Hormone imbalance linked to higher mortality and cardiovascular risks in men

In aging men, low levels of testosterone, high levels of luteinizing hormone (LH), and very low levels of estradiol are associated with increased all-cause mortality, according to a study. Additionally, lower concentrations of sex hormone-binding globulin (SHBG) and both low and high levels of dihydrotestosterone (DHT) are linked to higher risks of all-cause and cardiovascular disease (CVD) mortality.

The study analyzed data from 9 studies with individual participant data (IPD) totaling 255,830 participant-years, and 11 studies with summary estimates encompassing 24,109 men. A 2-stage random-effects IPD meta-analysis revealed several key associations:

• Men with baseline testosterone concentrations below 7.4 nmol/L had higher all-cause mortality.
• Elevated LH concentrations (above 10 IU/L) and very low estradiol concentrations (below 5.1 pmol/L) were linked to increased all-cause mortality.
• Testosterone levels below 5.3 nmol/L were associated with a higher risk of CVD mortality.
• Lower SHBG concentrations correlated with reduced all-cause and CVD mortality.
• Lower baseline DHT concentrations were associated with increased risks of all-cause and CVD mortality, as well as a higher risk for incident CVD events.

Reference
Yeap BB, Marriott RJ, Dwivedi G, et al. Associations of Testosterone and Related Hormones With All-Cause and Cardiovascular Mortality and Incident Cardiovascular Disease in Men: Individual Participant Data Meta-analyses. Ann Intern Med. 2024;177(6):768-781. doi: 10.7326/M23-2781. Epub 2024 May 14. PMID: 38739921.