Racial and Ethnic Differences in Classic and 11-Oxygenated Androgens in Men

BACKGROUND: Androgen-dependent prostate pathology, including prostate cancer and benign prostatic hyperplasia, differs in prevalence and phenotype across races/ethnicities. Adrenal-derived 11-oxygenated C19 steroids (11-oxyandrogens) are relevant to several androgen-dependent pathologies, but data on their race/ethnic variations are lacking. METHODS: Male participants in the multiethnic cross-sectional Dallas Heart Study-2 were included. Serum androstenedione, testosterone, and 11-oxyandrogens were quantified simultaneously using liquid chromatography-tandem mass spectrometry, and were compared across races, adjusting for age, BMI, and comorbidities. RESULTS: Of 1,025 men (mean age 51 ± 10 years), 478 (47%) were Black, 375 (37%) White, 141 (14%) Hispanic, and 31 (3%) other races. Androgen concentrations varied with race/ethnicity: testosterone medians [interquartile ranges]: 338 [248-465], 347 [287-428], and 307 [232-422] ng/dL; and 11-ketotestosterone: 27 [16-46], 24 [15-41], and 21 [13-36] ng/dL in Black, Hispanic, and White men, respectively (P < 0.01 for both). Compared with White men with similar age and BMI, Black men had higher concentrations of testosterone (β = 47.06 ± 13.05 ng/dL), 11-ketotestosterone (β = 7.30 ± 1.90 ng/dL), androstenedione, and 11-oxy-androstenedione; while Hispanic men had higher 11-ketoandrostenedione and 11-ketotestosterone P < 0.05 for all). Race- and age-adjusted concentrations of testosterone and androstenedione decreased with BMI, whereas all 11-oxyandrogens increased with BMI (P < 0.05). After adjusting for race and BMI, 11β-hydroxyandrostenedione increased with age (P < 0.001), while all other androgens remained stable across ages. CONCLUSION: Circulating 11-ketotestosterone concentrations were higher in Black and Hispanic men than in White men with similar age and BMI. Interethnic variability in systemic androgens might contribute to differences in androgen-related pathologies.