Ethnic differences in male reproductive hormones and relationships with adiposity and insulin resistance in older men
To assess ethnic differences in male reproductive hormone levels and to determine whether any differences are explained by adiposity, insulin resistance (IR) or comorbidities in older men.Design
Multi-ethnic cross-sectional observational study.Participants
Community dwelling middle-aged and elderly men residing in the UK aged 40–84 years of South Asian (SA; n = 180), White European (WE; n = 328) or African Caribbean (AC; n = 166) origin.Observations
Measured testosterone (T), calculated free T (cFT), sex hormone-binding globulin and LH in SA, WE and AC men along with an assessment of body composition, IR, lifestyle factors and medical conditions.Results
Age-adjusted mean T and cFT levels were lower in SA men when compared to WE and AC men (mean (SEM) T: SA: 14·0 ± 0·4; WE: 17·1 ± 0·3; AC: 17·2 ± 0·5 nmol/l, P < 0·001; cFT: SA: 283 ± 7; WE: 313 ± 5; AC: 314 ± 8 pmol/l, P < 0·006). Compared to WE and AC men, SA men had higher levels of body fat, IR, comorbidities and diabetes. After adjusting for body fat, IR and other confounders, T levels in SA men remained lower than in WE men (P = 0·04) but ethnic differences in cFT became nonsignificant. LH levels were higher in SA than WE men in age-adjusted and fully adjusted models.Conclusions
T and cFT are lower in SA men than in WE and AC men. Whether ethnic-specific reference ranges for T and cFT might be appropriate in clinical practice requires further investigation. Ethnic differences in cFT, but not T, appear to be, more readily, explained by ethnic differences in adiposity, thus providing insights into potential pathophysiological mechanisms.