Abstract
The purposes of this study were to evaluate the association between total testosterone (TT) deficiency and weakness on multimorbidity in men. Analyses were performed to examine the prevalence of multimobidity among young, middle-aged, and older men, with and without testosterone deficiency. Multivariate logistic models were also used to determine the association between age-specific TT tertiles and multimorbidity, adjusting for key sociodemographic variables, as well as a secondary analysis adjusted for grip strength. Multimorbidity was more prevalent among men with testosterone deficiency, compared to normal TT in the entire group (36.6% vs 55.2%; p < 0.001); however, differences were only seen within young (testosterone deficiency: 36.4%; normal TT: 13.5%; p < 0.001) and older men (testosterone deficiency: 75.0%; normal TT: 61.5%; p < 0.001). Robust associations were found between the age-specific low-TT (OR: 2.87; 95%CI: 2.14–3.83) and moderate-TT (OR: 1.67; 95%CI: 1.27–2.20) tertiles (reference high-TT) and multimorbidity. Secondary analysis demonstrated that both low TT (OR: 1.82; 95%CI: 1.29–2.55) and moderate-TT (OR: 1.31; 95%CI: 1.01–1.69) were associated with multimorbidity, even after adjusting for obesity (OR: 1.75; 95%CI: 1.07–2.87) and NGS (OR: 1.21 per 0.05 unit lower NGS). Low TT and weakness in men were independently associated with multimorbidity at all ages; however, multimorbidity was more prevalent among young and older men with testosterone deficiency.
Highlights
The purposes of this study were to evaluate the association between total testosterone (TT) deficiency and weakness on multimorbidity in men
The authors of a well-known systematic review assert that testosterone deficiency is robustly associated with obesity, insulin resistance, low high-density lipoprotein (HDL) cholesterol and elevated triglycerides, low-density lipoprotein (LDL) cholesterol, and plasminogen activator type 1, there is insufficient evidence to demonstrate a causal role of endogenous testosterone deficiency on coronary artery disease13-the leading cause of preventable death among men in the U.S14
Of the 2,399 men in the 2011–2012 National Health and Nutrition Examination Survey (NHANES) survey who were at least 20 years old, 2,161 had complete data for (1) demographic and anthropometric information; (2) valid questionnaire data pertaining to chronic disease diagnoses; (3) the necessary blood samples obtained for serum TT determination; (4) valid strength data from a handgrip dynamometer; and (5) the necessary examination or laboratory assessments for cardiometabolic disease risk factors
Summary
The purposes of this study were to evaluate the association between total testosterone (TT) deficiency and weakness on multimorbidity in men. Analyses were performed to examine the prevalence of multimobidity among young, middle-aged, and older men, with and without testosterone deficiency. Low TT and weakness in men were independently associated with multimorbidity at all ages; multimorbidity was more prevalent among young and older men with testosterone deficiency. Recent studies have suggested that testosterone deficiency is independently and robustly associated with various obesity-related chronic diseases in men, including type 2 diabetes and cardiovascular disease[9,10,11]. That investigation effectively defined “normal ranges” for TT levels in young healthy men, which may help limit misdiagnosis of testosterone deficiency Those ranges were derived from non-nationally representative pooled data across cohorts that do not reflect the growing, ethnically-diverse U.S population, and in which individuals with several morbid conditions were excluded. Standard cut points for abdominal obesity in men (>102 cm) were used
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