Cited by 671Hormonal and reproductive studiesSperm and Testicular FunctionAdrenal Hormones and Disorders

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Endogenous Testosterone and Mortality in Men: A Systematic Review and Meta-Analysis

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Araujo, Andre B., Dixon, Julia M., Suarez, Elizabeth A., Murad, M. Hassan, Guey, Lin T., Wittert, Gary A.·2011·The Journal of Clinical Endocrinology & Metabolism

DOI 10.1210/jc.2011-1137PMC PMC3200249

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Abstract

CONTEXT: Low testosterone levels have been associated with outcomes that reduce survival in men. OBJECTIVE: Our objective was to perform a systematic review and meta-analysis of published studies to evaluate the association between endogenous testosterone and mortality. DATA SOURCES: Data sources included MEDLINE (1966 to December 2010), EMBASE (1988 to December 2010), and reference lists. STUDY SELECTION: Eligible studies were published English-language observational studies of men that reported the association between endogenous testosterone and all-cause or cardiovascular disease (CVD) mortality. A two-stage process was used for study selection. 1) Working independently and in duplicate, reviewers screened a subset (10%) of abstracts. Results indicated 96% agreement, and thereafter, abstract screening was conducted in singlicate. 2) All full-text publications were reviewed independently and in duplicate for eligibility. DATA EXTRACTION: Reviewers working independently and in duplicate determined methodological quality of studies and extracted descriptive, quality, and outcome data. DATA SYNTHESIS: Of 820 studies identified, 21 were included in the systematic review, and 12 were eligible for meta-analysis [n = 11 studies of all-cause mortality (16,184 subjects); n = 7 studies of CVD mortality (11,831 subjects)]. Subject mean age and testosterone level were 61 yr and 487 ng/dl, respectively, and mean follow-up time was 9.7 yr. Between-study heterogeneity was observed among studies of all-cause (P < .001) and CVD mortality (P = 0.06), limiting the ability to provide valid summary estimates. Heterogeneity in all-cause mortality (higher relative risks) was observed in studies that included older subjects (P = 0.020), reported lower testosterone levels (P = 0.018), followed subjects for a shorter time period (P = 0.010), and sampled blood throughout the day (P = 0.030). CONCLUSION: Low endogenous testosterone levels are associated with increased risk of all-cause and CVD death in community-based studies of men, but considerable between-study heterogeneity, which was related to study and subject characteristics, suggests that effects are driven by differences between cohorts (e.g. in underlying health status).

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Authors: Araujo, A. B., Dixon, J. M., Suarez, E. A., Murad, M. H., Guey, L. T., & Wittert, G. A.
Affiliations: New England Research Institutes (US)
Mayo Clinic (US)
The University of Adelaide (AU)
ORCID: Dixon, Julia M.
Suarez, Elizabeth A.
Murad, M. Hassan
Guey, Lin T.
Wittert, Gary A.
Venue: The Journal of Clinical Endocrinology & Metabolism
Publisher: The Endocrine Society
Published: 2011-10
Volume: 96
Issue: 10
Pages: 3007-3019
ISSN: 0021-972X (ISSN-L)
1945-7197
DOI: 10.1210/jc.2011-1137
PMC: PMC3200249
OpenAlex: W1987977957
Cited by: 671
References: 65
Citations by year: 2026: 16 · 2025: 31 · 2024: 31 · 2023: 44 · 2022: 52 · 2021: 42 · 2020: 43 · 2019: 40 · 2018: 43 · 2017: 57 · 2016: 47 · 2015: 55 · 2014: 64 · 2013: 61 · 2012: 43
FWCI: 7.54
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Funders: Eli Lilly and Company
New England Research Institutes
National Institutes of Health
Medical Research Council
Australian Research Council
National Health and Medical Research Council
National Institute on Aging (R01AG020727)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords: endogenous testosterone, androgen deficiency, all-cause mortality, cardiovascular mortality, men, study heterogeneity, community-based cohort
MeSH terms: Adult, Age Factors, Aged, Cardiovascular Diseases, Cause of Death, Humans, Male, Middle Aged, Mortality, Smoking, Survival, Testosterone, United States, Meta-Analysis as Topic, Body Mass Index, Risk Assessment

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Endogenous Testosterone and Mortality in Men: A Systematic Review and Meta-Analysis

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