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Submitted on January 9, 2006
Accepted on August 3, 2006
New England Research Institutes, Watertown, MA, Section of Endocrinology, Diabetes, and Nutrition, Boston University, School of Medicine, Boston Medical Center
* To whom correspondence should be addressed. E-mail: hlitman{at}neriscience.com.
Context: Racial/ethnic differences in androgen levels could account for differences in prostate cancer risk, body composition, and bone loss.
Objective: To investigate racial/ethnic variations in testosterone, bioavailable testosterone, dihydrotestosterone (DHT), sex hormone-binding globulin (SHBG) and dehydroepiandrosterone sulfate (DHEAS) levels.
Design: The Boston Area Community Health (BACH) Survey was a multistage stratified cluster random sample, recruiting from 2002-2005.
Setting: Community-based sample of Boston.
Participants: Black, Hispanic or White, aged 30-79 yr, competent to sign informed consent and literate in English/Spanish. Of 2301 men recruited, 1899 provided blood samples (538 Black, 651 Hispanic, 710 White).
Intervention: Data obtained during in-person at-home interview, conducted by bilingual phlebotomist/interviewer.
Main Outcome Measure(s): Testosterone, bioavailable testosterone, DHT, DHT/testosterone ratio, SHBG, DHEAS.
Results: With or without adjustment for covariates, there were no significant differences in testosterone, bioavailable testosterone or SHBG levels by race/ethnicity. DHEAS levels differed by race/ethnicity before covariate adjustment; after adjustment this difference was attenuated. Before adjustment, DHT and DHT/testosterone ratios did not significantly differ by racial/ethnic group. After adjustment, there was evidence of racial/ethnic differences in DHT (P = 0.047) and DHT/testosterone (P = 0.038) levels; Black men had higher DHT levels and DHT/testosterone ratios than White and Hispanic men.
Conclusions: As there are no racial/ethnic differences in testosterone levels, normative ranges need not be adjusted by race/ethnicity for androgen deficiency diagnosis for men aged 30-79. Further investigation is needed to determine whether differences in DHT levels and DHT/testosterone ratio can help explain racial/ethnic variations in prostate cancer incidence, body composition, and bone mass.
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