Low testosterone concentrations and prediction of future heart failure in men and in women: evidence from the large FINRISK97 study.


Journal

ESC heart failure
ISSN: 2055-5822
Titre abrégé: ESC Heart Fail
Pays: England
ID NLM: 101669191

Informations de publication

Date de publication:
08 2021
Historique:
revised: 18 03 2021
received: 01 12 2020
accepted: 12 04 2021
pubmed: 3 5 2021
medline: 29 10 2021
entrez: 2 5 2021
Statut: ppublish

Résumé

The increased incidence of heart failure in men suggests that endogenous sex hormones might play a role in the development of heart failure, but epidemiological data remain sparse. Here, we evaluated the predictive value of low testosterone levels on future heart failure in the large population-based FINRISK97 study. Baseline serum testosterone concentrations were measured in 7855 subjects (3865 men and 3990 women) of the FINRISK97 study. During a median follow-up (FU) of 13.8 years, a total of 564 heart failure events were recorded. The age-adjusted baseline testosterone levels did not differ significantly between subjects developing incident heart failure during FU and those without incident events during FU (men: 16.6 vs. 17.1 nmol/L, P = 0.75; women: 1.15 vs. 1.17 nmol/L, P = 0.32). Relevant statistically significant correlations of testosterone levels were found with high-density lipoprotein cholesterol levels (R = 0.22; P < 0.001), body mass index (R = -0.23; P < 0.001), and waist-to-hip ratio (R = -0.21; P < 0.001) in men, while statistically significant correlations in women were negligible in effect size. In sex-stratified Cox regression analyses, taking age into account, a quite strong association between low testosterone and incident heart failure was found in men [hazard ratio (HR) 1.51 (95% confidence interval, CI: 1.09-2.10); P = 0.020 for lowest vs. highest quarter], but not in women [HR 0.70 (95% CI: 0.49-0.98); P = 0.086 for lowest vs. highest quarter]. Nevertheless, this association turned non-significant after full adjustment including body mass index and waist-to-hip ratio, and testosterone levels were no longer predictive for incident heart failure-neither in men [HR 0.99 (95% CI: 0.70-1.42); P = 0.77 for lowest vs. highest quarter] nor in women [HR 0.92 (95% CI: 0.64-1.33); P = 0.99 for lowest vs. highest quarter]. Accordingly, Kaplan-Meier analyses did not reveal significant association of testosterone levels with heart failure. Low levels of testosterone do not independently predict future heart failure.

Identifiants

pubmed: 33934533
doi: 10.1002/ehf2.13384
pmc: PMC8318459
doi:

Substances chimiques

Testosterone 3XMK78S47O

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2485-2491

Informations de copyright

© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

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Auteurs

Sarina Schäfer (S)

Department for Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany.

Muhammet Ali Aydin (MA)

Department of Cardiology, St. Adolf-Stift Hospital Reinbek, Reinbek, Germany.

Sebastian Appelbaum (S)

Department for Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany.

Kari Kuulasmaa (K)

Finnish Institute for Health and Welfare, Helsinki, Finland.

Tarja Palosaari (T)

Finnish Institute for Health and Welfare, Helsinki, Finland.

Francisco Ojeda (F)

Department for Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany.

Stefan Blankenberg (S)

Department for Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany.
German Centre for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany.

Pekka Jousilahti (P)

Finnish Institute for Health and Welfare, Helsinki, Finland.

Veikko Salomaa (V)

Finnish Institute for Health and Welfare, Helsinki, Finland.

Mahir Karakas (M)

Department for Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany.
German Centre for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany.

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