Context: Low sex hormone levels have been associated with the metabolic syndrome (MetS).

Objectives. To determine whether the association between sex hormone levels and MetS varies by race/ethnicity among men, and investigate the relationship of sex hormones and individual components of MetS.

Design: Population-based observational survey.

Participants: A multistage stratified design was used to recruit a random sample of 2,301 race/ethnically diverse men age 30–79 years. Blood samples were obtained on 1,899 men. Analyses were conducted on 1,885 men with complete data on total testosterone (T), free T, and SHBG.

Interventions: None.

Main outcome measure: MetS was defined using a modification of the Adult Treatment Panel (ATP) III guidelines. The association between MetS and sex hormone levels was assessed using odds ratios and 95% confidence intervals estimated using logistic regression models.

Results. A strong inverse association was observed, in both bivariate and multivariate analyses, between hormone levels and MetS. The odds of MetS increased about two-fold with a 1 standard deviation decrease in hormone levels. The association between sex hormones and MetS was statistically significant across race/ethnic groups. While the magnitude of this association was largest among white men, race/ethnic differences were not statistically significant. The strength of the association of sex hormones with individual components of MetS varied; stronger associations were observed with waist circumference and dyslipidemia and more modest associations with diabetes/elevated blood sugar

Conclusions. A robust, dose-response relationship between sex hormone levels and odds of the metabolic syndrome in men is consistent across race/ethnic groups.