Table 3.
Multivariable associations of total testosterone, hypercholesterolemia, and self-reported and prescribed lipid-lowering medication with all-cause, cardiovascular (CVD) and cancer mortality: NHANES 1988–2014 linked with 2015 mortality data
| Mortality full sample†a
N = 5,379 |
Mortality subset sample†b (Adjusted for estradiol and SHBG) N = 3,740 |
||||||
|---|---|---|---|---|---|---|---|
| All-cause | CVD | Cancer | All-cause | CVD | Cancer | ||
| HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | ||
|
| |||||||
| T deficiency (≤ 300 ng/dL), N = 1137 |
T deficiency (≤ 300 ng/dL), N = 659 |
||||||
| No | 1.0 | 1.0 | 1.0 | No | 1.0 | 1.0 | 1.0 |
| Yes | 0.90 (0.64, 1.26) |
1.11 (0.62, 2.00) |
0.92 (0.39, 2.14) |
Yes | 0.88 (0.61, 1.26) |
0.93 (0.50, 1.73) |
1.22 (0.51, 2.90) |
| Total T (ng/dL) | Total T (ng/dL) | ||||||
| T1 (100–354) (N = 1791) | 1.00 | 1.00 | 1.00 | T1 (100–374) (N = 1243) | 1.00 | 1.00 | 1.00 |
| T2 (355–519) (N = 1808) | 0.91 (0.68, 1.23) |
1.23 (0.70, 2.17) |
0.92 (0.44, 1.90) |
T2 (375–539) (N = 1242) | 0.91 (0.67, 1.25) |
1.58 (0.85, 2.94) |
0.74 (0.36, 1.51) |
| T3 (≥ 520) (N = 1780) | 1.11 (0.81, 1.53) |
1.19 (0.59, 2.39) |
1.74 (0.86, 3.50) |
T3 (≥ 540) (N = 1255) | 1.06 (0.75, 1.50) |
2.28 (0.86, 6.04) |
1.11 (0.54, 2.32) |
| P trend | 0.44 | 0.63 | 0.07 | P trend | 0.71 | 0.10 | 0.62 |
| Calculated free-T (pg/dL) | Calculated free-T (pg/dL) | ||||||
| T1 (≤ 15.5) (N = 1162) | 1.00 | 1.00 | 1.00 | T1 (≤ 15.5) (N = 1162) | 1.00 | 1.00 | 1.00 |
| T2 (15.6–22.3) (N = 1165) | 1.09 (0.81, 1.48) |
1.25 (0.78, 2.01) |
1.10 (0.47, 2.56) |
T2 (15.6–22.3) (N = 1,165) | 1.04 (0.76, 1.43) |
1.51 (0.84, 2.68) |
0.96 (0.42, 2.22) |
| T3 (22.3–24.70) (N = 1164) | 1.31 (0.99, 1.74) |
1.06 (0.46, 2.42) |
1.74 (0.82, 3.70) |
T3 (22.3–24.70) (N = 1164) | 1.19 (0.87, 1.63) |
1.76 (0.57, 5.48) |
1.29 (0.64, 2.61) |
| p trend | 0.06 | 0.86 | 0.12 | p trend | 0.27 | 0.29 | 0.43 |
| Hypercholesterolemia, ng/mL (N = 1837) | Hypercholesterolemia, ng/mL (N = 1234) | ||||||
| No | 1.00 | 1.00 | 1.00 | No | 1.00 | 1.00 | 1.00 |
| Yes | 0.76 (0.63, 0.91) |
1.05 (0.58, 1.92) |
0.56 (0.34,0.90) |
Yes | 0.78 (0.64, 0.95) |
1.08 (0.60, 1.92) |
0.60 (0.36, 0.98) |
| Self-reported lipid-lowering (N = 557) | 0.66 (0.42, 1.05) |
0.82 (0.34, 1.98) |
0.57 (0.19, 1.74) |
Self-reported lipid-lowering (N = 342) | 0.76 (0.47, 1.23) |
0.81 (0.34, 1.88) |
0.86 (0.25, 2.95) |
| No | 1.00 | 1.00 | 1.00 | No | 1.00 | 1.00 | 1.00 |
| Yes | 0.66 (0.42, 1.05) |
0.82 (0.34, 1.98) |
0.57 (0.19, 1.74) |
Yes | 0.76 (0.47, 1.23) |
0.81 (0.34, 1.88) |
0.86 (0.25, 2.95) |
| Prescribed lipid-lowering (N = 617) | Prescribed lipid-lowering (N = 373) | ||||||
| No | 1.00 | 1.00 | 1.00 | No | 1.00 | 1.00 | 1.00 |
| Yes | 0.74 (0.45, 1.21) |
0.99 (0.41, 2.38) |
0.52 (0.18, 1.52) |
Yes | 0.70 (0.40, 1.22) |
0.82 (0.34, 2.01) |
0.71 (0.22, 2.29) |
†
Multivariable model adjusted for age, race and ethnicity, smoking status, history of hypertension, physical activity, alcohol consumption, body mass index, and mutual adjustment between sex steroid hormones and hypercholesterolemia
a
NHANES waves 1988–1991, 1999–2004, 2011–2014
b
NHANES waves 1988–1991, 1999–2004, 2013–2014