Analysis of cardiovascular risk factors associated with serum testosterone levels according to the US 2011–2012 National Health and Nutrition Examination Survey

Figures & data

Table 1. Demographic characteristics of all enrolled subjects.

	Subjects
	n = 1545 (%)
Age (years)
≤50	430 (27.8)
51–60	400 (25.9)
61–70	383 (24.8)
>70	332 (21.5)
Race
Mexican-American	148 (9.6)
Other Hispanic	157 (10.2)
Non-Hispanic-white	614 (39.7)
Non-Hispanic-black	387 (25.0)
Non-Hispanic-Asian	198 (12.8)
Other Race	41 (2.7)
Education level
Less than 9th grade	209 (13.5)
9–11th grade (includes 12th grade with no diploma)	225 (14.6)
High school graduate/GED or equivalent	347 (22.5)
Some college or AA degree	383 (24.8)
College graduate or above	380 (24.6)
Cigarette smoker
Never	621 (40.2)
Yes but not now	567 (36.7)
Current	355 (23.0)
Had ≥12 alcohol drinks per year
Yes	1,196 (77.4)
No	212 (13.7)
MET scores
<12	1,192 (77.2)
≥12	353 (22.8)
Hypertension
No	720 (46.6)
Yes	825 (53.4)
Antihypertensive drugs	664 (42.9)

Note MET: integrated movement.

Table 2. Baseline levels of risk factors for CV and total serum testosterone for all enrolled subjects.

	Mean (SD) (n = 1545)
Systolic blood pressure (mmHg)	128.5 (17.6)
Diastolic blood pressure (mmHg)	72.9 (13.0)
BMI (kg/m^2)	28.7 (5.8)
Waist circumference	102.8 (14.7)
HDL (mmol/L)	1.2 (0.4)
Triglyceride (mmol/L)	1.7 (1.3)
LDL (mmol/L)	2.9 (0.9)
Fasting glucose	6.5 (2.3)
HbA1c	6.0 (1.3)
Total testosterone (ng/dL)	388.8 (192.8)

Table 3. Univariate analysis of risk factors and covariates related to cardiovascular events on different serum testosterone group.

	Serum testosterone
	≥300 ng/dL	<300 ng/dL
	(n = 1,001)	(n = 544)	p-value
Age (years)
≤50	267 (26.7%)	163 (30.0%)	.002
51–60	269 (26.9)	131 (24.1)
61–70	272 (27.2)	111 (20.4)
>70	193 (19.3)	139 (25.6)
Race
Mexican-American	102 (10.2)	46 (8.5)	.532
Other Hispanic	105 (10.5)	52 (9.6)
Non-Hispanic-white	382 (38.2)	232 (42.6)
Non-Hispanic-black	258 (25.8)	129 (23.7)
Non-Hispanic-Asian	126 (12.6)	72 (13.2)
Other Race	28 (2.8)	13 (2.4)
Education level
Less than 9th grade	129 (12.9)	80 (14.7)	.345
9–11th grade (includes 12th grade with no diploma)	140 (14.0)	85 (15.6)
High school graduate/GED or equivalent	231 (23.1)	116 (21.3)
Some college or AA degree	261 (26.1)	122 (22.4)
College graduate or above	239 (23.9)	141 (25.9)
Marital status
Married	608 (60.7)	355 (65.4)	.034
Widowed	60 (6.0)	41 (7.5)
Divorced	143 (14.3)	47 (8.7)
Separated	38 (3.8)	17 (3.1)
Never married	97 (9.7)	53 (9.8)
Living with partner	55 (5.5)	30 (5.5)
BMI (kg/m^2)
<18.5	25 (2.5)	14 (2.6)	<.000
18.5–24.9	299 (29.9)	83 (15.3)
25–29.9	406 (40.6)	198 (36.4)
30–34.9	202 (20.2)	150 (27.6)
≥35	69 (6.9)	99 (18.2)
HDL (mmol/L)
≥0.91	911 (91.0)	454 (83.5)	<.000
<0.91	90 (9.0)	90 (16.5)
Triglyceride (mmol/L)
<1.7	394 (71.6)	129 (58.4)	.000
≥1.7	156 (28.4)	92 (41.6)
LDL (mmol/L)
<3.1	319 (59.6)	139 (65.6)	.133
≥3.1	216 (40.4)	73 (34.4)
Hypercholesterolemia
No	337 (33.7)	169 (31.1)	.298
Yes	664 (66.3)	375 (68.9)
Diabetes
No	806 (80.5)	378 (69.5)	<.000
Yes	195 (19.5)	166 (30.5)
Hypertension
No	470 (47.0)	250 (46.0)	.708
Yes	531 (53.0)	294 (54.0)
Congestive heart failure
No	954 (95.6)	511 (94.1)	.199
Yes	44 (4.4)	32 (5.9)
Coronary heart disease
No	927 (93.4)	499 (92.1)	.348
Yes	66 (6.6)	43 (7.9)
Angina/angina pectoris
No	966 (97.1)	516 (95.2)	.058
Yes	29 (2.9)	26 (4.8)
Stroke
No	935 (93.5)	519 (95.4)	.127
Yes	65 (6.5)	25 (4.6)
MET score
<12	744 (74.3)	448 (82.4)	.000
≥12	257 (25.7)	96 (17.6)
Smoking
Never	386 (38.6)	235 (43.2)	.001
Ever but not now	353 (35.3)	214 (39.3)
Yes	260 (26.0)	95 (17.5)
Had ≥12 alcoholic drinks per year
Yes	785 (86.2)	411 (82.7)	.082
No	126 (13.8)	86 (17.3)

Table 4. Multivariable analysis of CVD risk factors and age variables on TD outcome events.

	Waldχ^2	OR (95% CI)	p-value
Age (years)
51–60 vs. ≤50	3.684	0.75 (0.55–1.01)	.055
61–70 vs. ≤50	10.7282	0.59 (0.43–0.81)	.001
>70 vs. ≤50	0.0681	1.05 (0.75–1.45)	.794
BMI
18.5–24.9 vs. <18.5	2.2104	0.58 (0.28–1.19)	.137
25–29.9 vs. <18.5	0.0305	0.94 (0.47–1.88)	.861
30–34.9 vs. <18.5	0.7554	1.37 (0.67–2.79)	.385
≥35 vs. <18.5	5.7969	2.51 (1.19–5.32)	.016
HDL
<0.91 vs. ≥0.91	7.5405	1.60 (1.14–2.24)	.006
Diabetes
Yes vs. No	8.4401	1.48 (1.14–1.92)	.004
MET scores
≥12 vs. <12	6.8717	0.69 (0.52–0.91)	.009
Smoking
Ever but not now vs. never	0.0038	1.01 (0.78–1.3)	.951
Ever vs. Never	5.6398	0.69 (0.51–0.94)	.018

Table 5. Comparison of total serum testosterone concentration in several CVDs.

Disease	Total testosterone (ng/dL)	p-value
Heart failure
No	390.7 (193.7)	.040
Yes	350.8 (174.0)
Coronary heart disease
No	390.6 (194.8)	.173
Yes	362.1 (168.1)
Angina/angina pectoris
No	392.2 (194.0)	.001
Yes	302.2 (141.3)
Stroke
No	389.2 (193.7)	.969
Yes	381.0 (180.3)

Data availability statement

All data generated or analyzed during this study are included in this published article.