Double Trouble: co-occurrence of testosterone deficiency and body fatness associated with all-cause mortality in US men

Summary

Background

Testosterone deficiency (TD, total testosterone ≤ 350 ng/dL [12.15 nmol/L]) and obesity epidemic are growing in parallel in the United States. Yet the sequelae of TD and obesity on the risk of mortality remains unclear.

Objective

To investigate whether the co-occurrence of TD and overall obesity (body mass index ≥ 30 kg/m²), and abdominal obesity (waist circumference ≥ 102 cm), is associated with a risk of all-cause mortality in American men.

Design

The data were obtained from the NHANES 1999-2004 and the Linked Mortality File (December 31, 2011). A total of 948 participants aged ≥ 20 years old with endogenous sex hormones and adiposity measurements data were included in this study.

Results

Over a median of 9.5 y of follow-up, 142 men died of any cause in this cohort. Multivariable analysis showed a 2.60 fold increased risk of death among men with TD compared with men without TD (Hazard Ratio [HR] = 2.60; 95% confidence interval [CI] = 1.20 – 5.80). No evidence for interaction between TD and overall or abdominal obesity with risk of death (P_interaction ≥ 0.80). However, only after comparing men with TD and abdominal obesity with men without TD and no abdominal obesity, we found a 3.30 fold increased risk of death (HR = 3.30, 95% CI = 1.21 – 8.71).

Conclusion

Men with co-occurrence of TD and abdominal obesity have a higher risk of mortality. The effect of co-occurrence of TD and abdominal obesity should be further explored with a larger and longer follow-up time study.

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