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Inverse Association of Testosterone and the Metabolic Syndrome in Men Is Consistent across Race and Ethnic Groups

New England Research Institutes (V.K., C.L.L., R.R., J.B.M.), Watertown, Massachusetts 02472; and Massachusetts General Hospital (F.J.H.), Boston, Massachusetts 02114

Address all correspondence to: Varant Kupelian, Research Scientist, 9 Galen Street, Watertown, Massachusetts 02472. E-mail: vkupelian{at}neriscience.

Context: Low sex hormone levels have been associated with the metabolic syndrome (MetS).

Objectives: Our objective was to determine whether the association between sex hormone levels and MetS varies by race/ethnicity among men and to investigate the relationship of sex hormones and individual components of MetS.

Design: We conducted a population-based observational survey.

Participants: A multistage stratified design was used to recruit a random sample of 2301 racially/ethnically diverse men age 30–79 yr. Blood samples were obtained on 1899 men. Analyses were conducted on 1885 men with complete data on total testosterone (T), free T, and SHBG.

Interventions: There were no interventions.

Main Outcome Measure: MetS was defined using a modification of the Adult Treatment Panel III guidelines. The association between MetS and sex hormone levels was assessed using odds ratios and 95% confidence intervals estimated using logistic regression models.

Results: A strong inverse association was observed, in both bivariate and multivariate analyses, between hormone levels and MetS. The odds of MetS increased about two-fold with a 1 SD decrease in hormone levels. The association between sex hormones and MetS was statistically significant across racial/ethnic groups. Although the magnitude of this association was largest among White men, racial/ethnic differences were not statistically significant. The strength of the association of sex hormones with individual components of MetS varied; stronger associations were observed with waist circumference and dyslipidemia and more modest associations with diabetes and elevated blood sugar.

Conclusions: A robust, dose-response relationship between sex hormone levels and odds of the metabolic syndrome in men is consistent across racial/ethnic groups.

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