Table 3.
Association Between Levels of Endogenous Testosterone and Mortality
| Study Name | Subfraction of Testosterone Used for Analysis | Sample Size | Sample Age Range/Sample Mean Age (Years) | Mean Follow‐up Period (Years) | Major Finding | Remarks |
|---|---|---|---|---|---|---|
| Haring et al35 (CS, n=1954) | TT | 1954 | 20 to 79/58.7 | 7.2 | Low TT is associated with increased risk of mortality from all causes and CV disease | ● HR of low TT for all‐cause mortality, 1.92 95% CI, 1.18 to 3.14; P<0.001 ● HR of low TT for CV mortality, 2.56; 95% CI, 1.15 to 6.52; P<0.05 |
| Khaw et al36 (CCS, n=11 606) | TT | 11 606 | 40 to 79/67.3 | 7 | Low TT is associated with higher risk of all‐cause and CV mortality. Same trend was noted for CHD mortality but statistical significance was not achieved | ● OR of low TT for all‐cause mortality, 0.59; P<0.001 ● OR of low TT for CV mortality, 0.53; P<0.01 |
| Menke et al39 (CS, n=1114) | TT, FT, BT | 1114 | ≥20/40 | 16 | Decrease in FT and BT from 90th to 10th percentile is associated with increased risk of all‐cause and CV mortality during the first 9 years of follow‐up | ● HR of FT decrease for all‐cause mortality, 1.43; 95% CI, 1.09 to 1.87 ● HR of BT decrease for all‐cause mortality, 1.52; 95% CI, 1.15 to 2.02 ● HR of FT decrease for CV mortality, 1.53; 95% CI, 1.05 to 2.23 ● HR of BT decrease for CV mortality, 1.63; 95% CI, 1.12 to 2.37 |
| Vikan et al40 (CS, n=1568) | TT, FT | 1568 | Not reported/59.6 | 11.2 | 24% Higher risk of all‐cause mortality for men with low FT levels | ● HR of low FT for all‐cause mortality, 1.24; 95% CI, 1.01 to 1.54 |
| Tivesten et al42 (CS, n=3014) | TT, FT | 2639 with TT; 2618 with FT | 69 to 80/75.4 | 4.5 | Increasing levels of TT and FT are associated with decreasing risk of all‐cause mortality | ● HR of high TT for all‐cause mortality, 0.59; P<0.001 ● HR of high FT for all‐cause mortality, 0.50; P<0.001 |
| Shores et al44 (CS, n=858) | TT | 858 | ≥40/61.4 | 4.3 | Low TT is associated with higher risk of all‐cause mortality | ● HR of low TT for all‐cause mortality, 1.88; P<0.001 |
| Laughlin et al46 (CS, n=794) | TT, BT | 794 | 63 to 78.9/71.2 | 11.8 | Low TT and BT are associated with higher risk of all‐cause and CV mortality | ● HR of low TT for all‐cause mortality, 1.44; P<0.002 ● HR of low BT for all‐cause mortality, 1.50; P<0.001 ● HR of low TT for CV mortality, 1.38; 95% CI, 1.02 to 1.85 ● HR of low BT for CV mortality, 1.36; 95% CI, 1.04 to 1.79 |
| Malkin et al47 (FU, n=930) | TT, BT | 930 | Not reported | 6.9 | Low BT is inversely associated with time to all‐cause and vascular mortality | ● HR of low BT for all‐cause mortality, 2.2; 95% CI, 1.4 to 3.6; P<0.0001 ● HR of low BT for vascular mortality, 2.2; 95% CI, 1.2 to 3.9; P=0.007 |
BT indicates bioavailable testosterone; CAD, coronary artery disease; CCS, case–control study; CHD, coronary heart disease; CI, confidence interval; CS, cohort study; CV, cardiovascular; FAI, free androgen index; FT, free testosterone; FU, follow‐up study; HR, hazard ratio; OR, odds ratio; TT, total testosterone.