Testosterone is positively associated with coronary artery calcium in a low cardiovascular disease risk population

Author:

Trumble Benjamin C1ORCID,Negrey Jacob1,Koebele Stephanie V1,Thompson Randall C2,Samuel Wann L3,Allam Adel H4,Beheim Bret5,Linda Sutherland M6,Sutherland James D6,Eid Rodriguez Daniel7,Michalik David E89ORCID,Rowan Chris J10,Lombardi Guido P11,Garcia Angela R1,Cummings Daniel K12,Seabright Edmond13,Alami Sarah13,Kraft Thomas S14,Hooper Paul12,Buetow Kenneth1,Irimia Andrei15ORCID,Gatz Margaret15ORCID,Stieglitz Jonathan16,Gurven Michael D17ORCID,Kaplan Hillard12,Thomas Gregory S618,

Affiliation:

1. Arizona State University, School of Human Evolution and Social Change, Center for Evolution and Medicine, Institute of Human Origins ,  Tempe, AZ , USA

2. Saint Luke’s Mid America Heart Institute, Department of Cardiology , Kansas City, MO , USA

3. University of New Mexico, School of Medicine , Albuquerque, NM , USA

4. Al Azhar University, School of Medicine , Cairo , Egypt

5. Max Planck Institute for Evolutionary Anthropology, Department of Human Behavior, Ecology and Culture , Leipzig , Germany

6. MemorialCare Health System , Fountain Valley, CA , USA

7. Universidad de San Simón, Department of Medicine , Cochabamba , Bolivia

8. University of California Irvine, School of Medicine , Irvine , CA , USA

9. Miller Women’s and Children’s Hospital Long Beach , CA , USA

10. University of Nevada, School of Medicine , NV , USA

11. Universidad Peruana Cayetano Heredia, Laboratorio de Paleopatología , Lima , Peru

12. Chapman University, Economic Science Institute , Orange, CA , USA

13. Mohammed VI Polytechnic University, School of Collective Intelligence , Ben Guerir , Morocco

14. University of Utah, Anthropology Department , Salt Lake City, UT , USA

15. University of Southern California, Psychology Department , Los Angeles, CA , USA

16. Toulouse Scool of Economics, Institute for Advanced Study Toulouse , Toulouse , France

17. University of California Santa Barbara, Department of Anthropology ,  Santa Barbara, CA , USA

18. University of California Irvine, Division of Cardiology , Orange, CA , USA

Abstract

Abstract Background In industrialized populations, low male testosterone is associated with higher rates of cardiovascular mortality. However, coronary risk factors like obesity impact both testosterone and cardiovascular outcomes. Here, we assess the role of endogenous testosterone on coronary artery calcium in an active subsistence population with relatively low testosterone levels, low cardiovascular risk and low coronary artery calcium scores. Methodology In this cross-sectional community-based study, 719 Tsimane forager-horticulturalists in the Bolivian Amazon aged 40+ years underwent computed tomography (49.8% male, mean age 57.6 years). Results Coronary artery calcium levels were low; 84.5% had no coronary artery calcium. Zero-inflated negative binomial models found testosterone was positively associated with coronary artery calcium for the full sample (Incidence Rate Ratio [IRR] = 1.477, 95% Confidence Interval [CI] 1.001–2.170, P = 0.031), and in a male-only subset (IRR = 1.532, 95% CI 0.993–2.360, P = 0.053). Testosterone was also positively associated with clinically relevant coronary atherosclerosis (calcium >100 Agatston units) in the full sample (Odds Ratio [OR] = 1.984, 95% CI 1.202–3.275, P = 0.007) and when limited to male-only sample (OR = 2.032, 95% CI 1.118–4.816, P = 0.024). Individuals with coronary artery calcium >100 had 20% higher levels of testosterone than those with calcium <100 (t = –3.201, P = 0.007). Conclusions and Implications Among Tsimane, testosterone is positively associated with coronary artery calcium despite generally low normal testosterone levels, minimal atherosclerosis and rare cardiovascular disease (CVD) events. Associations between low testosterone and CVD events in industrialized populations are likely confounded by obesity and other lifestyle factors.

Publisher

Oxford University Press (OUP)

Subject

Health, Toxicology and Mutagenesis,Ecology, Evolution, Behavior and Systematics,Medicine (miscellaneous)

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