Reference intervals for free testosterone in adult men measured using a standardized equilibrium dialysis procedure

Jasuja, Ravi; Pencina, Karol M.; Spencer, Daniel J.; Peng, Liming; Privat, Fabiola; Dhillo, Waljit; Jayasena, Channa N.; Hayes, Frances J.; Yeap, Bu B.; Matsumoto, Alvin M.; Bhasin, Shalender

doi:10.1111/andr.13310

Andrology

2022

DOI: 10.1111/andr.13310

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Reference intervals for free testosterone in adult men measured using a standardized equilibrium dialysis procedure

Ravi Jasuja

Karol M. Pencina

Daniel J. Spencer

et al.

Abstract: Background: Free testosterone (FT) determination may be helpful in evaluating men suspected of testosterone deficiency especially in conditions with altered bindingprotein concentrations. However, methods for measuring FT by equilibrium dialysis and reference intervals vary among laboratories.Objective: To determine reference intervals for FT in healthy, nonobese men by age groups as well as in healthy young men, 19-39 years, using a standardized equilibrium dialysis procedure Methods: We measured FT in 145 he… Show more

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Cited by 6 publications

References 50 publications

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Leveraging research into sex differences and steroid hormones to improve brain health

Lee,

Eid,

Hodges

et al. 2024

Nat Rev Endocrinol

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Leveraging research into sex differences and steroid hormones to improve brain health

Lee,

Eid,

Hodges

et al. 2024

Nat Rev Endocrinol

View full text Add to dashboard Cite

Sociodemographic, lifestyle, and medical factors associated with calculated free testosterone concentrations in men: individual participant data meta-analyses

Narinx,

Marriott,

Murray

et al. 2024

European Journal of Endocrinology

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Objective Sociodemographic, lifestyle, and medical variables influence total testosterone (T) and sex hormone-binding globulin (SHBG) concentrations. The relationship between these factors and “free” T remains unclear. We examined 21 sociodemographic, lifestyle, and medical predictors influencing calculated free T (cFT) in community-dwelling men across ages. Design This is a cross-sectional analysis in 20 631 participants in the Androgens in Men Study. Methods Individual participant data (IPD) were provided by 9 cohorts. Total T was determined using mass spectrometry, SHBG using immunoassays, and cFT using the Vermeulen formula. Associations were analyzed using 2-stage random effects IPD meta-analyses. Results Cohort median ages ranged from 40 to 76 years and median cFT concentrations from 174.3 to 422.8 pmol/L. In men aged 17-99 years, there was a linear inverse association of cFT with age (−57.2 pmol/L [95% confidence interval, −69.4, −44.9] per 1 SD increase in age). Calculated free T increased with increasing baseline body mass index (BMI) among men with BMI < 23.6 kg/m2, but decreased among men with BMI > 23.6 kg/m2 (−24.7 pmol/L [−29.1, −20.3] per 1 SD increase in the 25.4-29.6 kg/m2 BMI range). Calculated free T was lower in younger men, who were married or in a de facto relationship (−18.4 pmol/L [−27.6, −9.3]) and in men who formerly smoked (−5.7 pmol/L [−8.9, −2.6]), were in poor general health (−14.0 pmol/L [−20.1, −7.8]), and had diabetes (−19.6 pmol/L [−23.0, −16.3]), cardiovascular disease (−5.8 pmol/L [−8.3, −3.2]), or cancer (−19.2 pmol/L [−24.4, −14.1]). Conclusions Calculated free T was most prominently associated with age and BMI. The linear, inverse association with age, nonlinear association with BMI, and presence of diabetes, cancer, and sociodemographic factors should be considered when interpreting cFT values.

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Testosterone is positively associated with coronary artery calcium in a low cardiovascular disease risk population

Trumble,

Negrey,

Koebele

et al. 2023

Evolution, Medicine, and Public Health

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In industrialized populations low male testosterone is associated with higher rates of cardiovascular mortality. However, coronary risk factors like obesity impact both testosterone and cardiovascular outcomes. Here we assess the role of endogenous testosterone on coronary artery calcium in an active subsistence population with relatively low testosterone levels, low cardiovascular risk, and low coronary artery calcium scores. In this cross-sectional community-based study, 719 Tsimane forager-horticulturalists in the Bolivian Amazon aged 40+ years underwent computed tomography (49.8% male, mean age 57.6 years). Coronary artery calcium levels were low; 84.5% had no coronary artery calcium. Zero inflated negative binomial models found testosterone was positively associated with coronary artery calcium for the full sample (IRR= 1.477, 95% CI 1.001-2.170, p=0.031), and in a male-only subset (IRR=1.532, 95% CI 0.993-2.360, p=0.053). Testosterone was also positively associated with clinically relevant coronary atherosclerosis (calcium >100 Agatston units) in the full sample (OR = 1.984, 95% CI 1.202-3.275, p=0.007) and when limited to male only sample (OR= 2.032, 95% CI 1.118-4.816, p=0.024). Individuals with coronary artery calcium >100 had 20% higher levels of testosterone than those with calcium <100 (t=-3.201, p=0.007). Among Tsimane, testosterone is positively associated with coronary artery calcium despite generally low normal testosterone levels, minimal atherosclerosis and rare cardiovascular disease events. Associations between low testosterone and CVD events in industrialized populations are likely confounded by obesity and other lifestyle factors.

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Reference intervals for free testosterone in adult men measured using a standardized equilibrium dialysis procedure

Cited by 6 publications

References 50 publications

Leveraging research into sex differences and steroid hormones to improve brain health

Leveraging research into sex differences and steroid hormones to improve brain health

Sociodemographic, lifestyle, and medical factors associated with calculated free testosterone concentrations in men: individual participant data meta-analyses

Testosterone is positively associated with coronary artery calcium in a low cardiovascular disease risk population

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