TY - JOUR
T1 - Testosterone, sex hormone-binding globulin and the metabolic syndrome in men
T2 - An individual participant data meta-analysis of observational studies
AU - Brand, Judith S.
AU - Rovers, Maroeska M.
AU - Yeap, Bu B.
AU - Schneider, Harald J.
AU - Tuomainen, Tomi Pekka
AU - Haring, Robin
AU - Corona, Giovanni
AU - Onat, Altan
AU - Maggio, Marcello
AU - Bouchard, Claude
AU - Tong, Peter C Y
AU - Chen, Richard Y T
AU - Akishita, Masahiro
AU - Gietema, Jourik A.
AU - Gannagé-Yared, Marie Hélène
AU - Undeń, Anna Lena
AU - Hautanen, Aarno
AU - Goncharov, Nicolai P.
AU - Kumanov, Philip
AU - Chubb, S. A Paul
AU - Almeida, Osvaldo P.
AU - Wittchen, Hans Ulrich
AU - Klotsche, Jens
AU - Wallaschofski, Henri
AU - Völzke, Henry
AU - Kauhanen, Jussi
AU - Salonen, Jukka T.
AU - Ferrucci, Luigi
AU - Van Der Schouw, Yvonne T.
PY - 2014/7/14
Y1 - 2014/7/14
N2 - Background: Low total testosterone (TT) and sex hormone-binding globulin (SHBG) concentrations have been associated with the metabolic syndrome (MetS) in men, but the reported strength of association varies considerably. Objectives: We aimed to investigate whether associations differ across specific subgroups (according to age and body mass index (BMI)) and individual MetS components. Data sources: Two previously published meta-analyses including an updated systematic search in PubMed and EMBASE. Study Eligibility Criteria: Cross-sectional or prospective observational studies with data on TT and/or SHBG concentrations in combination with MetS in men. Methods: We conducted an individual participant data meta-analysis of 20 observational studies. Mixed effects models were used to assess cross-sectional and prospective associations of TT, SHBG and free testosterone (FT) with MetS and its individual components. Multivariable adjusted odds ratios (ORs) and hazard ratios (HRs) were calculated and effect modification by age and BMI was studied. Results: Men with low concentrations of TT, SHBG or FT were more likely to have prevalent MetS (ORs per quartile decrease were 1.69 (95% CI 1.60-1.77), 1.73 (95% CI 1.62-1.85) and 1.46 (95% CI 1.36-1.57) for TT, SHBG and FT, respectively) and incident MetS (HRs per quartile decrease were 1.25 (95% CI 1.16-1.36), 1.44 (95% 1.30-1.60) and 1.14 (95% 1.01-1.28) for TT, SHBG and FT, respectively). Overall, the magnitude of associations was largest in non-overweight men and varied across individual components: stronger associations were observed with hypertriglyceridemia, abdominal obesity and hyperglycaemia and associations were weakest for hypertension. Conclusions: Associations of testosterone and SHBG with MetS vary according to BMI and individual MetS components. These findings provide further insights into the pathophysiological mechanisms linking low testosterone and SHBG concentrations to cardiometabolic risk.
AB - Background: Low total testosterone (TT) and sex hormone-binding globulin (SHBG) concentrations have been associated with the metabolic syndrome (MetS) in men, but the reported strength of association varies considerably. Objectives: We aimed to investigate whether associations differ across specific subgroups (according to age and body mass index (BMI)) and individual MetS components. Data sources: Two previously published meta-analyses including an updated systematic search in PubMed and EMBASE. Study Eligibility Criteria: Cross-sectional or prospective observational studies with data on TT and/or SHBG concentrations in combination with MetS in men. Methods: We conducted an individual participant data meta-analysis of 20 observational studies. Mixed effects models were used to assess cross-sectional and prospective associations of TT, SHBG and free testosterone (FT) with MetS and its individual components. Multivariable adjusted odds ratios (ORs) and hazard ratios (HRs) were calculated and effect modification by age and BMI was studied. Results: Men with low concentrations of TT, SHBG or FT were more likely to have prevalent MetS (ORs per quartile decrease were 1.69 (95% CI 1.60-1.77), 1.73 (95% CI 1.62-1.85) and 1.46 (95% CI 1.36-1.57) for TT, SHBG and FT, respectively) and incident MetS (HRs per quartile decrease were 1.25 (95% CI 1.16-1.36), 1.44 (95% 1.30-1.60) and 1.14 (95% 1.01-1.28) for TT, SHBG and FT, respectively). Overall, the magnitude of associations was largest in non-overweight men and varied across individual components: stronger associations were observed with hypertriglyceridemia, abdominal obesity and hyperglycaemia and associations were weakest for hypertension. Conclusions: Associations of testosterone and SHBG with MetS vary according to BMI and individual MetS components. These findings provide further insights into the pathophysiological mechanisms linking low testosterone and SHBG concentrations to cardiometabolic risk.
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U2 - 10.1371/journal.pone.0100409
DO - 10.1371/journal.pone.0100409
M3 - Article
C2 - 25019163
AN - SCOPUS:84904249102
SN - 1932-6203
VL - 9
JO - PLoS One
JF - PLoS One
IS - 7
M1 - e100409
ER -