Document Type
Article
Publication Date
11-16-2023
Abstract
Background
In industrialized populations, low male testosterone is associated with higher rates of cardiovascular mortality. However, coronary risk factors like obesity impact both testosterone and cardiovascular outcomes. Here, we assess the role of endogenous testosterone on coronary artery calcium in an active subsistence population with relatively low testosterone levels, low cardiovascular risk and low coronary artery calcium scores.
Methodology
In this cross-sectional community-based study, 719 Tsimane forager-horticulturalists in the Bolivian Amazon aged 40+ years underwent computed tomography (49.8% male, mean age 57.6 years).
Results
Coronary artery calcium levels were low; 84.5% had no coronary artery calcium. Zero-inflated negative binomial models found testosterone was positively associated with coronary artery calcium for the full sample (Incidence Rate Ratio [IRR] = 1.477, 95% Confidence Interval [CI] 1.001–2.170, P = 0.031), and in a male-only subset (IRR = 1.532, 95% CI 0.993–2.360, P = 0.053). Testosterone was also positively associated with clinically relevant coronary atherosclerosis (calcium >100 Agatston units) in the full sample (Odds Ratio [OR] = 1.984, 95% CI 1.202–3.275, P = 0.007) and when limited to male-only sample (OR = 2.032, 95% CI 1.118–4.816, P = 0.024). Individuals with coronary artery calcium >100 had 20% higher levels of testosterone than those with calcium <100 >(t = –3.201, P = 0.007).
Conclusions and Implications
Among Tsimane, testosterone is positively associated with coronary artery calcium despite generally low normal testosterone levels, minimal atherosclerosis and rare cardiovascular disease (CVD) events. Associations between low testosterone and CVD events in industrialized populations are likely confounded by obesity and other lifestyle factors.
Recommended Citation
Benjamin C Trumble, Jacob Negrey, Stephanie V Koebele, Randall C Thompson, L Samuel Wann, Adel H Allam, Bret Beheim, M Linda Sutherland, James D Sutherland, Daniel Eid Rodriguez, David E Michalik, Chris J Rowan, Guido P Lombardi, Angela R Garcia, Daniel K Cummings, Edmond Seabright, Sarah Alami, Thomas S Kraft, Paul Hooper, Kenneth Buetow, Andrei Irimia, Margaret Gatz, Jonathan Stieglitz, Michael D Gurven, Hillard Kaplan, Gregory S Thomas, Tsimane Health and Life History Project Teams, Testosterone is positively associated with coronary artery calcium in a low cardiovascular disease risk population, Evolution, Medicine, and Public Health, Volume 11, Issue 1, 2023, Pages 472–484, https://doi.org/10.1093/emph/eoad039
Peer Reviewed
1
Copyright
The authors
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Included in
Biological and Physical Anthropology Commons, Economic Theory Commons, Other Economics Commons
Comments
This article was originally published in Evolution, Medicine, and Public Health, volume 11, issue 1, in 2023. https://doi.org/10.1093/emph/eoad039