Endocrine Abstracts

Background: The relationship between cardiovascular (CV) diseases (CVD) and testosterone levels in men has not been completely clarified.

Aim: To evaluate the association between testosterone levels and CV risk in subjects with erectile dysfunction (ED) and to verify whether their body mass index might (BMI) represents a possible confounder in testosterone-related CV stratification.

Material and methods: A consecutive series of 2269 male patients attending the outpatient clinic for ED was studied. The assessment of CV risk was evaluated using the engine derived from the Progetto Cuore study.

Results: After adjustment and for BMI and associated morbidities, sex hormone binding globulin bound (SHBG) and unbound testosterone levels decreased as a function of CV risk assessed thorough Progetto Cuore risk engine. In addition, a higher prevalence of hypogonadism related symptoms and signs was associated with a higher CV risk. Among factors included in the Progetto Cuore risk engine age, total and HDL cholesterol and diabetes were all significantly associated with CV risk-dependent modification of total and calculated free-testosterone levels. When the relationship between SHBG bound and unbound testosterone and CV risk was evaluated as a function of obesity (BMI >30 kg/m²), all the aforementioned associations were confirmed only in non obese patients.

Conclusions: Hypogonadism could be associated either with an increased or reduced CV risk, depending on the characteristics of subjects. Low testosterone observed in obese patients might represent the result of higher CV risk rather than a direct pathogenetic mechanism.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.