The association between low serum total testosterone and atherosclerotic cardiovascular disease

Abstract

Cardiovascular disease is the leading cause of mortality and morbidity globally. Recent studies have demonstrated that low testosterone in men tends to be a potent risk factor for cardiovascular diseases. However, the association between the testosterone and severity of the cardiovascular disease remains inconclusive. This study has evaluated testosterone as an independent marker for atherosclerotic cardiovascular disease in North Eastern Indian Population. This study was taken up to assess the correlation between serum testosterone and atherosclerotic cardiovascular disease and to find the association between serum testosterone levels and severity of coronary artery disease by Gensini score. This Cross-sectional study was conducted in NEIGRIHMS, Shillong involving 160 participants. Serum total testosterone levels were estimated along with other biochemical parameters. Gensini score and ejection fraction were calculated by cardiologist based on angiographic finding and echocardiograph respectively. Correlations between serum testosterone levels and Gensini scores were assessed using Pearson’s correlation and a multivariate logistic regression analysis was done to find the association of testosterone and cardiovascular disease. The mean serum total testosterone was significantly lower in the case group (3.49 ± 1.48) vs Controls (5.87 ± 1.25) (P< 0.001). A multiple logistic regression analysis demonstrated that low testosterone is an independent risk factor for CAD (P< 0.001). ROC analysis yielded an AUC of 0.886 with a P value of <0.001 with sensitivity 70% and specificity of 95.1% of serum total testosterone. The study demonstrates an inverse association between serum total testosterone and atherosclerotic cardiovascular disease, measurable through the Gensini score.