Sex Hormones and Frailty in Older Men: The Osteoporotic Fractures in Men (MrOS) Study
Sex Hormones and Frailty in Older Men: The Osteoporotic Fractures in Men (MrOS) Study
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DOI：
10.1210/jc.2009-0417
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发表时间：
2009-10-01
影响因子：
5.8
通讯作者：
Orwoll, Eric S.
中科院分区：
文献类型：
--
作者：
Cawthon, Peggy M.;Ensrud, Kristine E.;Orwoll, Eric S.
背景：随着男性年龄的增长，体弱的发生率增加，而雄激素水平下降。对这些因素之间的关系知之甚少。目的：本研究的目的是评估雌二醇、生物可利用雌二醇、睾酮、生物可利用睾酮 (bioT) 和性激素结合球蛋白 (SHBG) 与虚弱状态的横断面和纵向关联。设计和背景：男性骨质疏松性骨折 (MrOS) 研究在六个美国临床中心进行。参与者：总共 1469 名年龄至少 65 岁且具有基线数据的社区居住男性参与； 4.1 年后，对 1245 名男性的虚弱状态进行了重新评估。 主要结果测量：比例优势模型估计了更严重虚弱状态的可能性。体弱的男性至少有以下三种症状：虚弱、行动迟缓、活动量低、精疲力竭和肌肉萎缩/肌肉减少症；中间人有一个或两个标准；而强壮的男人却没有。在随访中，死亡被列为额外的顺序结果。通过光谱/色谱方法测定性激素。结果：在横断面分析中，在对年龄、体型、健康状况和医疗条件等协变量进行调整后，与最高四分位的男性相比，bioT 最低四分位的男性处于更严重虚弱状态的几率增加了 1.39 倍（95% 置信区间，1.02，1.91）。在年龄调整的纵向分析中，bioT 最低四分位的男性 4.1 年后，体弱状态的几率增加了 1.51 倍（95% 置信区间，1.10，2.07）。这种关联在很大程度上通过协变量的调整而减弱。调整后，没有其他激素以横向或纵向方式与虚弱状态相关。结论：bioT 水平低与基线虚弱状态较差独立相关。虚弱状态应被视为补充睾酮试验的结果。 (临床内分泌代谢杂志 94: 3806-3815, 2009)
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. (J Clin Endocrinol Metab 94: 3806-3815, 2009)