Abstract
ObjectiveLow grade systemic inflammation (LGSI) as well as androgen deficiency has in older men been associated with several pathologies, including cardiovascular disease (CVD). We wanted to investigate whether low testosterone levels are linked to biomarkers of LGSI already in young age, before any concurrent manifestations of CVD or other systemic diseases.DesignNested cross-sectional study.MethodsForty subfertile biochemically hypogonadal (n = 20) or eugonadal (n = 20) men (mean age 37 years, SD = 4.3) and 20 age-matched controls were randomly selected from an ongoing study on male subfertility. Subjects comprised male partners in infertile couples in whom also subnormal sperm concentration was present. Blood sampling, interviews, and anthropometric measures were undertaken. Serum levels of testosterone, LH, estradiol, SHBG, and 21 LGSI-markers were assessed.ResultsAmong 21 inflammatory markers, macrophage inflammatory protein 1-alpha (MIP1a) (ß = −0.025; p = 0.028), 1-beta (MIP1B) (ß = −0.015; p = 0.049) and tumor necrosis factor alpha (TNFa) (ß = −0.015; p = 0.040) showed negative association to total testosterone (TT) levels. MIP1a (ß = −1.95; p = 0.001) and TNFa (ß = −0.95; p = 0.014) showed negative association to calculated free testosterone (cFT) levels. Compared to men with normal TT and cFT levels, TNFa levels were higher in men with subnormal levels of TT (mean ratio 1.61; p = 0.006) and cFT (mean ratio 1.58; p = 0.007). Also, MIP1a levels were higher in men with subnormal levels of TT (mean ratio 1.84; p = 0.030).ConclusionsSubnormal testosterone may already in young age associate to LGSI, which might be a part of the mechanism underlying adverse health outcomes of male hypogonadism.
Highlights
Subnormal testosterone may already in young age associate to low grade systemic inflammation (LGSI), which might be a part of the mechanism underlying adverse health outcomes of male hypogonadism
Androgen deficiency in older men has been associated with the occurrence of cardiovascular disease (CVD) [1], type 2 diabetes [2], dyslipidemia [3] and the metabolic syndrome (MetS) [4]
macrophage inflammatory protein 1-alpha (MIP1a) (ß = 20.025; 95% CI, 20.048, 20.003; p = 0.028), MIP1B (ß = 20.015; 95% CI, 20.030, 20.001; p = 0.049) and tumor necrosis factor alpha (TNFa) (ß = 20.015; 95% CI, 20.029, 20.001; p = 0.040) showed negative association to TT levels
Summary
Androgen deficiency in older men has been associated with the occurrence of cardiovascular disease (CVD) [1], type 2 diabetes [2], dyslipidemia [3] and the metabolic syndrome (MetS) [4]. These conditions have been linked to low grade systemic inflammation (LGSI), characterized by increased levels of proinflammatory cytokines and chemokines in serum [5]. Based on a meta-analysis including 19 studies, Ruige et al found weak association between endogenous testosterone and risk for CVD in elderly but not middle-aged men and raise the question whether low androgens are a cause of CVD or, rather, a marker of a poor general health [12]
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