Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website http://www.cardiologyres.org

Original Article

Volume 10, Number 2, April 2019, pages 106-113

Clinical Significance of Low Blood Testosterone Concentration in Men as a Cardiovascular Risk Factor From the Perspective of Blood Rheology

Figure 1. The association between T-T and WBPT. There was a significantly negative correlation between T-T and WBPT (r = -0.45, P < 0.001). T-T: total testosterone; WBPT: whole blood passage time.

Figure 2. Receiver operating characteristic curve analysis for detection of high WBPT using T-T. Receiver operating characteristics determined the optimal cut-off point of T-T for high WBPT (> 72.4 s). The area under curve was 0.762 (P < 0.001). Maximum Youden’s index indicated that a T-T of < 551.4 ng/dL is an optimal cut-off point to determine high WBPT, with sensitivity of 88.5% and specificity of 61.7%. Arrow indicates the optimal cut-off point. T-T: total testosterone; WBPT: whole blood passage time; CI: confidence interval.

**Table 1.** Patients Characteristics
Data are expressed mean ± SD. BP: blood pressure; LDL: low-density lipoprotein; HDL: high-density lipoprotein; FBG: fasting blood glucose; HOMA-IR: homeostatic model assessment of insulin resistance; HbA1c: hemoglobin A1c; AF: autofluorescence; d-ROMs: derivatives of reactive oxygen metabolites; T-T: total testosterone; WBPT: whole blood passage time; RAS: renin-angiotensin system.
N	382
Age (years)	64 ± 10
Body mass index (kg/m²)	23.6 ± 3.8
Current smoker; n (%)	127 (33)
Hypertension; n (%)	289 (76)
Systolic BP (mm Hg)	141 ± 18
Diastolic BP (mm Hg)	89 ± 24
Dyslipidemia; n (%)	197 (52)
Total cholesterol (mg/dL)	212 ± 42
LDL cholesterol (mg/dL)	139 ± 38
Triglyceride (mg/dL)	138 ± 69
HDL cholesterol (mg/dL)	45 ± 14
Diabetes mellitus; n (%)	123 (32)
FBG (mg/dL)	110 ± 14
HOMA-IR	2.2 ± 1.2
HbA1c (%)	6.2 ± 1.0
Skin AF (arbitrary units)	2.7 ± 0.5
White blood cell (/µL)	6,116 ± 1,563
Hematocrit (%)	42.3 ± 4.1
Platelet (10⁴/µL)	24 ± 6
d-ROMs test (U. Carr)	320 ± 96
T-T (ng/dL)	567.9 ± 189.0
WBPT (s)	57.5 ± 15.9
Medications
RAS inhibitor; n (%)	142 (37)
Statin; n (%)	120 (31)
Anti-diabetic drugs; n (%)	84 (22)

Table 1. Patients Characteristics

Data are expressed mean ± SD. BP: blood pressure; LDL: low-density lipoprotein; HDL: high-density lipoprotein; FBG: fasting blood glucose; HOMA-IR: homeostatic model assessment of insulin resistance; HbA1c: hemoglobin A1c; AF: autofluorescence; d-ROMs: derivatives of reactive oxygen metabolites; T-T: total testosterone; WBPT: whole blood passage time; RAS: renin-angiotensin system.

382

Age (years)

64 ± 10

Body mass index (kg/m²)

23.6 ± 3.8

Current smoker; n (%)

127 (33)

Hypertension; n (%)

289 (76)

Systolic BP (mm Hg)

141 ± 18

Diastolic BP (mm Hg)

89 ± 24

Dyslipidemia; n (%)

197 (52)

Total cholesterol (mg/dL)

212 ± 42

LDL cholesterol (mg/dL)

139 ± 38

Triglyceride (mg/dL)

138 ± 69

HDL cholesterol (mg/dL)

45 ± 14

Diabetes mellitus; n (%)

123 (32)

FBG (mg/dL)

110 ± 14

HOMA-IR

2.2 ± 1.2

HbA1c (%)

6.2 ± 1.0

Skin AF (arbitrary units)

2.7 ± 0.5

White blood cell (/µL)

6,116 ± 1,563

Hematocrit (%)

42.3 ± 4.1

Platelet (10⁴/µL)

24 ± 6

d-ROMs test (U. Carr)

320 ± 96

T-T (ng/dL)

567.9 ± 189.0

WBPT (s)

57.5 ± 15.9

Medications

RAS inhibitor; n (%)

142 (37)

Statin; n (%)

120 (31)

Anti-diabetic drugs; n (%)

84 (22)

**Table 2.** Relationships Between WBPT, T-T and Various Clinical Parameters
	WBPT	T-T
Data are expressed mean ± SD. P < 0.05; P < 0.01; **P < 0.001. WBPT: whole blood passage time; T-T: total testosterone; BP: blood pressure; LDL: low-density lipoprotein; HDL: high-density lipoprotein; FBG: fasting blood glucose; HOMA-IR: homeostatic model assessment of insulin resistance; HbA1c: hemoglobin A1c; AF: autofluorescence; d-ROMs: derivatives of reactive oxygen metabolites; RAS: renin-angiotensin system.
Age	-0.03	0.03
Body mass index	0.22***	-0.16**
Current smoker (Yes = 1, No = 0)	0.18*	-0.06
Hypertension (Yes = 1, No = 0)	0.05	-0.07
Systolic BP	0.09	-0.07
Diastolic BP	0.06	-0.04
Dyslipidemia (Yes = 1, No = 0)	0.05	0.04
Total cholesterol	0.04	0.03
LDL cholesterol	0.04	0.04
Triglyceride	0.14**	-0.12*
HDL cholesterol	-0.16**	0.11*
Diabetes mellitus (Yes = 1, No = 0)	0.15**	-0.12*
FBG	0.07	-0.11*
HOMA-IR	0.13*	-0.36***
HbA1c	0.10	-0.12*
Skin AF	0.49***	-0.31***
White blood cell	0.09	-0.03
Hematocrit	0.24***	0.03
Platelet	0.07	0.06
d-ROMs test	0.28***	-0.25***
RAS inhibitor (Yes = 1, No = 0)	-0.08	0.05
Statin (Yes = 1, No = 0)	-0.07	0.04
Anti-diabetic drugs (Yes = 1, No = 0)	0.09	0.07

Table 2. Relationships Between WBPT, T-T and Various Clinical Parameters

WBPT

T-T

Data are expressed mean ± SD. *P < 0.05; **P < 0.01; ***P < 0.001. WBPT: whole blood passage time; T-T: total testosterone; BP: blood pressure; LDL: low-density lipoprotein; HDL: high-density lipoprotein; FBG: fasting blood glucose; HOMA-IR: homeostatic model assessment of insulin resistance; HbA1c: hemoglobin A1c; AF: autofluorescence; d-ROMs: derivatives of reactive oxygen metabolites; RAS: renin-angiotensin system.

Age

-0.03

0.03

Body mass index

0.22***

-0.16**

Current smoker (Yes = 1, No = 0)

0.18*

-0.06

Hypertension (Yes = 1, No = 0)

0.05

-0.07

Systolic BP

0.09

-0.07

Diastolic BP

0.06

-0.04

Dyslipidemia (Yes = 1, No = 0)

0.05

0.04

Total cholesterol

0.04

0.03

LDL cholesterol

0.04

Triglyceride

0.14**

-0.12*

HDL cholesterol

-0.16**

0.11*

Diabetes mellitus (Yes = 1, No = 0)

0.15**

-0.12*

FBG

0.07

-0.11*

HOMA-IR

0.13*

-0.36***

HbA1c

0.10

-0.12*

Skin AF

0.49***

-0.31***

White blood cell

0.09

-0.03

Hematocrit

0.24***

0.03

Platelet

0.07

0.06

d-ROMs test

0.28***

-0.25***

RAS inhibitor (Yes = 1, No = 0)

-0.08

0.05

Statin (Yes = 1, No = 0)

-0.07

0.04

Anti-diabetic drugs (Yes = 1, No = 0)

0.09

0.07

**Table 3.** Multiple Regression Analysis
Explanatory factor	β	P value
(A) Subordinate factor is WBPT; R² = 0.33; P < 0.001. (B) Subordinate factor is T-T; R² = 0.30; P < 0.001. AF: autofluorescence; T-T: total testosterone; d-ROMs: derivatives of reactive oxygen metabolites; HOMA-IR: homeostatic model assessment of insulin resistance; WBPT: whole blood passage time.
(A) Skin AF	0.32	< 0.001
T-T	-0.25	< 0.001
Body mass index	0.17	< 0.001
d-ROMs test	0.14	0.005
Hematocrit	0.13	0.007
Current smoker	0.08	0.083
(B) WBPT	-0.30	< 0.001
HOMA-IR	-0.28	< 0.001
Skin AF	-0.15	0.004
d-ROMs test	-0.12	0.010
Body mass index	-0.07	0.139

Table 3. Multiple Regression Analysis

Explanatory factor

P value

(A) Subordinate factor is WBPT; R² = 0.33; P < 0.001. (B) Subordinate factor is T-T; R² = 0.30; P < 0.001. AF: autofluorescence; T-T: total testosterone; d-ROMs: derivatives of reactive oxygen metabolites; HOMA-IR: homeostatic model assessment of insulin resistance; WBPT: whole blood passage time.

(A) Skin AF

0.32

< 0.001

T-T

-0.25

< 0.001

Body mass index

0.17

< 0.001

d-ROMs test

0.14

0.005

Hematocrit

0.13

0.007

Current smoker

0.08

0.083

(B) WBPT

-0.30

< 0.001

HOMA-IR

-0.28

< 0.001

Skin AF

-0.15

0.004

d-ROMs test

-0.12

0.010

Body mass index

-0.07

0.139

**Table 4.** Comparisons of Clinical Parameters of the High T-T and Low T-T Patients
	T-T (ng/dL)	P value
Data are expressed mean ± SD. T-T: total testosterone; BP: blood pressure; LDL: low-density lipoprotein; HDL: high- density lipoprotein; FBG: fasting blood glucose; HOMA-IR: homeostatic model assessment of insulin resistance; HbA1c: hemoglobin A1c; AF: autofluorescence; d-ROMs: derivatives of reactive oxygen metabolites; WBPT: whole blood passage time; RAS: renin-angiotensin system.
Age (years)	64 ± 11	64 ± 10	0.573
Body mass index (kg/m²)	23.2 ± 3.8	24.2 ± 3.8	0.028
Current smoker; n (%)	75 (32)	52 (35)	0.673
Hypertension; n (%)	172 (74)	117 (78)	0.424
Systolic BP (mm Hg)	140 ± 17	142 ± 19	0.159
Diastolic BP (mm Hg)	88 ± 22	90 ± 26	0.231
Dyslipidemia; n (%)	121 (52)	76 (51)	0.776
Total cholesterol (mg/dL)	213 ± 41	210 ± 44	0.431
LDL cholesterol (mg/dL)	140 ± 37	138 ± 38	0.534
Triglyceride (mg/dL)	136 ± 64	148 ± 77	0.078
HDL cholesterol (mg/dL)	46 ± 15	42 ± 12	0.012
Diabetes mellitus; n (%)	64 (28)	59 (39)	0.016
FBG (mg/dL)	107 ± 13	113 ± 14	0.018
HOMA-IR	1.9 ± 1.1	2.6 ± 1.2	< 0.001
HbA1c (%)	6.1 ± 1.0	6.4 ± 1.1	0.025
Skin AF (arbitrary units)	2.6 ± 0.5	2.9 ± 0.5	< 0.001
White blood cell (/µL)	6,080 ± 1,524	6,171 ± 1,624	0.583
Hematocrit (%)	42.3 ± 4.1	42.2 ± 4.1	0.894
Platelet (10⁴/µL)	24 ± 6	24 ± 6	0.956
d-ROMs test (U. Carr)	305 ± 94	342 ± 95	< 0.001
WBPT (s)	51.8 ± 12.9	66.2 ± 16.2	< 0.001
Medications
RAS inhibitor; n (%)	91 (39)	51 (34)	0.266
Statin; n (%)	77 (33)	43 (29)	0.354
Anti-diabetic drugs; n (%)	53 (22)	31 (21)	0.617

Table 4. Comparisons of Clinical Parameters of the High T-T and Low T-T Patients

T-T (ng/dL)

P value

High T-T (n = 232) ≥ 551.4

Low T-T (n = 150) < 551.4

Data are expressed mean ± SD. T-T: total testosterone; BP: blood pressure; LDL: low-density lipoprotein; HDL: high- density lipoprotein; FBG: fasting blood glucose; HOMA-IR: homeostatic model assessment of insulin resistance; HbA1c: hemoglobin A1c; AF: autofluorescence; d-ROMs: derivatives of reactive oxygen metabolites; WBPT: whole blood passage time; RAS: renin-angiotensin system.

Age (years)

64 ± 11

64 ± 10

0.573

Body mass index (kg/m²)

23.2 ± 3.8

24.2 ± 3.8

0.028

Current smoker; n (%)

75 (32)

52 (35)

0.673

Hypertension; n (%)

172 (74)

117 (78)

0.424

Systolic BP (mm Hg)

140 ± 17

142 ± 19

0.159

Diastolic BP (mm Hg)

88 ± 22

90 ± 26

0.231

Dyslipidemia; n (%)

121 (52)

76 (51)

0.776

Total cholesterol (mg/dL)

213 ± 41

210 ± 44

0.431

LDL cholesterol (mg/dL)

140 ± 37

138 ± 38

0.534

Triglyceride (mg/dL)

136 ± 64

148 ± 77

0.078

HDL cholesterol (mg/dL)

46 ± 15

42 ± 12

0.012

Diabetes mellitus; n (%)

64 (28)

59 (39)

0.016

FBG (mg/dL)

107 ± 13

113 ± 14

0.018

HOMA-IR

1.9 ± 1.1

2.6 ± 1.2

< 0.001

HbA1c (%)

6.1 ± 1.0

6.4 ± 1.1

0.025

Skin AF (arbitrary units)

2.6 ± 0.5

2.9 ± 0.5

< 0.001

White blood cell (/µL)

6,080 ± 1,524

6,171 ± 1,624

0.583

Hematocrit (%)

42.3 ± 4.1

42.2 ± 4.1

0.894

Platelet (10⁴/µL)

24 ± 6

0.956

d-ROMs test (U. Carr)

305 ± 94

342 ± 95

< 0.001

WBPT (s)

51.8 ± 12.9

66.2 ± 16.2

< 0.001

Medications

RAS inhibitor; n (%)

91 (39)

51 (34)

0.266

Statin; n (%)

77 (33)

43 (29)

0.354

Anti-diabetic drugs; n (%)

53 (22)

31 (21)

0.617