04551nas a2200505 4500008004100000022001400041245010500055210006900160260001600229520307000245100002203315700001803337700002103355700001803376700002803394700002203422700002203444700001903466700002203485700002103507700002003528700001803548700002503566700002203591700002003613700001803633700001803651700002103669700002003690700002403710700002003734700001903754700002403773700002003797700002203817700002103839700002103860700001903881700002403900700002503924700002103949700002303970700001603993856003604009 2023 eng d a1539-370400aFactors Associated With Circulating Sex Hormones in Men : Individual Participant Data Meta-analyses.0 aFactors Associated With Circulating Sex Hormones in Men Individu c2023 Aug 293 a

BACKGROUND: Various factors modulate circulating testosterone in men, affecting interpretation of testosterone measurements.

PURPOSE: To clarify factors associated with variations in sex hormone concentrations.

DATA SOURCES: Systematic literature searches (to July 2019).

STUDY SELECTION: Prospective cohort studies of community-dwelling men with total testosterone measured using mass spectrometry.

DATA EXTRACTION: Individual participant data (IPD) (9 studies;  = 21 074) and aggregate data (2 studies;  = 4075). Sociodemographic, lifestyle, and health factors and concentrations of total testosterone, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), dihydrotestosterone, and estradiol were extracted.

DATA SYNTHESIS: Two-stage random-effects IPD meta-analyses found a nonlinear association of testosterone with age, with negligible change among men aged 17 to 70 years (change per SD increase about the midpoint, -0.27 nmol/L [-7.8 ng/dL] [CI, -0.71 to 0.18 nmol/L {-20.5 to 5.2 ng/dL}]) and decreasing testosterone levels with age for men older than 70 years (-1.55 nmol/L [-44.7 ng/dL] [CI, -2.05 to -1.06 nmol/L {-59.1 to -30.6 ng/dL}]). Testosterone was inversely associated with body mass index (BMI) (change per SD increase, -2.42 nmol/L [-69.7 ng/dL] [CI, -2.70 to -2.13 nmol/L {-77.8 to -61.4 ng/dL}]). Testosterone concentrations were lower for men who were married (mean difference, -0.57 nmol/L [-16.4 ng/dL] [CI, -0.89 to -0.26 nmol/L {-25.6 to -7.5 ng/dL}]); undertook at most 75 minutes of vigorous physical activity per week (-0.51 nmol/L [-14.7 ng/dL] [CI, -0.90 to -0.13 nmol/L {-25.9 to -3.7 ng/dL}]); were former smokers (-0.34 nmol/L [-9.8 ng/dL] [CI, -0.55 to -0.12 nmol/L {-15.9 to -3.5 ng/dL}]); or had hypertension (-0.53 nmol/L [-15.3 ng/dL] [CI, -0.82 to -0.24 nmol/L {-23.6 to -6.9 ng/dL}]), cardiovascular disease (-0.35 nmol/L [-10.1 ng/dL] [CI, -0.55 to -0.15 nmol/L {-15.9 to -4.3 ng/dL}]), cancer (-1.39 nmol/L [-40.1 ng/dL] [CI, -1.79 to -0.99 nmol/L {-51.6 to -28.5 ng/dL}]), or diabetes (-1.43 nmol/L [-41.2 ng/dL] [CI, -1.65 to -1.22 nmol/L {-47.6 to -35.2 ng/dL}]). Sex hormone-binding globulin was directly associated with age and inversely associated with BMI. Luteinizing hormone was directly associated with age in men older than 70 years.

LIMITATION: Cross-sectional analysis, heterogeneity between studies and in timing of blood sampling, and imputation for missing data.

CONCLUSION: Multiple factors are associated with variation in male testosterone, SHBG, and LH concentrations. Reduced testosterone and increased LH concentrations may indicate impaired testicular function after age 70 years. Interpretation of individual testosterone measurements should account particularly for age older than 70 years, obesity, diabetes, and cancer.

PRIMARY FUNDING SOURCE: Medical Research Future Fund, Government of Western Australia, and Lawley Pharmaceuticals. (PROSPERO: CRD42019139668).

1 aMarriott, Ross, J1 aMurray, Kevin1 aAdams, Robert, J1 aAntonio, Leen1 aBallantyne, Christie, M1 aBauer, Douglas, C1 aBhasin, Shalender1 aBiggs, Mary, L1 aCawthon, Peggy, M1 aCouper, David, J1 aDobs, Adrian, S1 aFlicker, Leon1 aHandelsman, David, J1 aHankey, Graeme, J1 aHannemann, Anke1 aHaring, Robin1 aHsu, Benjumin1 aKarlsson, Magnus1 aMartin, Sean, A1 aMatsumoto, Alvin, M1 aMellström, Dan1 aOhlsson, Claes1 aO'Neill, Terence, W1 aOrwoll, Eric, S1 aQuartagno, Matteo1 aShores, Molly, M1 aSteveling, Antje1 aTivesten, Åsa1 aTravison, Thomas, G1 aVanderschueren, Dirk1 aWittert, Gary, A1 aWu, Frederick, C W1 aYeap, Bu, B uhttps://chs-nhlbi.org/node/9487