Low testosterone and high cholesterol levels in relation to all-cause, cardiovascular disease, and cancer mortality in White, Black, and Hispanic men: NHANES 1988-2015.

PURPOSE: The role of testosterone (T) deficiency (T ≤ 300 ng/dL) and hypercholesterolemia (total cholesterol ≥ 240 mg/dL) in the risk of all-cause cardiovascular diseases (CVD) and cancer mortality among a nationally representative sample of non-Hispanic White (NHW), non-Hispanic Black (NHB) and Hispanic men remains poorly understood. METHODS: Data included a full sample (NHANES 1988-1991, 1999-2004, 2011-2014) and subset sample (excluding 2011-2012, no estradiol and SHBG levels available) of 5379 and 3740 men, respectively. Participants were aged ≥ 20 y with serum T and cholesterol data (median follow-up 7.6 years). Weighted multivariable-adjusted Cox proportional hazards models were used in this study. RESULTS: In the overall population of full and subset samples, hypercholesterolemia was inversely associated with all-cause (HR = 0.76, 95% CI, 0.63-0.91) and cancer mortality (HR = 0.56, 95% CI, 0.34-0.90). Similar findings were observed among NHW men, but higher T levels increased the risk of CVD mortality in the subset sample (T3 vs T1, Ptrend = 0.02). Among NHB men in the full and subset samples, T deficiency increased the risk of CVD mortality, but T3 vs. T1 decreased it (Ptrend = 0.03), and hypercholesterolemia decreased cancer mortality. Among Hispanic men in the full and subset samples, T deficiency increased, and hypercholesterolemia decreased the risk of CVD mortality. CONCLUSION: Hypercholesterolemia was inversely associated with cancer mortality. However, higher levels of T were positively associated with CVD mortality among NHW and were inversely associated with CVD mortality among NHB and Hispanic men. Larger prospective studies are warranted to clarify the underlying relationship between T and cholesterol with mortality among racial and ethnic groups.

Psychological and Biological Pathways Linking Perceived Neighborhood Characteristics and Body Mass Index.

BACKGROUND: Perceived neighborhood characteristics are linked to obesity, however, the mechanisms linking these two factors remain unknown. PURPOSE: This study aimed to examine associations between perceived neighborhood characteristics and body mass index (BMI), establish whether indirect pathways through psychological distress and inflammation are important, and determine whether these associations vary by race/ethnicity. METHODS: Participants were 1,112 adults enrolled in the Texas City Stress and Health Study. Perceived neighborhood characteristics were measured using the Perceived Neighborhood Scale. Psychological distress was measured with the Center for Epidemiological Studies Depression Scale, Perceived Stress Scale and mental health subscale of the Short Form Health Survey-36. Markers of inflammation included C-reactive protein, interleukin-6, and tumor necrosis factor receptor-1. Associations were examined with Structural Equation Modeling. RESULTS: A model linking neighborhood characteristics with BMI through direct and indirect (i.e., psychological distress and inflammation) paths demonstrated good fit with the data. Less favorable perceived neighborhood characteristics were associated with greater psychological distress (B = -0.87, ß = -0.31, p < .001) and inflammation (B = -0.02, ß = -0.10, p = .035). Psychological distress and inflammation were also significantly associated with BMI (Bdistress = 0.06, ß = 0.08, p = .006; Binflammation = 4.65, ß = 0.41, p < .001). Indirect paths from neighborhood characteristics to BMI via psychological distress (B = -0.05, ß = -0.03, p = .004) and inflammation (B = -0.08, ß = -0.04, p = .045) were significant. In multiple group analysis, a model with parameters constrained equal across race/ethnicity showed adequate fit suggesting associations were comparable across groups. CONCLUSION: Our study extends the literature by demonstrating the importance of neighborhood perceptions as correlates of BMI across race/ethnicity, and highlights the role of psychological and physiological pathways.

Life-space mobility in Mexican Americans aged 75 and older.

OBJECTIVES: To examine the factors associated with life-space mobility in older Mexican Americans. DESIGN: Cross-sectional study involving a population-based survey. SETTING: Hispanic Established Population for the Epidemiologic Study of the Elderly survey conducted in the southwestern of United States (Texas, Colorado, Arizona, New Mexico, and California). PARTICIPANTS: Seven hundred twenty-eight Mexican-American men and women aged 75 and older. MEASUREMENTS: Sociodemographic factors, self-reported physician diagnoses of medical conditions (arthritis, diabetes mellitus, heart attack, stroke, hip fracture, and cancer), depressive symptoms, cognitive function, body mass index (BMI), upper and lower extremity muscle strength, Short Physical Performance Battery (SPPB), activities of daily living (ADLs), and the life-space assessment (LSA) were assessed in in-home interviews. RESULTS: The mean age of participants was 84.2 ± 4.2. Sixty-five percent were female. Mean LSA score was 41.7 ± 20.9. Multiple regression analysis showed that older age, being female, limitation in ADLs, stroke, high depressive symptoms, and a BMI index of 35 kg/m(2) and greater were significantly associated with lower LSA scores. Education and better lower extremity function and muscle strength were factors significantly associated with higher LSA scores. CONCLUSION: Older Mexican Americans had restricted life-space, with approximately 80% limited to their home or neighborhood. Older age, female sex, stroke, high depressive symptoms, BMI of 35 kg/m(2) or greater, and ADL disability were related to less life-space. Future studies are needed to examine the association between life-space and health outcomes and to characterize the trajectory of life-space over time in this population.