[Modification of low-density lipoprotein cholesterol on the relationship of serum testosterone with all-cause mortality in Hainan male centenarians].

Abstract

Objective: To explore the association between serum testosterone and all-cause mortality in Hainan male centenarians, and the modifying effect of low-density lipoprotein cholesterol (LDL-C). Methods: Based on the China Hainan Centenarian Cohort Study, 167 male participants with complete data were followed up for survival status and death outcomes. Restricted cubic splines (RCS), Cox proportional hazards regression model, and Kaplan-Meier survival curves were used to investigate the relationship between testosterone and mortality. The effect of LDL-C on the relationship between testosterone and all-cause mortality was analyzed using the likelihood ratio test. Results: As of March 31, 2023, the median follow-up time M(Q₁, Q₃) was 22.90 (10.00, 48.60) months. RCS results showed a linear negative association between testosterone levels and mortality (P=0.042, P for nonlinear=0.061). Kaplan-Meier survival curves analysis indicated that lower testosterone levels were significantly associated with shorter survival time (22.50 months vs. 28.00 months, P=0.006). Interaction analysis revealed that LDL-C influenced the independent predictive ability of testosterone for all-cause mortality in male centenarians (P for linear <0.001; P for nonlinear=0.003). Conclusions: Among male centenarians in Hainan, decreased serum testosterone levels are associated with an increased risk of all-cause mortality. Furthermore, when serum LDL-C levels are low, the association between testosterone levels and higher mortality is more pronounced.