Testosterone is positively associated with coronary artery calcium in a low 
cardiovascular disease risk population

Trumble, Benjamin C.; Negrey, Jacob; Koebele, Stephanie V.; Thompson, Randall C.; Wann, L. Samuel; Allam, Adel H.; Beheim, Bret; Sutherland, M. Linda; Sutherland, James D.; Rodriguez, Daniel Eid; Michalik, David E.; Rowan, Chris J.; Lombardi, Guido P.; Garcia, Angela R.; Cummings, Daniel K.; Seabright, Edmond; Alami, Sarah; Kraft, Thomas S.; Hooper, Paul; Buetow, Kenneth; Irimia, Andrei; Gatz, Margaret; Stieglitz, Jonathan; Gurven, Michael D.; Kaplan, Hillard; Thomas, Gregory S.

doi:10.1093/emph/eoad039

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Testosterone is positively associated with coronary artery calcium in a low cardiovascular disease risk population

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Beheim, Bret
Department of Human Behavior Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Max Planck Society;

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Trumble, B. C., Negrey, J., Koebele, S. V., Thompson, R. C., Wann, L. S., Allam, A. H., et al. (2023). Testosterone is positively associated with coronary artery calcium in a low cardiovascular disease risk population. Evolution, Medicine and Public Health, 11(1), 472 -484. doi:10.1093/emph/eoad039.

Cite as: https://hdl.handle.net/21.11116/0000-000E-5CEB-3

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 [removed]