Greater physical activity and higher androgen concentrations are independently associated with lower cardiometabolic risk in men

Abstract

Context

Male ageing is associated with lower circulating testosterone (T) and increased incidence of cardiovascular disease (CVD). Whether physical activity (PA) interacts with hormones to modify CVD risk is unclear.

Objective

We assessed whether PA and sex hormone concentrations were independently associated with measures of CVD risk.

Participants

1,649 men.

Methods

Leisure, home, work and total PA were ascertained. At baseline, serum T, dihydrotestosterone (DHT) and estradiol (E2) were assayed. Men were stratified into high PA+high hormone (H/H); low PA+high hormone (L/H); high PA+low hormone (H/L) and low PA+low hormone (L/L).

Results

Mean age was 49.8 years at outset with 415 CVD events and 127 CVD deaths occurring during 20-year follow-up. Men with higher PA and higher T or DHT had lower odds of metabolic syndrome (eg. leisure H/H vs L/L odds ratio [OR] 0.17 p<0.001 for T, 0.26 p<0.001 for DHT). Men with higher PA and E2 had lower risk of metabolic syndrome (eg. leisure PA H/H vs L/L OR 0.51, p=0.001). Men with higher leisure, work or total PA and higher DHT had the lowest risk of CVD death (eg. leisure H/H HR 0.55 vs L/L, p=0.033). Men with lower leisure, home or work PA and higher E2 were at greater risk of CVD death (eg. leisure L/H HR 1.60 vs L/L, p=0.039).

Conclusions

Considering T, DHT and E2 in the context of PA better informs consideration of cardiovascular risk. A 2x2 factorial RCT assessing PA and androgens would illuminate the scope for preventing CVD in men.

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