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7350493 
Book/Book Chapter 
Plasma Testosterone and Dihydrotestosterone as Markers of Heart Disease and Mortality in Older Men 
Yeap, BuB 
2016 
Biomarkers in Disease 
425-447 
WOS:000425058500021 
Testosterone (T) is the primary male sex hormone, exerting its effects directly or following conversion to dihydrotestosterone (DHT) which is a more potent ligand for the androgen receptor. Circulating concentrations of T are lower in older compared to younger men, and lower T is associated with a range of poorer health outcomes. Several studies have identified lower circulating T as a predictor of cardiovascular disease (CVD) risk. Concentrations of DHT are preserved in older men, but associations of DHT with health outcomes in this expanding demographic group are relatively unexplored. Recent studies have utilized mass spectrometry to accurately measure circulating T and DHT in large population-based cohorts of older men. Lower T has been associated with CVD events and all-cause mortality. Lower DHT concentrations are associated with higher mortality from ischemic heart disease. However, interventional studies of T supplementation have not been powered for the outcome of CVD events or mortality. Therefore, while reduced T and DHT are robust biomarkers for heart disease and related mortality, additional studies are required to determine causality and assess the role of T therapy in older men without proven androgen deficiency. 
Testosterone; Dihydrotestosterone; Estradiol; Cardiovascular disease; Ischemic heart disease; Myocardial infarction; Stroke; Mortality