Association of Serum Androgen Levels With Framingham Cardiovascular Risk Score in Individuals With Obesity

Background Obesity is strongly associated with increased cardiovascular morbidity and mortality. Although traditional risk factors are incorporated into widely used cardiovascular risk scores such as the Framingham Risk Score, hormonal alterations accompanying obesity, particularly changes in serum androgen levels, may also contribute to cardiovascular risk. This study aimed to investigate the relationship between serum androgen levels and estimated 10-year cardiovascular risk in individuals with obesity. Methods This retrospective study included 203 adults with obesity followed in an obesity clinic over a five-year period. Demographic, anthropometric, clinical, and laboratory data were collected. Cardiovascular risk was assessed using the Framingham Risk Score, and patients were stratified into low, intermediate, and high risk categories. Associations between hormonal parameters and cardiovascular risk were evaluated using correlation analyses and multivariable linear regression models adjusted for major metabolic risk factors. Results Serum dehydroepiandrosterone sulfate (DHEAS) levels showed a significant inverse correlation with the Framingham Risk Score in the overall cohort and in both sexes (p < 0.05). In multivariable linear regression analysis adjusted for age, body mass index, HbA1c, triglycerides, total cholesterol, and LDL cholesterol, DHEAS levels remained independently associated with the Framingham Risk Score (p = 0.027). DHEAS and estradiol levels decreased across increasing cardiovascular risk categories, whereas body mass index and total testosterone did not differ among risk groups. Measures of central adiposity, including waist circumference and waist-to-hip ratio, demonstrated stronger associations with cardiovascular risk than body mass index. Conclusion Lower serum DHEAS levels are associated with higher estimated cardiovascular risk in individuals with obesity, independent of traditional metabolic risk factors when cardiovascular risk is assessed as a continuous variable. Central adiposity measures appear to be more informative than body mass index for cardiovascular risk stratification. Incorporating hormonal parameters and indices of abdominal obesity may enhance cardiovascular risk assessment in obese populations.