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男性和女性低睾酮浓度与冠心病和死亡率的预测价值——来自 FINRISK97 研究的证据。

Predictive value of low testosterone concentrations regarding coronary heart disease and mortality in men and women - evidence from the FINRISK97 study.

机构信息

Clinic of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.

German Center for Cardiovascular Research (DZHK), Partner Site Hamburg, Lübeck, Kiel, Hamburg, Germany.

出版信息

J Intern Med. 2019 Sep;286(3):317-325. doi: 10.1111/joim.12943. Epub 2019 Jun 14.

Abstract

INTRODUCTION

The relevance of low testosterone concentrations for incident coronary heart disease (CHD) and mortality has been discussed in various studies. Here, we evaluate the predictive value of low baseline testosterone levels in a large population-based cohort.

METHODS

We measured the serum levels of testosterone in 7671 subjects (3710 male, 3961 female) of the population-based FINRISK97 study.

RESULTS

The median follow-up (FU) was 13.8 years. During the FU, a total of 779 deaths from any cause, and 395 incident CHD events were recorded. The age-adjusted baseline testosterone levels were similar in subjects suffering incident events during FU and those without incident events during FU (men: 15.80 vs. 17.01 nmol L ; P = 0.69, women: 1.14 vs. 1.15 nmol L ; P = 0.92). Weak correlations of testosterone levels were found with smoking (R = 0.09; P < 0.001), HDL cholesterol levels (R = 0.22, P < 0.001), systolic blood pressure (R = -0.05; P = 0.011), BMI (R = -0.23; P < 0.001) and waist-hip-ratio (R = -0.21; P < 0.001) in men, and with eGFR (R = -0.05; P = 0.009) in women. Kaplan-Meier analyses did not reveal a positive association of testosterone levels with incident CHD or mortality. Accordingly, also in Cox regression analyses, testosterone levels were not predictive for incident CHD or mortality - neither in men (HR 1.02 [95%CI: 0.70-1.51]; P = 0.79 for lowest versus highest quarter regarding CHD and HR 1.06 [95%CI: 0.80-1.39]; P = 0.67 regarding mortality), nor in women (HR 1.13 [95%CI: 0.69-1.85]; P = 0.56 for lowest versus highest quarter regarding CHD and HR 0.99 [95%CI: 0.71-1.39]; P = 0.80 regarding mortality).

CONCLUSIONS

Low levels of testosterone are not predictive regarding future CHD or mortality - neither in men, nor in women.

摘要

简介

低睾酮浓度与冠心病(CHD)和死亡率的相关性在各种研究中都有讨论。在这里,我们评估了在大型基于人群的队列中低基线睾酮水平的预测价值。

方法

我们测量了来自基于人群的 FINRISK97 研究的 7671 名受试者(3710 名男性,3961 名女性)的血清睾酮水平。

结果

中位随访(FU)时间为 13.8 年。在 FU 期间,共记录了 779 例任何原因导致的死亡和 395 例冠心病事件。FU 期间发生事件的受试者与 FU 期间无事件的受试者的年龄调整基线睾酮水平相似(男性:15.80 与 17.01 nmol/L;P=0.69,女性:1.14 与 1.15 nmol/L;P=0.92)。睾酮水平与吸烟(R=0.09;P<0.001)、高密度脂蛋白胆固醇水平(R=0.22,P<0.001)、收缩压(R=-0.05;P=0.011)、BMI(R=-0.23;P<0.001)和腰围-臀围比(R=-0.21;P<0.001)呈弱相关,与女性的 eGFR(R=-0.05;P=0.009)呈弱相关。Kaplan-Meier 分析并未显示睾酮水平与冠心病或死亡率之间存在正相关。因此,在 Cox 回归分析中,睾酮水平也不能预测冠心病或死亡率-在男性中,无论是最低四分位与最高四分位(CHD:HR 1.02[95%CI:0.70-1.51];P=0.79)还是最低四分位与最高四分位(死亡率:HR 1.06[95%CI:0.80-1.39];P=0.67),均无相关性;在女性中,无论是最低四分位与最高四分位(CHD:HR 1.13[95%CI:0.69-1.85];P=0.56)还是最低四分位与最高四分位(死亡率:HR 0.99[95%CI:0.71-1.39];P=0.80),均无相关性。

结论

低睾酮水平与未来的 CHD 或死亡率无关-无论是男性还是女性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8fd/6851597/83c0c6fde3bb/JOIM-286-317-g001.jpg

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