TY - JOUR
T1 - Sex hormones and frailty in older men
T2 - The osteoporotic fractures in men (MrOS) study
AU - Cawthon, Peggy M.
AU - Ensrud, Kristine E.
AU - Laughlin, Gail A.
AU - Cauley, Jane A.
AU - Dam, Thuy Tien L.
AU - Barrett-Connor, Elizabeth
AU - Fink, Howard A.
AU - Hoffman, Andrew R.
AU - Lau, Edith
AU - Lane, Nancy E.
AU - Stefanick, Marcia L.
AU - Cummings, Steven R.
AU - Orwoll, Eric S.
PY - 2009
Y1 - 2009
N2 - Context: As men age, the prevalence of frailty increases whereas levels of androgens decline. Little is known about the relation between these factors. Objective: The aim of this study was to assess cross-sectional and longitudinal associations of estradiol, bioavailable estradiol, testosterone, bioavailable testosterone (bioT), and SHBG with frailty status. Design and Setting: The Osteoporotic Fractures in Men (MrOS) study was conducted at six U.S. clinical centers. Participants: A total of 1469 community-dwelling men at least 65 yr old with baseline data participated; 1245 men had frailty status reassessed 4.1 yr later. Main Outcome Measure: Proportional odds models estimated the likelihood of greater frailty status. Frail men had at least three of the following: weakness, slowness, low activity, exhaustion, and shrinking/sarcopenia; intermediate men had one or two criteria; and robust men had none. At follow-up, death was included as an additional ordinal outcome. Sex hormones were assayed by spectrometry/chromatographic methods. Results: In cross-sectional analyses, men in the lowest quartile of bioT had 1.39-fold (95% confidence interval, 1.02, 1.91) increased odds of greater frailty status compared to men in the highest quartile after adjustment for covariates including age, body size, health status, and medical conditions. In age-adjusted longitudinal analyses, men in the lowest quartile of bioT had 1.51-fold (95% confidence interval, 1.10, 2.07) increased odds of greater frailty status 4.1 yr later. This association was largely attenuated by adjustment for covariates. No other hormones were associated in a cross-sectional or longitudinal manner with frailty status after adjustment. Conclusions: Low levels of bioT were independently associated with worse baseline frailty status. Frailty status should be considered as an outcome in trials of testosterone supplementation.
AB - Context: As men age, the prevalence of frailty increases whereas levels of androgens decline. Little is known about the relation between these factors. Objective: The aim of this study was to assess cross-sectional and longitudinal associations of estradiol, bioavailable estradiol, testosterone, bioavailable testosterone (bioT), and SHBG with frailty status. Design and Setting: The Osteoporotic Fractures in Men (MrOS) study was conducted at six U.S. clinical centers. Participants: A total of 1469 community-dwelling men at least 65 yr old with baseline data participated; 1245 men had frailty status reassessed 4.1 yr later. Main Outcome Measure: Proportional odds models estimated the likelihood of greater frailty status. Frail men had at least three of the following: weakness, slowness, low activity, exhaustion, and shrinking/sarcopenia; intermediate men had one or two criteria; and robust men had none. At follow-up, death was included as an additional ordinal outcome. Sex hormones were assayed by spectrometry/chromatographic methods. Results: In cross-sectional analyses, men in the lowest quartile of bioT had 1.39-fold (95% confidence interval, 1.02, 1.91) increased odds of greater frailty status compared to men in the highest quartile after adjustment for covariates including age, body size, health status, and medical conditions. In age-adjusted longitudinal analyses, men in the lowest quartile of bioT had 1.51-fold (95% confidence interval, 1.10, 2.07) increased odds of greater frailty status 4.1 yr later. This association was largely attenuated by adjustment for covariates. No other hormones were associated in a cross-sectional or longitudinal manner with frailty status after adjustment. Conclusions: Low levels of bioT were independently associated with worse baseline frailty status. Frailty status should be considered as an outcome in trials of testosterone supplementation.
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U2 - 10.1210/jc.2009-0417
DO - 10.1210/jc.2009-0417
M3 - Article
C2 - 19737923
AN - SCOPUS:70349918163
SN - 0021-972X
VL - 94
SP - 3806
EP - 3815
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 10
ER -