Testosterone, Sex Hormone-Binding Globulin and the Metabolic Syndrome in Men: An Individual Participant Data Meta-Analysis of Observational Studies

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. We aimed to investigate whether associations differ across specific subgroups (according to...

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Vydané v:	PloS one Ročník 9; číslo 7; s. e100409
Hlavní autori:	Brand, Judith S., Rovers, Maroeska M., Yeap, Bu B., Schneider, Harald J., Tuomainen, Tomi-Pekka, Haring, Robin, Corona, Giovanni, Onat, Altan, Maggio, Marcello, Bouchard, Claude, Tong, Peter C. Y., Chen, Richard Y. T., Akishita, Masahiro, Gietema, Jourik A., Gannagé-Yared, Marie-Hélène, Undén, Anna-Lena, Hautanen, Aarno, Goncharov, Nicolai P., Kumanov, Philip, Chubb, S. A. Paul, Almeida, Osvaldo P., Wittchen, Hans-Ulrich, Klotsche, Jens, Wallaschofski, Henri, Völzke, Henry, Kauhanen, Jussi, Salonen, Jukka T., Ferrucci, Luigi, van der Schouw, Yvonne T.
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States Public Library of Science 14.07.2014 Public Library of Science (PLoS)
Predmet:	Adult Age Factors Aged Aged, 80 and over Alcohol use Analysis Androgens Binding Biology and Life Sciences Body mass Body Mass Index Body size Body weight Cross-Sectional Studies Data analysis Data processing Epidemiology Globulins Health risks Hormones Humans Hyperglycemia Hypertension Hypertriglyceridemia Low concentrations Male Medical research Medicine and Health Sciences Men Meta-analysis Metabolic disorders Metabolic syndrome Metabolic Syndrome - epidemiology Middle Aged Obesity Observational studies Observational Studies as Topic Odds Ratio Overweight Physical Sciences Prospective Studies Research and Analysis Methods Sex Sex Hormone-Binding Globulin - analysis Subgroups Testosterone Testosterone - blood Upgrading Young Adult Istanbul Turkey Perth Western Australia Australia Singapore United States > US Netherlands Turkey China Finland Louisiana Hong Kong China Italy Australia Germany
ISSN:	1932-6203, 1932-6203
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Shrnutí:	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. We aimed to investigate whether associations differ across specific subgroups (according to age and body mass index (BMI)) and individual MetS components. Two previously published meta-analyses including an updated systematic search in PubMed and EMBASE. Cross-sectional or prospective observational studies with data on TT and/or SHBG concentrations in combination with MetS in men. 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. 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. 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.
Bibliografia:	ObjectType-Article-2 SourceType-Scholarly Journals-1 content type line 14 ObjectType-Feature-3 ObjectType-Evidence Based Healthcare-1 ObjectType-Article-1 ObjectType-Feature-2 content type line 23 Deceased. Conceived and designed the experiments: JSB MMR YTvdS. Performed the experiments: BBY HJS TPT RH GC AO MM CB PCYT RYTC MA JAG MHGY ALU AH NPG PK SAPC OPA HUW JK HW HV JK JTS LF. Analyzed the data: JSB. Contributed reagents/materials/analysis tools: BBY HJS TPT RH GC AO MM CB PCYT RYTC MA JAG MHGY ALU AH NPG PK SAPC OPA HUW JK HW HV JK JTS LF. Wrote the paper: JSB MMR YTvdS. Competing Interests: The authors have the following interests: Prof. Jukka T. Salonen is currently employed by MAS-Metabolic Analytical Services Oy. This employment commenced after the completion of this study. There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0100409