Journal of the American Geriatrics Society · 2011
Frailty in relation to variations in hormone levels of the hypothalamic-pituitary-testicular axis in older men: results from the European male aging study.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Tajar Abdelouahid, O'Connell Matthew D L, Mitnitski Arnold B, O'Neill Terence W, Searle Samuel D, Huhtaniemi Ilpo T, Finn Joseph D, Bartfai György, Boonen Steven, Casanueva Felipe F, Forti Gianni, Giwercman Aleksander, Han Thang S, Kula Krzysztof, Labrie Fernand, Lean Michael E J, Pendleton Neil, Punab Margus, Silman Alan J, Vanderschueren Dirk, Rockwood Kenneth, Wu Frederick C W, European Male Aging Study Group
Аннотация
OBJECTIVES: To explore the associations between frailty and reproductive axis hormones (as an important regulatory system) in middle aged and older men.
DESIGN: Cross-sectional.
SETTING: The European Male Aging Study.
PARTICIPANTS: Three thousand two hundred nineteen community-dwelling European men aged 40 to 79.
MEASUREMENTS: Interviewer-assisted questionnaires to assess physical activity, health status, and mood were administered. Testosterone (T), luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone sulfate (DHEAS), and sex hormone-binding globulin (SHBG) were measured in a fasting morning blood sample. Frailty was assessed as an index (FI) according to the number (out of 43 possible) of health deficits (symptoms, signs, and functional impairments). Relationships between FI and hormone levels (as outcomes) were explored using regression models.
RESULTS: Mean FI was 0.12 ± 0.11 (range 0-0.67) was highest in the oldest group. After adjustment for confounders, higher levels of FI were significantly associated with lower levels of total T, free T, and DHEAS and higher levels of gonadotropins and SHBG; a 1-standard deviation cross-sectional increase in FI was associated with a regression coefficient of -0.30 nmol/L (95% confidence interval (CI)=-0.53 to -0.07) decrease in total T and 0.66 U/L (95% CI=0.48-0.83) increase in LH.
CONCLUSIONS: The associations between high FI, high gonadotropins, and well-maintained circulating T suggest that these changes are markers of aging-related disruptions of multiple physiological regulation, of which alterations in pituitary-testicular function represent a sensitive marker rather than an underlying pathogenic mechanism for frailty.
DESIGN: Cross-sectional.
SETTING: The European Male Aging Study.
PARTICIPANTS: Three thousand two hundred nineteen community-dwelling European men aged 40 to 79.
MEASUREMENTS: Interviewer-assisted questionnaires to assess physical activity, health status, and mood were administered. Testosterone (T), luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone sulfate (DHEAS), and sex hormone-binding globulin (SHBG) were measured in a fasting morning blood sample. Frailty was assessed as an index (FI) according to the number (out of 43 possible) of health deficits (symptoms, signs, and functional impairments). Relationships between FI and hormone levels (as outcomes) were explored using regression models.
RESULTS: Mean FI was 0.12 ± 0.11 (range 0-0.67) was highest in the oldest group. After adjustment for confounders, higher levels of FI were significantly associated with lower levels of total T, free T, and DHEAS and higher levels of gonadotropins and SHBG; a 1-standard deviation cross-sectional increase in FI was associated with a regression coefficient of -0.30 nmol/L (95% confidence interval (CI)=-0.53 to -0.07) decrease in total T and 0.66 U/L (95% CI=0.48-0.83) increase in LH.
CONCLUSIONS: The associations between high FI, high gonadotropins, and well-maintained circulating T suggest that these changes are markers of aging-related disruptions of multiple physiological regulation, of which alterations in pituitary-testicular function represent a sensitive marker rather than an underlying pathogenic mechanism for frailty.
Предметные рубрики MeSH
AgedAgingBiomarkersCross-Sectional StudiesDehydroepiandrosterone SulfateEuropeFollicle Stimulating HormoneFrail ElderlyGeriatric AssessmentHealth Status IndicatorsHumansHypothalamo-Hypophyseal SystemHypothalamusLuteinizing HormoneMaleMotor ActivityPituitary GlandProspective StudiesRegression AnalysisSex Hormone-Binding GlobulinSurveys and QuestionnairesTestisTestosterone