The association between androgenic profile and cardiometabolic risk factors in young men: insights from a large observational cohort study

Abstract Purpose The current single-center, retrospective, observational cohort study with a cross-sectional design was conducted to evaluate the association between androgenic profile and metabolic cardiovascular risk (mCVR) factors and to explore whether testosterone deficiency was associated with an unfavourable cardiometabolic profile in a large community-recruited cohort of 659 young men aged 18–35 years. Methods Participants underwent comprehensive assessment of anthropometric, biochemical, clinical, and hormonal parameters. Results Body mass index (BMI), expression of generalized obesity, waist circumference (WC), expression of abdominal/visceral obesity, diastolic blood pressure (DBP) and triglycerides (TG) significantly and progressively decreased and high-density lipoprotein (HDL)-cholesterol significantly increased across total testosterone (TT) tertiles. Similarly, weight, BMI, WC, systolic blood pressure (SBP), DBP and TG significantly decreased and HDL-cholesterol significantly increased across SHBG tertiles. Weight and adiposity-related anthropometric parameters, namely BMI and WC, significantly and progressively decreased across calculated free testosterone (cFT) tertiles. Spearman correlation analysis showed that TT and SHBG were significantly and negatively correlated with weight ( r =-0.149, r =-0.154), BMI ( r =-0.204, r =-0.165), WC ( r =-0.234, r =-0.225), SBP ( r =-0.112, r =-0.142) and TG ( r =-0.117, r =-0.204), and significantly and positively correlated with HDL-cholesterol ( r = 0.167, r = 0.251). Additionally, SHBG was significantly and negatively correlated with DBP ( r =-0.173). cFT was significantly and negatively correlated with age ( r =-0.108) and BMI ( r =-0.132). In a multiple linear regression analysis in models adjusted for age, BMI and WC, TT and SHBG were independently associated with HDL-cholesterol (β = 0.151, β = 0.186), and SHBG was independently associated with SBP (β=-0.177) and DBP (β=-0.204). Men with testosterone below the normal range (Hypo-T group) showed a significantly higher prevalence of generalized obesity and abdominal obesity than men with testosterone within the normal range (Normal-T group). Conversely, Overweight/Obese men exhibited significantly lower TT and a significantly higher prevalence of testosterone deficiency than Normal-Weight men. Conclusion In young adult men, androgenic profile was found to be robustly associated with mCVR factors; however, causality and temporal directionality cannot be inferred because of the cross-sectional design of the study.