Testosterone is positively associated with coronary artery calcium in a low cardiovascular disease risk population
Year: 2023
Type: article
Study design: Observational Study
Abstract: Background: 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. Methodology: 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). Results: 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 (Incidence Rate Ratio [IRR] = 1.477, 95% Confidence Interval [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 (Odds Ratio [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). Conclusions and Implications: Among Tsimane, testosterone is positively associated with coronary artery calcium despite generally low normal testosterone levels, minimal atherosclerosis and rare cardiovascular disease (CVD) events. Associations between low testosterone and CVD events in industrialized populations are likely confounded by obesity and other lifestyle factors.
DOI: 10.1093/emph/eoad039
Authors: Benjamin C Trumble, Jacob Negrey, Stephanie V Koebele, Randall C Thompson, L Samuel Wann, Adel H Allam, Bret Beheim, M Linda Sutherland, James D Sutherland, Daniel Eid Rodriguez, David E Michalik, Chris J Rowan, Guido P Lombardi, Angela R Garcia, Daniel K Cummings, Edmond Seabright, Sarah Alami, Thomas S Kraft, Paul Hooper, Kenneth Buetow, Andrei Irimia, Margaret Gatz, Jonathan Stieglitz, Michael D Gurven, Hillard Kaplan, Gregory S Thomas, Tsimane Health and Life History Project Teams
Institutions: Arizona State University, Saint Luke's Hospital, University of New Mexico, Al-Azhar University, Max Planck Institute for Evolutionary Anthropology, MemorialCare Health System, Universidad Mayor de San Simón, University of California, Irvine, Miller Children's & Women's Hospital, University of Nevada, Reno, Universidad Peruana Cayetano Heredia, Chapman University, Université Mohammed VI Polytechnique, University of Utah, University of Southern California, Toulouse School of Economics, Institute for Advanced Study in Toulouse, University of California, Santa Barbara
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,488
OpenAlex ID: W4388733608