Associations of testosterone, dihydrotestosterone and estradiol measured using liquid chromatography-tandem mass spectrometry with physical, metabolic and health-related factors in men aged 17-97 years from the Busselton Health Survey. (#68)
Lower testosterone (T) levels are associated with poorer health outcomes in older men, but associations in younger men are uncertain and data for dihydrotestosterone (DHT) and estradiol (E2) are lacking. We assessed associations of circulating T, DHT and E2 with physical, metabolic and health-related factors in Western Australian men.
Participants and methods
Serum from 2,087 community-dwelling men aged 17-97 years who participated in the 1994/95 Busselton Health Survey was assayed for T, DHT and E2 using liquid chromatography-tandem mass spectrometry and for sex hormone-binding globulin (SHBG) and luteinising hormone (LH) by immunoassay. Free T was calculated using empirical formulae. Men were receiving hormonal therapy, or with any history of prostate cancer or orchidectomy were excluded.
Mean (±SD) age was 50.4±16.7 years and BMI was 26.5±3.4 kg/m2. A total of 43% had never smoked, 6.3% had diabetes and 17.0% a history of cardiovascular disease (CVD). Levels of T and calculated free T declined with age, DHT was constant while E2, SHBG and LH increased with age. Total T, free T, DHT, E2, SHBG and LH were all higher in current smokers and all, except for E2, were negatively correlated with adiposity. Total T was moderately correlated with DHT (r=0.57), E2 (r=0.35) and SHBG (r=0.53). In age-, smoking- and waist circumference-adjusted models, total T was positively associated with HDL, haemoglobin and adiponectin, and negatively associated with glucose, insulin, triglycerides and CRP. DHT was associated with the same covariates except adiponectin. E2 was positively associated with BMI, HDL and haemoglobin, and negatively associated with CRP. Sex steroids were not associated with total cholesterol, hypertension, renal disease or CVD.
After adjusting for age, smoking and waist circumference, higher circulating total T and DHT are associated with favourable lipid and glucose profiles, and reduced inflammation. E2 levels are associated with other measures of body habitus and inversely with CRP. In men spanning younger, middle and older ages, circulating androgens are related to metabolic factors rather than pre-existing medical comorbidities.