Abstract
PURPOSE: Sex hormones are closely linked to inflammation and lipid metabolism. This study explores the correlation of residual cholesterol risk and residual inflammation risk with sex hormones. MATERIALS AND METHODS: Logistic regression and dose-response curve analyses were conducted to examine the associations of total testosterone (TT), Sex Hormone Binding Protein (SHBG), Estradiol (E2), and Free testosterone (FT) with low density lipoprotein cholesterol (LDL-C) and high sensitive c-reactive protein (hs-CRP). Testosterone deficiency, defined as TT below 300 ng/dL, was analyzed across various subgroups based on LDL-C and hs-CRP levels. Grouped by LDL-C and hs-CRP: normal, LDL-C < 2.6 mmol/L, hs-CRP < 3mg/L, residual cholesterol risk only (RCR): LDL-C ≥ 2.6 mmol/L, hs-CRP < 3mg/L, residual inflammation risk only (RIR): LDL-C < 2.6 mmol/L. hs-CRP ≥ 3mg/L, both risk (BR): LDL-C ≥ 2.6 mmol/L, hs-CRP ≥ 3mg/L. RESULTS: The results indicated a negative association between hs-CRP and TT (β = -1.98, 95% CI [-3.54, -0.42], p = 0.013), as well as FT (β = -0.04, 95% CI [-0.07, -0.02], p = 0.0002). Similar trends were observed for the relationship between hs-CRP and SHBG (β = -3.61, 95% CI [-5.33, -1.90], p = 0.0003). In the presence of both risk factors (BR), TT decreased most significantly (β = -79.37, 95% CI [-112.74, -46.00], p < 0.0001), as did FT in the same subgroup (β = -1.00, 95% CI [-1.61, -0.40], p = 0.0012). Notably, hs-CRP exhibited a non-linear correlation with TT, SHBG, and FT, with distinct inflection points. Furthermore, in diabetic patients, hs-CRP was positively linked to E2 (β = 0.39, 95% CI [0.03, 0.74], p = 0.0328). CONCLUSIONS: LDL-C was independently correlated with SHBG, hs-CRP with TT and FT, and the BR population had a higher risk of testosterone deficiency. Special populations with diabetes and hypertension need to be concerned about residual cholesterol risk and inflammatory risk.