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Reproductive hormone levels predict changes in frailty status in community-dwelling older men : European male ageing study prospective data

Swiecicka, Agnieszka; Eendebak, Robert J.A.H.; Lunt, Mark; O'Neill, Terence W.; Bartfai, György; Casanueva, Felipe F.; Forti, Gianni; Giwercman, Aleksander LU ; Han, Thang S. and Slowikowska-Hilczer, Jolanta, et al. (2018) In Journal of Clinical Endocrinology and Metabolism 103(2). p.701-709
Abstract

Context: Clinical sequelae of androgen deficiency share common features with frailty. Evidence supporting the role of androgens in the development of frailty is limited and conflicting. Objective: To determine associations between male reproductive hormones and prospective changes in frailty status. Design/Setting: A 4.3-year prospective cohort study of community-dwelling men participating in the European Male Ageing Study. Participants: A total of 3369 men aged 40 to 79 from eight European centers. Intervention: None. Main Outcome Measure: Frailty status was determined using frailty index (FI; n = 2278) and frailty phenotype (FP; n = 1980). Results: After adjusting for baseline frailty, age, center, and smoking, the risk ofworsening FI... (More)

Context: Clinical sequelae of androgen deficiency share common features with frailty. Evidence supporting the role of androgens in the development of frailty is limited and conflicting. Objective: To determine associations between male reproductive hormones and prospective changes in frailty status. Design/Setting: A 4.3-year prospective cohort study of community-dwelling men participating in the European Male Ageing Study. Participants: A total of 3369 men aged 40 to 79 from eight European centers. Intervention: None. Main Outcome Measure: Frailty status was determined using frailty index (FI; n = 2278) and frailty phenotype (FP; n = 1980). Results: After adjusting for baseline frailty, age, center, and smoking, the risk ofworsening FI decreased with higher testosterone (T), free T, and dihydrotestosterone (DHT) [percentage change (95% confidence interval) in FI associated with 1 standard deviation higher hormone level: -3.0 (-5.9, -1.0) for total T; -3.9 (-6.8, -2.0) for free T; and -3.9 (-6.8, -2.0) forDHT]. After further adjustment for bodymass index, only free T remained a significant predictor of FI change. In fully adjusted models, higher luteinizing hormone and follicle-stimulating hormone were positively related to worsening FI only in men ,60 years, and higher estradiol predicted lower likelihood of improving FP [odds ratio: 0.68 (0.52, 0.88)]. Conclusions: These prospective data support the hypothesis that higher androgen levels may protect elderly men from worsening frailty. However, the causal nature of these relationships requires further investigation.Whereas raised gonadotropins inmen,60 yearsmight be an earlymarker of frailty, the role of estradiol in frailty needs further clarification.

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Journal of Clinical Endocrinology and Metabolism
volume
103
issue
2
pages
9 pages
publisher
The Endocrine Society
external identifiers
  • scopus:85041893721
ISSN
0021-972X
DOI
10.1210/jc.2017-01172
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English
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yes
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034795d9-f8b0-4fb4-ba8c-978754b77cff
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2018-03-06 11:31:06
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2018-05-29 11:04:16
@article{034795d9-f8b0-4fb4-ba8c-978754b77cff,
  abstract     = {<p>Context: Clinical sequelae of androgen deficiency share common features with frailty. Evidence supporting the role of androgens in the development of frailty is limited and conflicting. Objective: To determine associations between male reproductive hormones and prospective changes in frailty status. Design/Setting: A 4.3-year prospective cohort study of community-dwelling men participating in the European Male Ageing Study. Participants: A total of 3369 men aged 40 to 79 from eight European centers. Intervention: None. Main Outcome Measure: Frailty status was determined using frailty index (FI; n = 2278) and frailty phenotype (FP; n = 1980). Results: After adjusting for baseline frailty, age, center, and smoking, the risk ofworsening FI decreased with higher testosterone (T), free T, and dihydrotestosterone (DHT) [percentage change (95% confidence interval) in FI associated with 1 standard deviation higher hormone level: -3.0 (-5.9, -1.0) for total T; -3.9 (-6.8, -2.0) for free T; and -3.9 (-6.8, -2.0) forDHT]. After further adjustment for bodymass index, only free T remained a significant predictor of FI change. In fully adjusted models, higher luteinizing hormone and follicle-stimulating hormone were positively related to worsening FI only in men ,60 years, and higher estradiol predicted lower likelihood of improving FP [odds ratio: 0.68 (0.52, 0.88)]. Conclusions: These prospective data support the hypothesis that higher androgen levels may protect elderly men from worsening frailty. However, the causal nature of these relationships requires further investigation.Whereas raised gonadotropins inmen,60 yearsmight be an earlymarker of frailty, the role of estradiol in frailty needs further clarification.</p>},
  author       = {Swiecicka, Agnieszka and Eendebak, Robert J.A.H. and Lunt, Mark and O'Neill, Terence W. and Bartfai, György and Casanueva, Felipe F. and Forti, Gianni and Giwercman, Aleksander and Han, Thang S. and Slowikowska-Hilczer, Jolanta and Lean, Michael E.J. and Pendleton, Neil and Punab, Margus and Vanderschueren, Dirk and Huhtaniemi, Ilpo T. and Wu, Frederick C.W. and Rutter, Martin K.},
  issn         = {0021-972X},
  language     = {eng},
  month        = {02},
  number       = {2},
  pages        = {701--709},
  publisher    = {The Endocrine Society},
  series       = {Journal of Clinical Endocrinology and Metabolism},
  title        = {Reproductive hormone levels predict changes in frailty status in community-dwelling older men : European male ageing study prospective data},
  url          = {http://dx.doi.org/10.1210/jc.2017-01172},
  volume       = {103},
  year         = {2018},
}