Abstract
Abstract Background: Testosterone (T) plays an important role in men's health and its deficiency has been linked with prostate cancer (PCa).1-3 In the U.S., there are approximately 2.4 million men (40-69 years old) with T deficiency4-7 and this number is projected to increase to 6.5 million men by 2025.8 Although this may be due, in part, to the increasing elderly population and body size, dietary factors may also play a role in T levels.9,16 Dietary patterns have been linked with PCa, and it has been hypothesized that T levels may be involved in the biological pathway.10-15 Therefore, we investigated the associations of prudent, western and alternative healthy eating index (AHEI) dietary pattern scores with serum T levels and whether these associations varied by obesity status (body mass index ≥ 30 kg/m2). Methods: We performed a cross-sectional analysis for the associations of the dietary pattern scores with T levels in 1,376 male participants of the Health Professionals Follow-up Study (HPFS). Total testosterone was measured by chemiluminescent immunoassay in blood samples collected in three assay batches: blood-draw to 1996, 1996-1998, 1998-2000. T deficiency was defined as total testosterone ≤ 350 ng/dL.17 We assessed diet every 4 years using a validated food frequency questionnaire.18 Western (high in red meat, refined grains, and high-fat dairy) and prudent (high in fruits, vegetables, and whole grains) dietary patterns were identified using principal component analysis. AHEI-2010 score is a modified version of the Healthy Eating Index 2005. Multivariable linear and logistic regression analyses were conducted to investigate these associations.Results: After adjusting for risk factors of T levels, we did not identify significant associations between quintiles (lowest to highest) of prudent, western, and AHEI dietary pattern scores with T levels, Ptrend ≥ 0.05 for all. However, there seemed to be a weak association with AHEI, Ptrend ≥ 0.07. Furthermore, a potential nonlinear relationship with the prudent diet was observed (Pnonlinearity = 0.0005). The associations of the three dietary patterns with T deficiency did not reach statistical significance, Ptrend ≥ 0.48 for all. In stratified analysis, we identified a weak linear relationship between prudent diet and T levels in obese men (Ptrend = 0.05).Conclusion: With the exception of a weak association with AHEI, we did not find a significant linear relationship between prudent and western dietary patterns and T levels, but this doesn't exclude potential nonlinear associations. Although we only identified a weak relationship between prudent diet and T levels in obese men, it seemed that obesity overwhelmed any impact of the three dietary patterns on T levels because in general the T levels across the quintiles of the three dietary patterns scores were lower among obese than non-obese men irrespective of the diet. Citation Format: David S. Lopez, Lydia Liu, Stephanie A. Smith-Warner, Eric B. Rimm, Konstantinos K. Tsilidis, Steven Canfield, Edward Giovannucci. Association of dietary patterns with serum testosterone levels in men [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5265.
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