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Causal relationships of total testosterone and bioavailable testosterone with aortic aneurysm: A Mendelian randomization study
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Liwen HOU1, 2, Ying WANG1, Zhichun GAO1, Linggong ZHAO1, Yidan XU1, Jun JIN1
Journal of Army Medical University | 2026, 48(6) : 783 - 792
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Journal of Army Medical University | 2026, 48(6): 783-792
• Clinical Medicine •
Causal relationships of total testosterone and bioavailable testosterone with aortic aneurysm: A Mendelian randomization study
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Liwen HOU1, 2, Ying WANG1, Zhichun GAO1, Linggong ZHAO1, Yidan XU1, Jun JIN1
Affiliations
  • 1Department of Cardiovascular Medicine, Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
  • 2Department of Cardiovascular Surgery, General Hospital of Western Theater Command, Chengdu, Sichuan, China
Published: 2026-03-30 doi: 10.16016/j.2097-0927.202512163
Outline
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Objective

To explore the causal relationships between plasma total testosterone (TT), bioavailable testosterone (Bio-T) levels and the pathogenesis of aortic aneurysm (AA) using Mendelian randomization (MR).

Methods

Single nucleotide polymorphisms (SNPs) strongly associated with TT and Bio-T (P<5×10-10) and with low bias were selected from the IEU Open GWAS public genome database as instrumental variables, with AA as the outcome. The inverse variance weighted (IVW) method served as the primary analytical approach, complemented by MR-Egger regression, weighted median estimation (WME), simple mode, and weighted mode analyses. Sensitivity analyses were conducted using Cochran’s Q test, MR-Egger intercept test, MR-PRESSO test, leave-one-out analysis, and funnel plot inspection, with statistical significance set at P<0.05.

Results

Two-sample MR analyses revealed causal associations between both TT and Bio-T levels and AA risk, with consistent directional results from MR-Egger regression and WME. MR analysis indicated heterogeneity for the causal association between TT and AA (Cochran’s Q=132.081, P=0.024); MR-PRESSO identified no outlier SNPs, prompting adoption of the random-effects model as the primary result (IVW: OR=0.856, 95%CI: 0.744 to 0.985, P=0.030). The causal effect of Bio-T (IVW: OR=0.551, 95%CI: 0.304 to 0.998, P=0.049) on AA incidence was stronger than that of TT (OR=0.856). Progressive stringent SNP selection thresholds (down to P<5×10-33) and a suite of sensitivity analyses confirmed the robustness of the causal association between Bio-T and AA.

Conclusion

Both plasma TT and Bio-T levels are causally associated with AA occurrence, with Bio-T conferring a stronger and more robust causal effect. Maintaining healthy, adequate plasma testosterone levels, particularly Bio-T levels, markedly reduce AA risk, offering novel targets and insights for AA prevention and treatment strategies.

total testosterone  /  bioavailable testosterone  /  aortic aneurysm  /  Mendelian randomization
侯力文, 王颖, 高智春, 赵灵巩, 徐一丹, 晋军. 基于孟德尔随机化的总睾酮、生物可利用睾酮与主动脉瘤的因果关系研究. 陆军军医大学学报, 2026 , 48 (6) : 783 -792 . DOI: 10.16016/j.2097-0927.202512163
Liwen HOU, Ying WANG, Zhichun GAO, Linggong ZHAO, Yidan XU, Jun JIN. Causal relationships of total testosterone and bioavailable testosterone with aortic aneurysm: A Mendelian randomization study[J]. Journal of Army Medical University, 2026 , 48 (6) : 783 -792 . DOI: 10.16016/j.2097-0927.202512163
Year 2026 volume 48 Issue 6
94
34
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Article Info
doi: 10.16016/j.2097-0927.202512163
  • Receive Date:2025-12-31
  • Online Date:2026-10-23
  • Published:2026-03-30
Article Data
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History
  • Received:2025-12-31
  • Revised:2026-01-27
Affiliations
    1Department of Cardiovascular Medicine, Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
    2Department of Cardiovascular Surgery, General Hospital of Western Theater Command, Chengdu, Sichuan, China
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表12种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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