCa (p < 0.001) or when metastasis status was not taken into account (p < 0.001). The Bayesian analysis corroborates the finding. Conclusion: This research supports our previous findings and shows that there are no racial differences in survival outcomes between African American and white patients with mPCa. In contrast, racial disparities in the survival outcome continue to exist among non-metastatic PCa patients. Further research is warranted to explain this difference.

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“…12,13 One study in adolescents showed Mexican-Americans to have the highest testosterone compared to non-Hispanic Whites, and non-Hispanic Blacks 12 and another showed that Blacks had a higher level of testosterone only in the age category 20-39. 14 While some studies have shown no difference, 15 a recent meta-analysis compared sex-steroid hormone concentration in black and white men and found that black men had a slightly significant higher level of free testosterone. 16 Identified racial differences in semen parameters and hormones may be genetic, due to sociodemographic factors but also due to dietary and/or cultural differences.…”

Section: Punjani Et Al Effect Of Ethnicity On Semen and Hormonal Parametersmentioning

confidence: 99%

The effect of ethnicity on semen analysis and hormones in the infertile patient

Punjani

Nayan

Jarvi

et al. 2019

CUAJ

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Introduction: We aimed to study the association of ethnicity on semen parameters and hormones in patients presenting with infertility. Methods: Data from men presenting for infertility assessment were prospectively collected and retrospectively reviewed. Demographic and clinical history was self-reported. Semen analysis included volume, count, motility, morphology, and vitality. The 2010 World Health Organization cutoffs were used. Baseline total testosterone and follicle-stimulating hormone (FSH) levels were recorded. Ethnicity data was classified as Caucasian, African-Canadian, Asian, Indo-Canadian, Native-Canadian, Hispanic, and Middle Eastern. All patients with complete data were included and statistical analysis was performed. Results: A total of 9079 patients were reviewed, of which 3956 patients had complete data. Of these, 839 (21.2%) were azoospermic. After adjusting for age, African-Canadians (odds ratio [OR] 1.70; 95% confidence interval [CI] 1.28‒2.25) and Asians (1.34; 95% CI 1.11‒1.62) were more likely to be azoospermic compared to Caucasians. Similarly, African Canadians (OR 1.75; 95% CI 1.33‒2.29) were more likely to be oligospermic and Asians (OR 0.82; 95% CI 0.70‒0.97) less likely to be oligospermic. Low volume was found in African-Canadian (OR 1.42; 95% CI 1.05‒1.91), Asians (OR 1.23; 95% CI 1.01‒1.51), and Indo-Canadians (OR 1.47; 95% CI 1.01‒2.13). Furthermore, Asians (OR 0.73; 95% CI 0.57‒0.93) and Hispanics (OR 0.58; 95% CI 034‒0.99) were less likely to have asthenospermia. Asians (OR 0.73; 95% CI 0.57‒0.94) and Indo-Canadians (OR 0.58; 95% CI 0.35‒0.99) were less likely to have teratozospermia. No differences were seen for vitality. No differences were seen for FSH levels, however, Asians (p<0.01) and Indo-Canadians (p<0.01) were more likely to have lower testosterone. Conclusions: Our study illustrates that variations in semen analyses and hormones exist in men with infertility. This may provide insight into the workup and management for infertile men from different ethnicities.

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Racial Differences in Age-Related Variations of Testosterone Levels Among US Males: Potential Implications for Prostate Cancer and Personalized Medication

Cited by 19 publications

References 29 publications

Association between age‐related reductions in testosterone and risk of prostate cancer—An analysis of patients' data with prostatic diseases

Association between age‐related reductions in testosterone and risk of prostate cancer—An analysis of patients' data with prostatic diseases

Lack of Racial Survival Differences in Metastatic Prostate Cancer in National Cancer Data Base (NCDB): A Different Finding Compared to Non-metastatic Disease

The effect of ethnicity on semen analysis and hormones in the infertile patient

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