TY - JOUR
T1 - Reproductive hormone levels predict changes in frailty status in community-dwelling older men
T2 - European male ageing study prospective data
AU - Swiecicka, Agnieszka
AU - Eendebak, Robert J.A.H.
AU - Lunt, Mark
AU - O'Neill, Terence W.
AU - Bartfai, György
AU - Casanueva, Felipe F.
AU - Forti, Gianni
AU - Giwercman, Aleksander
AU - Han, Thang S.
AU - Slowikowska-Hilczer, Jolanta
AU - Lean, Michael E.J.
AU - Pendleton, Neil
AU - Punab, Margus
AU - Vanderschueren, Dirk
AU - Huhtaniemi, Ilpo T.
AU - Wu, Frederick C.W.
AU - Rutter, Martin K.
N1 - Funding Information:
Financial Support: This work was supported by the Commission of the European Communities Fifth Framework Program “Quality of Life and Management of Living Resources” Grant QLK6-CT-2001-00258 (to F.C.W.W.), the Manchester Biomedical Research Centre, the National Institute for Health Research Greater Manchester Clinical Research Network, the Arthritis Research UK Centre for Epidemiology, the National Institute for Health Research, the Manchester Biomedical Research Centre, and Medical Research Council Grant MR/ K025252/1 (to A.S. and F.C.W.W.).
Funding Information:
Disclosure Summary: F.C.W.W. has acted as a consultant for Bayer-Schering, Eli Lilly, and Besins Healthcare, participated in advisory board meetings and lectured on their behalf, received lecture fees from Bayer-Schering and Besins Healthcare, and received grant support (2013 to 2017) from Besins Healthcare, Eli Lilly, Merck Serono, and Mereo Biopharma. M.K.R. has acted as a consultant for GlaxoSmithKline, Roche, and Merck Sharp & Dohme Limited (MSD), participated in advisory board meetings on their behalf, and received lecture fees from MSD and grant support from Novo Nordisk, MSD, and GlaxoSmithKline. I.T.H. acts as a consultant for Ferring Pharmaceuticals and Novartis and receives research funding from Ferring Pharmaceuticals.
Publisher Copyright:
Copyright © 2018 Endocrine Society.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85041893721&partnerID=8YFLogxK
U2 - 10.1210/jc.2017-01172
DO - 10.1210/jc.2017-01172
M3 - Article
C2 - 29186457
AN - SCOPUS:85041893721
SN - 0021-972X
VL - 103
SP - 701
EP - 709
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 2
ER -
