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.

Details

Title
Testosterone is positively associated with coronary artery calcium in a low cardiovascular disease risk population
Author
Trumble, Benjamin C 1   VIAFID ORCID Logo  ; Negrey, Jacob 1 ; Koebele, Stephanie V 1 ; Thompson, Randall C 2 ; Wann, L Samuel 3 ; Allam, Adel H 4 ; Beheim, Bret 5 ; Sutherland, M Linda 6 ; Sutherland, James D 6 ; Daniel Eid Rodriguez 7 ; Michalik, David E 8   VIAFID ORCID Logo  ; Rowan, Chris J 9 ; Lombardi, Guido P 10 ; Garcia, Angela R 1 ; Cummings, Daniel K 11 ; Seabright, Edmond 12 ; Alami, Sarah 12 ; Kraft, Thomas S 13 ; Hooper, Paul 11 ; Buetow, Kenneth 1 ; Irimia, Andrei 14   VIAFID ORCID Logo  ; Gatz, Margaret 14   VIAFID ORCID Logo  ; Stieglitz, Jonathan 15 ; Gurven, Michael D 16   VIAFID ORCID Logo  ; Kaplan, Hillard 11 ; Thomas, Gregory S 6 

1  Arizona State University, School of Human Evolution and Social Change, Center for Evolution and Medicine, Institute of Human Origins ,  Tempe, AZ , USA 
2  Saint Luke’s Mid America Heart Institute, Department of Cardiology , Kansas City, MO , USA 
3  University of New Mexico, School of Medicine , Albuquerque, NM , USA 
4  Al Azhar University, School of Medicine , Cairo , Egypt 
5  Max Planck Institute for Evolutionary Anthropology, Department of Human Behavior, Ecology and Culture , Leipzig , Germany 
6  MemorialCare Health System , Fountain Valley, CA , USA 
7  Universidad de San Simón, Department of Medicine , Cochabamba , Bolivia 
8  University of California Irvine, School of Medicine , Irvine , CA , USA 
9  University of Nevada, School of Medicine , NV , USA 
10  Universidad Peruana Cayetano Heredia, Laboratorio de Paleopatología , Lima , Peru 
11  Chapman University, Economic Science Institute , Orange, CA , USA 
12  Mohammed VI Polytechnic University, School of Collective Intelligence , Ben Guerir , Morocco 
13  University of Utah, Anthropology Department , Salt Lake City, UT , USA 
14  University of Southern California, Psychology Department , Los Angeles, CA , USA 
15  Toulouse Scool of Economics, Institute for Advanced Study Toulouse , Toulouse , France 
16  University of California Santa Barbara, Department of Anthropology ,  Santa Barbara, CA , USA 
Pages
472-484
Publication year
2023
Publication date
2023
Publisher
Oxford University Press
e-ISSN
20506201
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1093/emph/eoad039
ProQuest document ID
3168006936
Copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.