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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Vydáno v:PloS one Ročník 9; číslo 7; s. e100409
Hlavní autoři: 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:angličtina
Vydáno: United States Public Library of Science 14.07.2014
Public Library of Science (PLoS)
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ISSN:1932-6203, 1932-6203
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Abstract 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.
AbstractList 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.
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. 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.
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.BACKGROUNDLow 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.OBJECTIVESWe 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.DATA SOURCESTwo 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.STUDY ELIGIBILITY CRITERIACross-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.METHODSWe 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.RESULTSMen 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.CONCLUSIONSAssociations 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.
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.
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.
Audience Academic
Author Akishita, Masahiro
Tuomainen, Tomi-Pekka
Völzke, Henry
Tong, Peter C. Y.
Kauhanen, Jussi
Corona, Giovanni
Goncharov, Nicolai P.
Undén, Anna-Lena
Brand, Judith S.
Onat, Altan
Kumanov, Philip
Wallaschofski, Henri
Ferrucci, Luigi
Bouchard, Claude
Salonen, Jukka T.
van der Schouw, Yvonne T.
Haring, Robin
Chen, Richard Y. T.
Schneider, Harald J.
Almeida, Osvaldo P.
Klotsche, Jens
Rovers, Maroeska M.
Maggio, Marcello
Chubb, S. A. Paul
Hautanen, Aarno
Yeap, Bu B.
Wittchen, Hans-Ulrich
Gietema, Jourik A.
Gannagé-Yared, Marie-Hélène
AuthorAffiliation 19 Clinical Center of Endocrinology and Gerontology, Medical University, Sofia, Bulgaria
5 Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
13 Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
7 Andrology and Sexual Medicine Unit Department of Clinical Physiopathology, University of Florence, Florence, Italy
University of Padova, Italy
23 MAS-Metabolic Analytical Services Oy, Helsinki, Finland
22 Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
16 Center for Family and Community Medicine, Stockholm, Sweden
24 Clinical Research Branch, National Institute on Aging, Baltimore, Maryland, United States of America
11 Department of Medicine and Therapeutics, Chinese University of Hong Kong, Shatin, Hong Kong, Hong Kong
21 Institute of Clinical Psychology, Center of Clinical Epidemiology and Longitudinal Studies, University of Dresden, Dresden, Germany
2 Departments of EBH
AuthorAffiliation_xml – name: 11 Department of Medicine and Therapeutics, Chinese University of Hong Kong, Shatin, Hong Kong, Hong Kong
– name: 9 Department of Internal Medicine and Biomedical Sciences, University of Parma, Parma, Italy
– name: 6 Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
– name: 5 Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
– name: 13 Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
– name: University of Padova, Italy
– name: 21 Institute of Clinical Psychology, Center of Clinical Epidemiology and Longitudinal Studies, University of Dresden, Dresden, Germany
– name: 10 Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, United States of America
– name: 15 Department of Endocrinology, Saint-Joseph University, Beirut, Lebanon
– name: 17 Department of Clinical Chemistry, University of Helsinki, Helsinki, Finland
– name: 3 School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
– name: 4 Medizinische Klinik Innenstadt der Universität München, München, Germany
– name: 7 Andrology and Sexual Medicine Unit Department of Clinical Physiopathology, University of Florence, Florence, Italy
– name: 12 Department of Endocrinology, Changing General Hospital, Singapore, Singapore
– name: 16 Center for Family and Community Medicine, Stockholm, Sweden
– name: 20 School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
– name: 19 Clinical Center of Endocrinology and Gerontology, Medical University, Sofia, Bulgaria
– name: 8 Department of Cardiology, Istanbul University, Istanbul, Turkey
– name: 14 Department of Medical Oncology, University Medical Center Groningen, Groningen, Netherlands
– name: 1 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
– name: 23 MAS-Metabolic Analytical Services Oy, Helsinki, Finland
– name: 18 Endocrinology Research Center, Moscow, Russia
– name: 22 Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
– name: 24 Clinical Research Branch, National Institute on Aging, Baltimore, Maryland, United States of America
– name: 2 Departments of EBH and operating rooms, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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  surname: van der Schouw
  fullname: van der Schouw, Yvonne T.
BackLink https://www.ncbi.nlm.nih.gov/pubmed/25019163$$D View this record in MEDLINE/PubMed
http://kipublications.ki.se/Default.aspx?queryparsed=id:129476431$$DView record from Swedish Publication Index (Karolinska Institutet)
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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.
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Snippet Low total testosterone (TT) and sex hormone-binding globulin (SHBG) concentrations have been associated with the metabolic syndrome (MetS) in men, but the...
Background Low total testosterone (TT) and sex hormone-binding globulin (SHBG) concentrations have been associated with the metabolic syndrome (MetS) in men,...
BACKGROUND:Low total testosterone (TT) and sex hormone-binding globulin (SHBG) concentrations have been associated with the metabolic syndrome (MetS) in men,...
Background Low total testosterone (TT) and sex hormone-binding globulin (SHBG) concentrations have been associated with the metabolic syndrome (MetS) in men,...
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StartPage e100409
SubjectTerms 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
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Title Testosterone, Sex Hormone-Binding Globulin and the Metabolic Syndrome in Men: An Individual Participant Data Meta-Analysis of Observational Studies
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