High LH Associated with Higher Cancer Mortality.

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Nelson Vergel

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Agergaard Holmboe S, Vradi E, Kold Jensen T, et al.


The association of reproductive hormone levels and all-cause, cancer and cardiovascular disease mortality in men. The Journal of Clinical Endocrinology & Metabolism. http://press.endocrine.org/doi/abs/10.1210/jc.2015-2460



Context: Testosterone levels (T) have been associated with mortality, but controversy exists.


Objective: To investigate associations between serum levels of total testosterone, SHBG, free testosterone, estradiol, LH and FSH, and subsequent mortality with up to 30 years of follow-up.


Design: A prospective cohort study consisting of men participating in four independent population-based surveys (MONICA I-III and Inter99) from 1982 to 2001 and followed until December 2012 with complete registry follow-up.


Setting and participants: 5,350 randomly selected men from the general population aged 30, 40, 50, 60 or 70 years at baseline.


Main Outcome measures: All-cause mortality, cardiovascular disease (CVD) mortality and cancer mortality.


Results: 1,533 men died during the follow-up period; 428 from CVD and 480 from cancer.


Cox proportional hazard models revealed that men in highest LH quartile had an increased all-cause mortality compared to lowest quartile (HR=1.32, 95%CI: 1.14 to 1.53). Likewise, increased quartiles of LH/T and estradiol increased the risk of all-cause mortality (HR=1.23, 95%CI: 1.06 to 1.43, HR=1.23, 95%CI: 1.06 to 1.43). No association to testosterone levels was found.


Higher LH levels were associated with increased cancer mortality (HR=1.42, 95%CI: 1.10 to 1.84) independently of smoking status.


Lower CVD mortality was seen for men with testosterone in the highest quartile compared to lowest (HR=0.72, 95%CI: 0.53 to 0.98). Furthermore, negative trends were seen for SHBG and free testosterone in relation to CVD mortality, however insignificant.


Conclusion: The observed positive association of LH and LH/T, but not testosterone, with all-cause mortality suggests that a compensated impaired Leydig cell function may be a risk factor for death by all causes in men. Our findings underpin the clinical importance of including LH measurement in the diagnostic work-up of male patients seeking help for possible androgen insufficiency.
 
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