Levels of TT remained almost constant until the age of 50, after which they declined somewhat more slowly compared to the decrease in cBT (Fig. 2A and B). Mean age at the first visit was 49.2 ± 11.6 and 58.9 ± 11.8 years at the second visit (Table 1). Testosterone was set as the dependent variable (TT and calculated bioavailable testosterone (cBT)) with logCRP as the independent variable. Characteristics of the study population were assessed using descriptive statistics to calculate means and confidence intervals. Calculation of bioavailable testosterone was done using the formula according to Vermuelen et al. (18). Blood pressure was measured in the supine position after 5 min of rest at baseline and follow-up.
High Testosterone/CRP Ratio levels above the standard range may indicate an underlying health condition that warrants further evaluation. Although BACH measured demographics, medications and comorbidities in detail, residual confounding in this observational study cannot be excluded as the explanation for these associations. Although the effect of anti-inflammatory medications are controlled for in the present analysis, the effect of the treatment of comorbid conditions, which could have further attenuated CRP levels, are not accounted for in this analysis.
Non-fasting blood samples were collected close to waking time (median time since awakening 3 h 38 min) to control for diurnal variation in hormone levels. Interviews were completed with 63.3% of eligible subjects, resulting in a total sample of 5504 adults (2301 men, 3203 women, 1767 Black, 1877 Hispanic, 1859 White respondents). Detailed methods have been described elsewhere.9 In brief, BACH used a multi-stage stratified random sample to recruit approximately equal numbers of subjects according to age (30–39, 40–49, 50–59, 60–79 years), gender, and race/ethnic group (African American (Black), Hispanic, and Caucasian (White)). The BACH survey is a population-based epidemiologic survey of a broad range of urologic symptoms and risk factors in a randomly selected sample. A positive trend between estradiol (total and free) and CRP levels was not statistically significant.
Message frequency varies.‍Long live humans. All material, information, data, and content that Function Health provides is strictly for general information purposes. Function Health is a healthcare technology company and not a laboratory or medical provider. Best money I have spent on healthcare. I am thrilled to know more about my health and how to improve it. 100+ lab tests chosen by the world’s top doctors to help give you the most complete picture of your current and future health. The study was supported by The Local Research and Development Council Göteborg och Södra Bohuslän, the VGR Regional Research and Development Council Grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement.
The concentration of CRP was determined using an immunoturbidimetric assay on the Hitachi 917 analyzer (Roche Diagnostics - Indianapolis, IN), using reagents and calibrators from DiaSorin (Stillwater, MN). The inter-assay CVs for E2 concentrations 4.6–220 pmol/L (1.25–60 pg/mL) ranged between 13.4–6.0%. To reliably measure E2 levels in the low range, E2 values less than 46 pmol/L (12.5 pg/mL) were calculated by manual integration of chromatograms. The inter-assay coefficients of variation (CV) for T at concentrations of 0.8, 9.5 and 24.3 nmol/L (24, 275, and 700 ng/dL) were 7.4, 2.2, and 1.7%, respectively.
However, CRP is known to be unspecific, and the use of other inflammatory markers such as IL-6 might provide a more precise estimate of inflammation (3, 36). In our study, questionnaires on clinical symptoms were included only at the second visit. Another limitation of the study is the possibility of evaluation of body composition with radiological techniques that could have given a more precise estimation of abdominal obesity. According to the European Urology Association guidelines on testosterone measurement, both immuno-assay and mass spectrometry, providing a reference range for normal men, would be applicable with reliable results (6).
The estradiol and CRP association was attenuated but remained significant in multivariate models; however, this association was further attenuated and statistically non-significant after adjusting for intra-abdominal fat. Adjusting for waist circumference instead of BMI, similar results were observed. BMI had the largest impact on the association of CRP with T and SHBG level with changes of 35–40% in the regression coefficients after adding BMI to the model. Twenty-five multiple imputations were performed separately by race/ethnicity using all relevant variables to obtain plausible values for missing data on covariates included in the analysis.
A scatterplot presenting the association between baseline CRP and calculated bioavailable testosterone (A) and SHBG (B) at both visits. A constant and significant decrease in bioavailable testosterone was observed with increasing age, as well as increase of SHBG with age. Evaluation of the association between logCRP and testosterone was made through cross-sectional linear regression both at the first visit and in the longitudinal analyses. As measurement techniques changed during follow-up time, we compared similar age groups at both baseline and follow-up in order to estimate the change in concentration due to method change. Participants who did not participate in the second visit or had missing information on anthropometric measures, testosterone levels, sex hormone-binding globulin (SHBG), smoking, hypertension, leisure-time physical activity (LTPA), or diabetes were excluded, leaving a remainder of 641 men. The focus of this cohort study was the detection of early cardiometabolic disorders, and thus the age of participants ranged between 30 and 74, with oversampling of subjects between 30 and 50 years of age.
These associations remained statistically significant after adjusting for age, body mass index (BMI), comorbid conditions, and lifestyle factors. A multistage stratified design was used to recruit a random sample of 2,301 racially and ethnically diverse men age 30–79 years. Low-grade inflammation may be involved in the pathogenesis of subjective symptoms of androgen deficiency in ageing men.

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