Skip to main content

Advertisement

SpringerLink
Log in

The association of serum testosterone with dyslipidemia is mediated by obesity: the Henan Rural Cohort Study

  • Original Article
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Background and aims

This study aimed to evaluate the relationships of serum testosterone with dyslipidemia and blood lipid levels and test whether obesity mediated these associations by gender in Chinese rural population.

Methods and results

A total of 6150 subjects were finally analyzed in this study. Serum testosterone for each subject was detected by liquid chromatography equipped with tandem mass spectrometry. Logistic regression and linear regression were employed to evaluate the associations of serum testosterone with the prevalence of dyslipidemia and blood lipid levels. Mediation analysis was conducted to identify the mediation effects of obesity on the relationship between serum testosterone and dyslipidemia. After adjusting for multiple confounders, per unit change in serum ln-testosterone levels was associated with a decreased prevalent dyslipidemia in men (odds ratio (OR): 0.785, 95% confidence interval (CI) (0.708, 0.871)). Males with the levels of serum testosterone in the third or fourth quartiles had a 49.4% (OR: 0.506, 95% CI 0.398, 0.644) or 67.1% (OR: 0.329, 95% CI 0.253, 0.428) significantly lower odds of prevalence of dyslipidemia. In addition, a onefold increase in ln-testosterone was related to a 0.043 mmol/L (95% CI 0.028, 0.059) increase in high-density lipoprotein cholesterol (HDL-C) in men. Results of the mediation analysis suggested that obesity played a partial role in the association of testosterone with dyslipidemia in men.

Conclusions

These findings suggested that serum testosterone levels were negatively associated with lipid levels and prevalent dyslipidemia, and obesity mediated the effects of serum testosterone on dyslipidemia in men, implying that obesity prevention should be highlighted to decrease the prevalence of dyslipidemia related to changes in testosterone levels.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Mendis S, Davis S, Norrving B (2015) Organizational update: the world health organization global status report on noncommunicable diseases 2014; one more landmark step in the combat against stroke and vascular disease. Stroke 46(5):e121–e122

    Article  PubMed  Google Scholar 

  2. Yusuf S et al (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 364(9438):937–952

    Article  PubMed  Google Scholar 

  3. Pan L et al (2016) The prevalence, awareness, treatment and control of dyslipidemia among adults in China. Atherosclerosis 248:2–9

    Article  CAS  PubMed  Google Scholar 

  4. Opoku S et al (2019) Prevalence and risk factors for dyslipidemia among adults in rural and urban China: findings from the China national stroke screening and prevention project (CNSSPP). BMC Public Health 19(1):1500

    Article  PubMed  PubMed Central  Google Scholar 

  5. Liu X et al (2018) Dyslipidemia prevalence, awareness, treatment, control, and risk factors in Chinese rural population: the Henan rural cohort study. Lipids Health Dis 17(1):119

    Article  PubMed  PubMed Central  Google Scholar 

  6. Traish AM (2014) Testosterone and weight loss: the evidence. Curr Opin Endocrinol Diabetes Obes 21(5):313–322

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Corona G et al (2014) Testosterone supplementation and sexual function: a meta-analysis study. J Sex Med 11(6):1577–1592

    Article  CAS  PubMed  Google Scholar 

  8. Haring R et al (2011) Prospective association of low total testosterone concentrations with an adverse lipid profile and increased incident dyslipidemia. Eur J Cardiovasc Prev Rehabil 18(1):86–96

    Article  PubMed  Google Scholar 

  9. Cardarelli R et al (2014) The association of free testosterone levels in men and lifestyle factors and chronic disease status: a north texas healthy heart study. J Prim Care Community Health 5(3):173–179

    Article  PubMed  Google Scholar 

  10. Makinen JI et al (2008) Endogenous testosterone and serum lipids in middle-aged men. Atherosclerosis 197(2):688–693

    Article  CAS  PubMed  Google Scholar 

  11. Akishita M et al (2010) Association of low testosterone with metabolic syndrome and its components in middle-aged Japanese men. Hypertens Res 33(6):587–591

    Article  CAS  PubMed  Google Scholar 

  12. Agledahl I et al (2008) Low serum testosterone in men is inversely associated with non-fasting serum triglycerides: the Tromsø study. Nutr Metab Cardiovasc Dis 18(4):256–262

    Article  CAS  PubMed  Google Scholar 

  13. Zhang N et al (2014) The relationship between endogenous testosterone and lipid profile in middle-aged and elderly Chinese men. Eur J Endocrinol 170(4):487–494

    Article  CAS  PubMed  Google Scholar 

  14. Lambrinoudaki I et al (2006) Endogenous sex hormones and risk factors for atherosclerosis in healthy Greek postmenopausal women. Eur J Endocrinol 154(6):907–916

    Article  CAS  PubMed  Google Scholar 

  15. Phillips GB et al (2000) Association of hyperandrogenemia and hyperestrogenemia with type 2 diabetes in Hispanic postmenopausal women. Diabetes Care 23(1):74–79

    Article  CAS  PubMed  Google Scholar 

  16. Bays HE et al (2013) Obesity, adiposity, and dyslipidemia: a consensus statement from the National Lipid Association. J Clin Lipidol 7(4):304–383

    Article  PubMed  Google Scholar 

  17. Vekic J et al (2019) Obesity and dyslipidemia. Metabolism 92:71–81

    Article  CAS  PubMed  Google Scholar 

  18. Klop B, Elte JW, Cabezas MC (2013) Dyslipidemia in obesity: mechanisms and potential targets. Nutrients 5(4):1218–1240

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Tsai EC et al (2000) Low serum testosterone level as a predictor of increased visceral fat in Japanese-American men. Int J Obes Relat Metab Disord 24(4):485–491

    Article  CAS  PubMed  Google Scholar 

  20. Khaw KT, Barrett-Connor E (1992) Lower endogenous androgens predict central adiposity in men. Ann Epidemiol 2(5):675–682

    Article  CAS  PubMed  Google Scholar 

  21. Kelly DM, Jones TH (2015) Testosterone and obesity. Obes Rev 16(7):581–606

    Article  CAS  PubMed  Google Scholar 

  22. Wei D et al (2021) Interaction between testosterone and obesity on hypertension: a population-based cross-sectional study. Atherosclerosis 330:14–21

    Article  CAS  PubMed  Google Scholar 

  23. Diagnosis and classification of diabetes mellitus (2009) Diabetes Care, 32 (Suppl 1) S62–7

  24. Canguven O et al (2017) Testosterone therapy has positive effects on anthropometric measures, metabolic syndrome components (obesity, lipid profile, diabetes mellitus control), blood indices, liver enzymes, and prostate health indicators in elderly hypogonadal men. Andrologia 49(10):e12768

    Article  Google Scholar 

  25. Corona G et al (2011) Testosterone and metabolic syndrome: a meta-analysis study. J Sex Med 8(1):272–283

    Article  CAS  PubMed  Google Scholar 

  26. Maseroli E et al (2021) Testosterone treatment is associated with reduced adipose tissue dysfunction and nonalcoholic fatty liver disease in obese hypogonadal men. J Endocrinol Invest 44(4):819–842

    Article  CAS  PubMed  Google Scholar 

  27. Solomon H et al (2006) Erectile dysfunction and statin treatment in high cardiovascular risk patients. Int J Clin Pract 60(2):141–145

    Article  CAS  PubMed  Google Scholar 

  28. Coogan PF, Rosenberg L, Strom BL (2007) Statin use and the risk of 10 cancers. Epidemiology 18(2):213–219

    Article  PubMed  Google Scholar 

  29. Britto R et al (2012) Improvement of the lipid profile in post menopausal women who use estradiol and testosterone implants. Gynecol Endocrinol 28(10):767–769

    Article  CAS  PubMed  Google Scholar 

  30. Wang X, Magkos F, Mittendorfer B (2011) Sex differences in lipid and lipoprotein metabolism: it’s not just about sex hormones. J Clin Endocrinol Metab 96(4):885–893

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Hewitt KN et al (2003) The aromatase knockout mouse presents with a sexually dimorphic disruption to cholesterol homeostasis. Endocrinology 144(9):3895–3903

    Article  CAS  PubMed  Google Scholar 

  32. Clark RV et al (2019) Large divergence in testosterone concentrations between men and women: frame of reference for elite athletes in sex-specific competition in sports, a narrative review. Clin Endocrinol (Oxf) 90(1):15–22

    Article  CAS  PubMed  Google Scholar 

  33. Pizzocaro A et al (2020) Testosterone treatment in male patients with Klinefelter syndrome: a systematic review and meta-analysis. J Endocrinol Invest 43(12):1675–1687

    Article  CAS  PubMed  Google Scholar 

  34. Langer C et al (2002) Testosterone up-regulates scavenger receptor BI and stimulates cholesterol efflux from macrophages. Biochem Biophys Res Commun 296(5):1051–1057

    Article  CAS  PubMed  Google Scholar 

  35. Tsai EC et al (2004) Association of bioavailable, free, and total testosterone with insulin resistance: influence of sex hormone-binding globulin and body fat. Diabetes Care 27(4):861–868

    Article  CAS  PubMed  Google Scholar 

  36. Liu X et al (2019) Association of serum testosterone with different classes of glucose metabolism and the mediation effect of obesity: the henan rural cohort study. Diabetes Metab Res Rev 35(5):e3133

    Article  PubMed  Google Scholar 

  37. Rovira-Llopis S et al (2017) Low testosterone levels are related to oxidative stress, mitochondrial dysfunction and altered subclinical atherosclerotic markers in type 2 diabetic male patients. Free Radic Biol Med 108:155–162

    Article  CAS  PubMed  Google Scholar 

  38. Allan CA et al (2008) Testosterone therapy prevents gain in visceral adipose tissue and loss of skeletal muscle in nonobese aging men. J Clin Endocrinol Metab 93(1):139–146

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank the participants, coordinators, and administrators for their supports, and laboratory for the facility support at the school of Public Health, Zhengzhou University, during the study.

Funding

This research was supported by the National Key Research and Development Program of China (Grant No. 2019YFC1710002), the National Natural Science Foundation of China (Grant No.: 42177415, 21806146), the Postdoctoral Science Foundation of China (Grant No.: 2020T130604, 2021M702934), the Science and Technique Foundation of Henan Province (Grant No. 212102310074), the Scientific and Technological Innovation of Colleges and Universities in Henan Province Talent Support Program (Grant No. 22HASTIT044), the Young Backbone Teachers Program of Colleges and Universities in Henan Province (Grant No. 2021GGJS015), and the Excellent Youth Development Foundation of Zhengzhou University (Grant No. 2021ZDGGJS057).

Author information

Authors and Affiliations

  1. Department of Hypertension, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan, People’s Republic of China

    C. Fan

  2. Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People’s Republic of China

    D. Wei, L. Wang, P. Liu, K. Fan, X. Liu, J. Hou, L. Li, C. Wang & Z. Mao

  3. Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China

    L. Nie & W. Huo

  4. Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China

    X. Li & W. Li

Authors
  1. C. Fan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. Wei
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Fan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L. Nie
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. X. Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J. Hou
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. W. Huo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. L. Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. X. Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. W. Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. C. Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Z. Mao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Z. Mao.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This study involved human participants to evaluate the relationships of serum testosterone with dyslipidemia and blood lipid levels and test whether obesity mediate these associations by gender in Chinese rural population.

Informed consent

Informed consent was obtained from all individuals included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 22 KB)

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fan, C., Wei, D., Wang, L. et al. The association of serum testosterone with dyslipidemia is mediated by obesity: the Henan Rural Cohort Study. J Endocrinol Invest 46, 679–686 (2023). https://doi.org/10.1007/s40618-022-01911-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40618-022-01911-6

Keywords

Search

Navigation