Nelson Vergel
Founder, ExcelMale.com
Temporal Changes in Androgens and Estrogens are associated with All-Cause and Cause-Specific Mortality in Older Men - See more at: http://press.endocrine.org/doi/abs/10.1210/jc.2016-1025#sthash.73MY7E3L.dpuf
Abstract
Context:
The dynamic temporal relationship between changes in serum reproductive hormones and mortality in men has not been reported.
Objective:
To examine the relationship between progressive changes in circulating reproductive hormones over time with all-cause and cause-specific mortality in older men.
Design, Setting and Participants:
Community-dwelling men aged 70 years and older from CHAMP study were assessed at baseline (2005–2007, n=1705), 2-years (n=1367) and 5-years follow-up (n=958).
Main Outcomes and Measures:
At all three time-points, testosterone (T), dihydrotestosterone (DHT), estradiol (E2), and estrone (E1) were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and SHBG, LH, and FSH were determined by immunoassay and free testosterone (cFT) was calculated according to Sartorius. Mortality was ascertained through the state death registry. Statistical modeling was by General Estimating Equations (GEE) with Poisson regression.
Results:
Serum T over time (relative risk (RR) per 1 SD decrease in concentration: 1.18, 95%CI:1.05–1.32), DHT (RR:1.17, 95%CI:1.05–1.32), E2 (RR:1.46, 95%CI:1.30–1.63) as well as cFT (RR:1.27, 95%CI:1.13–1.41) were associated with all-cause mortality. After adjusting for multiple covariables, the decline in serum T (RR:1.17, 95%CI:1.03–1.32), DHT (RR:1.17, 95%CI:1.03–1.32) and cFT (RR:1.13, 95%CI:1.08–1.19) remained significantly associated with all-cause mortality. Similar relationships were observed for cancer, but not cardiovascular mortality. Progressive decline in serum E2 levels remained significantly associated with all-cause (RR:1.49, 95%CI:1.31–1.69), cancer (RR:1.82, 95%CI:1.45–2.28) and cardiovascular (RR:1.37, 95%CI:1.13–1.66) mortality even after adjustment for covariables. Serum E1, LH, FSH and SHBG were not associated with all-cause, cancer, or cardiovascular mortality.
Conclusion:
Dynamic temporal changes in serum T, cFT, DHT and E2 (but not E1, LH, FSH, SHBG) in older men are associated with all-cause and cause-specific mortality in distinct patterns.
Affiliations
1ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New S Wales, Australia
2Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, Sydney, New S Wales, Australia
3School of Public Health, University of Sydney, Sydney, New S Wales, Australia
- See more at: http://press.endocrine.org/doi/abs/10.1210/jc.2016-1025#sthash.73MY7E3L.dpuf
FULL PAPER: http://press.endocrine.org/doi/pdf/10.1210/jc.2016-1025
Abstract
Context:
The dynamic temporal relationship between changes in serum reproductive hormones and mortality in men has not been reported.
Objective:
To examine the relationship between progressive changes in circulating reproductive hormones over time with all-cause and cause-specific mortality in older men.
Design, Setting and Participants:
Community-dwelling men aged 70 years and older from CHAMP study were assessed at baseline (2005–2007, n=1705), 2-years (n=1367) and 5-years follow-up (n=958).
Main Outcomes and Measures:
At all three time-points, testosterone (T), dihydrotestosterone (DHT), estradiol (E2), and estrone (E1) were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and SHBG, LH, and FSH were determined by immunoassay and free testosterone (cFT) was calculated according to Sartorius. Mortality was ascertained through the state death registry. Statistical modeling was by General Estimating Equations (GEE) with Poisson regression.
Results:
Serum T over time (relative risk (RR) per 1 SD decrease in concentration: 1.18, 95%CI:1.05–1.32), DHT (RR:1.17, 95%CI:1.05–1.32), E2 (RR:1.46, 95%CI:1.30–1.63) as well as cFT (RR:1.27, 95%CI:1.13–1.41) were associated with all-cause mortality. After adjusting for multiple covariables, the decline in serum T (RR:1.17, 95%CI:1.03–1.32), DHT (RR:1.17, 95%CI:1.03–1.32) and cFT (RR:1.13, 95%CI:1.08–1.19) remained significantly associated with all-cause mortality. Similar relationships were observed for cancer, but not cardiovascular mortality. Progressive decline in serum E2 levels remained significantly associated with all-cause (RR:1.49, 95%CI:1.31–1.69), cancer (RR:1.82, 95%CI:1.45–2.28) and cardiovascular (RR:1.37, 95%CI:1.13–1.66) mortality even after adjustment for covariables. Serum E1, LH, FSH and SHBG were not associated with all-cause, cancer, or cardiovascular mortality.
Conclusion:
Dynamic temporal changes in serum T, cFT, DHT and E2 (but not E1, LH, FSH, SHBG) in older men are associated with all-cause and cause-specific mortality in distinct patterns.
Affiliations
1ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New S Wales, Australia
2Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, Sydney, New S Wales, Australia
3School of Public Health, University of Sydney, Sydney, New S Wales, Australia
- See more at: http://press.endocrine.org/doi/abs/10.1210/jc.2016-1025#sthash.73MY7E3L.dpuf
FULL PAPER: http://press.endocrine.org/doi/pdf/10.1210/jc.2016-1025
