Endogenous testosterone does not improve prediction of incident cardiovascular disease in a community-based cohort of adult men: results from the Tehran Lipid and Glucose Study

Abstract

Introduction: To explore the predictive value of testosterone added to the Framingham Risk Score (FRS) for cardiovascular disease (CVD).

Methods: Among 816 men, 30–70 years/old, without prevalent CVD, from a community-based cohort (Tehran Lipid and Glucose Study), we assessed the predictive value of testosterone with incident CVD, using three multivariate Cox proportional-hazards models. Model I: FRS variables; model II: Model I plus total testosterone; model III: Model II plus Systolic blood pressure (SBP) * total testosterone (the best fit interaction-term between testosterone and FRS variables). Discriminations and goodness-of-fit were assessed by the C-statistic and the approach of Grønnesby, respectively. p Value <.05 was significant.

Results: During 12 years of follow-up, 121 CVD events occurred. In all models, age, treated SBP, smoking, and diabetes were associated with increased CVD (p values <.05). Neither testosterone (models II and III), nor SBP * testosterone (model III) were associated with CVD (p values >.05). The C-statistics for models I, II, and III were 0.819, 0.820, and 0.821, respectively, indicating no significant improvement in the discrimination power. The models’ goodness-of-fit did not improve compared with the FRS.

Conclusion: Testosterone could not add to the predictive value of FRS for CVD in men, either directly, or through interactions with FRS variables.

Keywords:

• Endogenous testosterone
• total testosterone
• cardiovascular disease
• Framingham Risk Score
• risk assessment

Acknowledgements

This article has been extracted from the thesis written by Donna Parizadeh for fulfillment of a Master of Public Health (MPH) degree, at the School of Public Health, Shahid Beheshti University of Medical Sciences. The authors would like to thank the staff of the Research Institute for Endocrine Sciences and the School of Public health, Shahid Beheshti University of Medical Sciences, for their valuable efforts. The authors also wish to acknowledge Ms. Niloofar Shiva for critical editing of English grammar and syntax of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The TLGS has been funded by the National Research Council of Islamic Republic of Iran [Grant no. 121].