Yang Han-Hsuan, Tu Shih-Kai, Chen Hsin-Hung, Hung Chia-Lien, Kuo Chia-Wen, Tsan Yu-Tse, Chu Wei-Min, Lee Meng-Chih, Liao Chun-Cheng
Department of Family Medicine, Taichung Armed Forces General Hospital, Taichung City, Taiwan.
Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung City, Taiwan.
Front Cardiovasc Med. 2022 Apr 14;9:869251. doi: 10.3389/fcvm.2022.869251. eCollection 2022.
Low testosterone levels are associated with increased risk of cardiovascular disease; however, most previous studies assessed the relationship of testosterone levels with a history of cardiovascular (CV) events rather than with CV risk prediction scores consequently neglecting the effect of testosterone on CV risk in healthy young individuals. The aim of this study was to investigate the relationship between testosterone levels and predict the 10-year risk of cardiovascular disease. This retrospective cohort study was conducted through a large medical health examination system in four metropolises in Taiwan. Two risk scores were used to predict the 10-year cardiovascular risk of participants: the Framingham Risk Score (FRS) (2008) and the Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator (2013). Multivariate-adjusted logistic regression was used to calculate odds ratios (ORs) for the correlation of testosterone level reduction with the increase in predicted CV risk. We used the MJ Health Research Foundation database to collect reports of 125,414 individuals who underwent medical checkups between 2007 and 2016. The final sample size included 1,253 male participants. A reduction in testosterone level between two subsequent medical checkups was associated with higher CV risk estimated by the FRS and ASCVD Risk Estimator in young participants aged 30-49 years (OR = 0.804, 95% CI: 0.711-0.909, p < 0.01 and OR = 0.841, 95% CI: 0.742-0.953, p < 0.01, respectively). Reduction in total testosterone levels increases CV risk in men aged 30 to 49 years, while the CV risk is not influenced by low testosterone levels at baseline.
低睾酮水平与心血管疾病风险增加相关；然而，大多数先前的研究评估的是睾酮水平与心血管（CV）事件病史之间的关系，而非与CV风险预测评分的关系，因此忽略了睾酮对健康年轻个体CV风险的影响。本研究的目的是调查睾酮水平与预测心血管疾病10年风险之间的关系。这项回顾性队列研究是通过台湾四个大都市的大型医疗健康检查系统进行的。使用了两个风险评分来预测参与者的10年心血管风险：弗雷明汉风险评分（FRS）（2008年）和动脉粥样硬化性心血管疾病（ASCVD）风险评估器（2013年）。采用多变量调整逻辑回归来计算睾酮水平降低与预测CV风险增加之间相关性的优势比（OR）。我们使用MJ健康研究基金会数据库收集了2007年至2016年间接受体检的125414人的报告。最终样本量包括1253名男性参与者。在30至49岁的年轻参与者中，两次连续体检之间睾酮水平的降低与FRS和ASCVD风险评估器估计的更高CV风险相关（OR分别为0.804，95%CI：0.711 - 0.909，p < 0.01和OR = 0.841，95%CI：0.742 - 0.953，p < 0.01）。总睾酮水平的降低会增加30至49岁男性的CV风险，而基线时低睾酮水平不会影响CV风险。
