All-cause Mortality and Mortality of Myocardial Infarction for 989 Legally Castrated Men

European Journal of Epidemiology volume 20, pages863–869(2005)Cite this article

An Erratum to this article was published on 01 January 2006

Abstract

Background:

Male gender is an independent coronary risk factor.

Method:

Long-term follow-up of 989 Danish men who underwent legal castration between 1929 and 1968.

Results:

The legally castrated men were unmarried and belonged to social class IV and V more often than were Danish men in general. During the follow-up until 2000, 835 of the 989 (85%) castrated men died, including 148 who died of myocardial infarction. In multiple Poisson regression analyses, the men had a standardized mortality rate (SMR) for all-cause mortality of 1.30 (95% CI: 1.26–1.36) and a SMR for mortality of myocardial infarction of 1.08 (95% CI: 1.04–1.16). Thus, the castrated men had a lower proportion of deaths of myocardial infarction (148/792, 18.7% (95% CI: 16.0–21.6%)) than was expected based on the mortality rates for the Danish male population (136/608, 22.4%). The castrated men had discordant changes for the SMR for all-cause mortality and mortality of myocardial infarction whereas subgroups of the Danish population previously has been found to have concordant changes for the two SMRs.

Conclusion:

The castrated men had fewer deaths of myocardial infarction than expected, so men may not have increased risk of coronary heart disease from unphysiologically low levels of endogenous androgens.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

US$ 39.95

Tax calculation will be finalised during checkout.

References

  1. 1

    WB Kannel (1992) The Framingham experience Marmot Elliott (Eds) Coronary heart disease: epidemiology from aetiology to public health Oxford Medical Publication Oxford

    Google Scholar 

  2. 2.

    S Sana H Kesteloot D Kromhout (1997) ArticleTitleThe burden of cardiovascular disease mortality in Europe. Task Force of the European Society of Cardiology on Cardiovascular Mortality and Morbidity Statistics in Europe Eur Heart J 18 1231–1248

    Google Scholar 

  3. 3.

    MM Gertler PD White (1954 ) Coronary heart disease in young adults: a multidisciplinary study Harvard University Press Cambridge: USA

    Google Scholar 

  4. 4.

    KT Khaw E Barret-Connor (1992) Sex differences, hormones, and coronary heart disease. M Marmot P Elliott (Eds) Coronary heart disease: epidemiology from aetiology to public health Oxford Medical Publications Oxford 274–283

    Google Scholar 

  5. 5.

    FC Wu A von Eckardstein (2003) ArticleTitleAndrogens and coronary artery disease Endocrine Rev 24 183–217 Occurrence Handle10.1210/er.2001-0025 Occurrence Handle1:CAS:528:DC%2BD3sXjsFyltL0%3D

    Article  CAS  Google Scholar 

  6. 6.

    GB Phillips (2005) ArticleTitleIs atherosclerotic cardiovascular disease an endocrinological disorder? The estrogen–androgen paradox J Clin Endocrinol Metab 90 2708–2711 Occurrence Handle1:CAS:528:DC%2BD2MXkt1Wgsbs%3D Occurrence Handle15687329

    CAS  PubMed  Google Scholar 

  7. 7.

    JB Hamilton GE Mestler (1969) ArticleTitleMortality and survival: comparison of eunuchs with intact men and women in a mentally retarded population J Gerontol 24 395–411 Occurrence Handle1:STN:280:CS%2BD2srks1c%3D Occurrence Handle5362349

    CAS  PubMed  Google Scholar 

  8. 8.

    Anon. Treatment and survival of patients with cancer of the prostate. Veterans Administration Co-operative Urological Research Group. Surg Gynecol Obstet 1967; 124: 1011–1017

  9. 9.

    P Henriksson O Edhag (1986) ArticleTitleOrchidectomy versus oestrogen for prostatic carcinoma: cardiovascular effects Br Med J 293 413–415 Occurrence Handle1:STN:280:BimB1Mjktl0%3D

    CAS  Google Scholar 

  10. 10.

    FE von Eyben (2001) ArticleTitleCompulsion and public health Bibliotek for Laeger 193 210–216

    Google Scholar 

  11. 11.

    P Suacidani HO Hein F Gyntelberg (2001) ArticleTitleSocioeconomic status and ischemic heart disease: Importance of the duration of follow-up The Copenhagen Male Study. Int J Epidemiol 30 248–255

    Google Scholar 

  12. 12.

    K Fremming (1947) Prevalence of psychiatric disorders and other mental abnormalities in a Danish average population Munksgaard Copenhagen

    Google Scholar 

  13. 13

    R Lund BE Holstein M Osler (2004) ArticleTitleMarital history from age 15 to 40 years and subsequent 10-year mortality: a longitudinal study of Danish males born in 1953 Int J Epidemiol 33 389–397 Occurrence Handle10.1093/ije/dyh065 Occurrence Handle15082647

    Article  PubMed  Google Scholar 

  14. 14.

    Anon. Statistical yearbook 1995. Copenhagen: Danmarks Statistik, 1995

  15. 15.

    O Ingerslev M Madsen O Andersen (1994) Social inequality for mortality in Denmark. Mortality with regard to occupation, socioeconomic group, education, and unemployment Ministry of Health Copenhagen 7–124

    Google Scholar 

  16. 16.

    Suadicani P. Identification of risk factors mediating the excess risk of ischaemic heart disease in low social classes. Copenhagen, 2002 (thesis)

  17. 17.

    J Bigaard A Tjonneland BL Thomsen K Overvad BL Heitman TI Sorensen (2003) ArticleTitleWaist circumference, BMI, smoking and mortality in middle-aged men and women Obes Res 11 895–903 Occurrence Handle12855760

    PubMed  Google Scholar 

  18. 18.

    FE von Eyben E Mouritsen J Holm et al. (2002) ArticleTitleSmoking, low density lipoprotein cholesterol, fibrinogen and myocardial infarction before 41 years of age: a Danish case-control study J Cardiovasc Risk 9 121–128 Occurrence Handle10.1097/00043798-200206000-00006

    Article  Google Scholar 

  19. 19.

    E Nieschlag S Nieschlag HM Behre (1993) ArticleTitleLifespan and testosterone Nature 366 215 Occurrence Handle10.1038/366215a0 Occurrence Handle1:STN:280:ByuD2M%2FhslU%3D Occurrence Handle8232579

    Article  CAS  PubMed  Google Scholar 

  20. 20.

    A Dupont M Vaeth P Videbech (1987) ArticleTitleMortality, life expectancy and causes of death of mildly mentally retarded in Denmark Ups J Med Sci 44 Suppl 76–82

    Google Scholar 

  21. 21.

    T Drivsholm H Ibsen M Schroll M Davidsen K Borch-Johnsen (1991) ArticleTitleIncreasing prevalence of diabetes mellitus and impaired glucose tolerance among 60-year-old Danes Diabetes Med 18 125–132

    Google Scholar 

  22. 22.

    G Teilum (1937) ArticleTitleHypercholesterolemia in castrated males Ugeskr Laeg 99 437–440

    Google Scholar 

  23. 23.

    De Backer G, Ambrasiani E, Baran-Johnsen K, et al. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur J Cardiovasc Prev Rehabil 2003; 10(Suppl 1): S1–S10

    Google Scholar 

  24. 24.

    C Isles DJ Hole VM Hawthorne AF Lever (1992) ArticleTitleRelation between coronary risk factors and coronary mortality in women of the Renfrew and Paisley survey: comparison with men Lancet 339 702–706 Occurrence Handle10.1016/0140-6736(92)90599-X Occurrence Handle1:STN:280:By2C1cnkvFw%3D Occurrence Handle1347584

    Article  CAS  PubMed  Google Scholar 

  25. 25.

    DL Wingard L Suarez E Barrett-Connor (1983) ArticleTitleThe sex differential in mortality from all causes and ischemic heart disease Am J Epidemiol 117 165–172 Occurrence Handle1:STN:280:BiyC2cbosVI%3D Occurrence Handle6829546

    CAS  PubMed  Google Scholar 

  26. 26.

    AE Hak JC Witteman FH de Jong MI Geerlings A Hofman HA Pols (2003) ArticleTitleLow levels of endogenous androgens increase the risk of atherosclerosis in elderly men: the Rotterdam study J Clin Endocrinol Metab 87 3632–3639

    Google Scholar 

  27. 27.

    CJ Malkin PJ Pugh PD Morris et al. (2004) ArticleTitleTestosterone replacement in hypogonadal men with angina improves ischaemic threshold and quality of life Heart 90 871–876 Occurrence Handle10.1136/hrt.2003.021121 Occurrence Handle1:CAS:528:DC%2BD2cXnt1KmtLw%3D Occurrence Handle15253956

    Article  CAS  PubMed  Google Scholar 

  28. 28.

    GB Phillips BH Pinkernell TY Jing (2004) ArticleTitleAre major risk factors for myocardial infarction the major predictors of degree of coronary artery disease in men? Metabolism 53 324–329 Occurrence Handle10.1016/j.metabol.2003.11.008 Occurrence Handle1:CAS:528:DC%2BD2cXhsFWltbc%3D Occurrence Handle15015144

    Article  CAS  PubMed  Google Scholar 

  29. 29.

    DA Lawlor S Ebrahim G Davey Smith (2001) ArticleTitleSex matters: secular and geographical trends in sex differences in coronary heart disease mortality Br Med J 323 541–545 Occurrence Handle1:STN:280:DC%2BD3MvpvVSisQ%3D%3D

    CAS  Google Scholar 

  30. 30.

    RT Kirkland BS Keenan JL Probstfield et al. (1987) ArticleTitleDecrease in plasma high-density lipoprotein cholesterol levels at puberty in boys with delayed adolescence. Correlation with plasma testosterone levels JAMA 257 502–507 Occurrence Handle10.1001/jama.257.4.502 Occurrence Handle1:STN:280:BiiD1cjgtlQ%3D Occurrence Handle3098992

    Article  CAS  PubMed  Google Scholar 

  31. 31.

    FE von Eyben E Mouritsen J Holm et al. (2003) ArticleTitleIntra-abdominal obesity and metabolic risk factors: a study of young adults Int J Obes Metab Rel Dis 27 941–949 Occurrence Handle1:STN:280:DC%2BD3szjtVymuw%3D%3D

    CAS  Google Scholar 

  32. 32.

    M Parssinen V Kujala E Vartiainen T Seppala (2000) ArticleTitleIncreased premature mortality of competitive powerlifters suspected to have used anabolic agents Int J Sports Med 21 225–227 Occurrence Handle1:STN:280:DC%2BD3cvht1Khtw%3D%3D Occurrence Handle10834358

    CAS  PubMed  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Internal Medicine, Herning Central Hospital, Herning, Denmark

    Finn Edler von Eyben

  2. Department of Public Health, University of Copenhagen, Copenhagen, Denmark

    Christian Graugaard

  3. Department of Biostatistics, University of Aarhus, Aarhus C, Denmark

    Michael Vaeth

Authors
  1. Finn Edler von Eyben
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christian Graugaard
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael Vaeth
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Finn Edler von Eyben.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s10654-006-6643-2.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Eyben, F.E., Graugaard, C. & Vaeth, M. All-cause Mortality and Mortality of Myocardial Infarction for 989 Legally Castrated Men. Eur J Epidemiol 20, 863–869 (2005). https://doi.org/10.1007/s10654-005-2150-0

Download citation

Keywords

  • All-cause mortality
  • Castration
  • Myocardial infarction mortality
  • Poisson regression