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Moreover, it was stated that a change in BMI from "non-obese to obese" may be equivalent to a 15-year fall in the T concentration (32) and that interventions reducing BMI are expected to increase serum T in men (33). They also correspond to the results of Svartberg et al. (30), who reported that the inverse correlation between T and cIMT (carotid intima–media thickness, a marker of artery atherosclerosis) was BMI-dependent. It must also be acknowledged that these results, which are based on correlations, do not infer causation. Moreover, we also determined the relationship between T, fT, and the fT/C ratio and physical activity level. Rotter I, Ciosek Ż, Syroka A and Ryl A (2025) A cross-sectional study of testosterone deficiency and inflammatory markers in older men. Moreover, the positive correlation between testosterone and physical activity level suggests that exercise training may reduce the age-related decrease in gonadal androgens, which seems to be one of the main beneficial effects (anti-inflammatory one) of physical activity in aging men. Based on the above literature data, it may be inferred that the correlation between androgens and inflammatory markers observed in this study is not accidental. The study investigated the correlation between anthropometric factors, hormone levels, and hsCRP concentrations in patients with and without testosterone deficiency (Table 1). The relationship between anthropometric factors, and hormone levels in the group of patients with testosterone deficiency syndrome (TDS) according to hsCRP concentration. In Table 3, the relationship between anthropometric factors, and hormone levels in the group of patients with testosterone deficiency (TDS) was analyzed based on hsCRP concentration. In Table 2, the relationship between anthropometric factors, and hormone levels in the group of patients without testosterone deficiency was analyzed based on hsCRP concentration. This cross-sectional study aimed to examine the relationship between total testosterone (TT) levels, the diagnosis of testosterone deficiency syndrome (TDS), and high-sensitivity C-reactive protein (hsCRP) concentrations in aging men. The training-induced changes in the androgen concentrations, regardless of whether they are related to the direct stimulation of the HPG axis or to the effects of body fat–androgens interactions, may be of great importance because we have demonstrated that they are inversely correlated with markers of inflammation and blood lipids (Figures 1 and 2). Although we have demonstrated that physically active men tend to have higher sex hormone concentrations than do the inactive ones (see Results, Bivariate Correlations), there was a significant negative correlation between age and the androgen status, especially the fT concentration, i.e., the biologically active form of gonadal androgens (see Table 2). Other studies have similarly reported associations between low testosterone (hypogonadism) and elevated hsCRP and additional inflammatory markers in aging males (20, 30, 31). In contrast, a study involving 890 men showed that testosterone deficiency was present in 20% of individuals aged 60–89 years, 30% in those aged 70–79, and 50% in participants over 80 years old (23). Testosterone deficiency syndrome (TDS), BMI, body mass index; TT, total testosterone; LH, luteinizing hormone; SHBG, sex hormone binding globulin; DHEA-S, dehydroepiandrosterone sulfate; E2, estradiol; I, insulin; hsCRP, high sensitivity; C, reactive protein. It was indicated that patients with higher hsCRP levels exhibit a higher BMI, larger waist and hip circumferences, and higher triglyceride (TAG) levels compared to patients with lower hsCRP concentrations. The analysis did not show any correlation in the group of patients without TDS based on the level of hsCRP concentration. Furthermore, variations were observed in testosterone (TT), sex hormone-binding globulin (SHBG), estradiol (E2), insulin (I), and hsCRP levels among these patients. Design of the research conducted, taking into account the study groups; testosterone deficiency syndrome (TDS), TT, total testosterone; LH, luteinizing hormone; SHBG, sex hormone binding globulin; DHEA-S, dehydroepiandrosterone sulfate; E2, estradiol; I, Insulin; hsCRP, high sensitivity C-reactive protein. We based this conclusion on the observation of the significant correlation between the markers of androgen profile and the AAG concentration in the multiple regression analysis including age and BMI as relevant and independent potential confounders (see Table 3). In this multiple regression analysis, there were significant inverse correlations (or clear tendency for it) between all the androgen profile variables and the age- and lipid profile-adjusted CRP, AAG, and FER concentrations. However, findings by Grandys et al. (2021) indicated that the relationship between testosterone and inflammation markers such as CRP and ferritin (FER) was influenced by body mass index and not independent of it (20). Relationship between anthropometric factors, and hormone levels in the group of patients without testosterone deficiency according to hsCRP concentration. The analyses were performed using STATISTICA software, version 10 (StatSoft, Inc., 2011; ). The data points that deviated from the group means by more than 3 SDs were treated as outliers and excluded from further analysis. Non-normally distributed variables were log-transformed prior to analysis in order to reduce skewness of the data. All hormone measurements were performed in duplicate, and serum T, C, and SHBG were determined by an electrochemiluminescence immunoassay using the Cobas e411 analyzer (Roche Diagnostics, Mannheim, Germany) with detection limits of 0.09, 1.0, and 0.8 nmol L−1 for T, C, and SHBG, respectively. This finding led the authors to the conclusion that the changes in the androgen levels observed in other studies may be rather attributable to comorbidities in the aging population than to the aging process itself. It is widely accepted that aging per se decreases the T and fT concentrations in men (48), especially after the fifth decade of life (49), but the degree of this process also depends on the health status of the studied men (50). On the other hand, the BMI-independent relationship between androgens and AAG could be explained by the fact that extrahepatic AAG expression occurs in cell types other than the adipose tissue and may be regulated by inflammatory mediators, as in hepatocytes (41). The negative association between T concentration and the inflammatory markers, which is frequently reported (12, 43), supports this conclusion.
