Li Meiling, Wang Xiaoyi, Wang Qi, Fu Chunying, Shrestha Nipun, Virani Salim S, Zhu Dongshan
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong, 250012, China.
Health Evidence Synthesis, Recommendations and Impact (HESRI), School of Public Health, University of Adelaide, Adelaide, South Australia, Australia.
Hormones (Athens). 2025 Apr 29. doi: 10.1007/s42000-025-00655-1.
Studies exploring the relationship between male-specific factors and risks of cardiovascular disease (CVD) are limited and inconsistent. We aimed to examine the association of male hormone levels and sexual factors (e.g., onset of puberty and baldness pattern) with CVD events.
This study included 154,970 men from the UK Biobank for prospective analyses. Cox proportional hazards regression was performed, with outcomes of CVD, coronary heart disease (CHD), stroke, and heart failure (HF), and adjusted for sociodemographics, lifestyle, and medical factors. Restricted cubic spline models assessed nonlinear associations between sex hormone levels and CVD risks.
Over a median follow-up of 13.0 years, 20,216 men (13.0%) experienced a CVD event. Men in the highest quintile of total testosterone had increased stroke risk (HR 1.13, 95% CI: 1.04-1.23). A J-shaped relationship was found between sex hormone-binding globulin (SHBG) levels and CVD risk, with the highest risk in Q5 (1.08, 1.03-1.13). A U-shaped association was noted for free testosterone (FT), where Q3 had lower CVD risk (0.94, 0.90-0.98). Earlier onset of facial hair or voice breaking (< 13 years) correlated with higher CVD risks (HR 1.10, 95% CI: 1.04-1.16 and HR 1.14, 95% CI: 1.06-1.22, respectively). Vertex baldness was linked to increased CVD risk (1.05, 1.01-1.09) and CHD risk (1.06, 1.02-1.11).
Elevated SHBG levels, earlier puberty onset, and vertex baldness were associated with increased CVD risks in men, highlighting the need for targeted prevention strategies.
探索男性特定因素与心血管疾病（CVD）风险之间关系的研究有限且结果不一致。我们旨在研究男性激素水平和性因素（如青春期开始时间和脱发模式）与CVD事件之间的关联。
本研究纳入了来自英国生物银行的154,970名男性进行前瞻性分析。采用Cox比例风险回归模型，以CVD、冠心病（CHD）、中风和心力衰竭（HF）为结局，并对社会人口统计学、生活方式和医学因素进行了调整。限制三次样条模型评估了性激素水平与CVD风险之间的非线性关联。
在中位随访13.0年期间，20,216名男性（13.0%）发生了CVD事件。总睾酮水平处于最高五分位数的男性中风风险增加（风险比[HR] 1.13，95%置信区间[CI]：1.04 - 1.23）。性激素结合球蛋白（SHBG）水平与CVD风险之间呈J形关系，在五分位数5中风险最高（1.08，1.03 - 1.13）。游离睾酮（FT）呈U形关联，其中三分位数3的CVD风险较低（0.94，0.90 - 0.98）。面部毛发或变声过早开始（<13岁）与较高的CVD风险相关（HR分别为1.10，95% CI：1.04 - 1.16和HR 1.14，95% CI：1.06 - 1.22）。头顶秃发与CVD风险增加（1.05，1.01 - 1.09）和CHD风险增加（1.06，1.02 - 1.11）相关。
SHBG水平升高、青春期过早开始和头顶秃发与男性CVD风险增加相关，突出了针对性预防策略的必要性。
