Relationship between low levels of anabolic hormones and 6-year mortality in older men - The aging in the Chianti area (InCHIANTI) study
Relationship between low levels of anabolic hormones and 6-year mortality in older men - The aging in the Chianti area (InCHIANTI) study
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DOI：
10.1001/archinte.167.20.2249
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发表时间：
2007-11-12
影响因子：
--
通讯作者：
Ferrucci, Luigi
中科院分区：
文献类型：
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作者：
Maggio, Marcello;Lauretani, Fulvio;Ferrucci, Luigi
背景：男性衰老的特点是合成代谢激素水平逐渐下降，例如睾酮、胰岛素样生长因子 1 (IGF-1) 和硫酸脱氢表雄酮 (DHEA-S)。我们假设，在老年男性中，生物可利用睾酮、IGF-1 和 DHEA-S 分泌量与年龄相关的平行下降与较高的死亡率相关，与潜在的混杂因素无关。 方法：对参与基安蒂地区老龄化 (InCHIANTI) 研究的 410 名 65 岁及以上男性代表性样本中的睾酮、IGF-1、DHEA-S 和人口特征进行评估。在 6 年的随访期间，共有 126 名男性死亡。生物可利用睾酮的最低四分位数定义的阈值为 70 ng/dL（转换为纳摩尔每升，乘以 0.0347），总 IGF-1 为 63.9 ng/mL（转换为纳摩尔每升，乘以 0.131），总 IGF-1 为 50 pg/dL（转换为微摩尔每升，乘以 0.027）。 DHEA-S。男性被分为 4 组：最低四分位数（参考）无激素，最低四分位数有 1、2 和 3 种激素。分析中使用了针对混杂因素进行调整的 Kaplan-Meier 生存模型和 Cox 比例风险模型。结果：与所有 3 种激素水平均高于最低四分位数的男性相比，具有 1、2 和 3 种激素失调的男性的死亡率风险比分别为 1.47（95% 置信区间 [CI]，0.882.44）、1.85（95% CI，1.04-3.30）和 2.29（95% CI，1.124.68）。分别（趋势检验，P < .001）。在完全调整的分析中，只有患有 3 种合成代谢激素缺乏症的男性死亡率显着增加（风险比，2.44；95% CI，1.09-5.46（趋势检验，P < .001）。结论：与年龄相关的合成代谢激素水平下降是老年男性死亡率的一个强有力的独立预测因素。多种激素缺乏症而非单一合成代谢激素缺乏症是一个强有力的生物标志物老年人的健康状况。
Background: Aging in men is characterized by a progressive decline in levels of anabolic hormones, such as testosterone, insulinlike growth factor 1 (IGF-1), and dehydroepiandrosterone sulfate (DHEA-S). We hypothesized that in older men a parallel age-associated decline in bioavailable testosterone, IGF-1, and DHEA-S secretion is associated with higher mortality independent of potential confounders.Methods: Testosterone, IGF-1, DHEA-S, and demographic features were evaluated in a representative sample of 410 men 65 years and older enrolled in the Aging in the Chianti Area (InCHIANTI) study. A total of 126 men died during the 6-year follow-up. Thresholds for lowest-quartile definitions were 70 ng/dL (to convert to nanomoles per liter, multiply by 0.0347) for bioavailable testosterone, 63.9 ng/mL (to convert to nanomoles per liter, multiply by 0.131) for total IGF-1, and 50 pg/dL (to convert to micromoles per liter, multiply by 0.027) for DHEA-S. Men were divided into 4 groups: no hormone in the lowest quartile (reference) and 1, 2, and 3 hot-mones in the lowest quartiles. Kaplan-Meier survival and Cox proportional hazards models adjusted for confounders were used in the analysis. Results: Compared with men with levels of all 3 hormones above the lowest quartiles, having 1, 2, and 3 dys-regulated hormones was associated with hazard ratios for mortality of 1.47 (95% confidence interval [CI], 0.882.44), 1.85 (95% CI, 1.04-3.30), and 2.29 (95% CI, 1.124.68), respectively (test for trend, P < .001). In the fully adjusted analysis, only men with 3 anabolic hormone deficiencies had a significant increase in mortality (hazard ratio, 2.44; 95% CI, 1.09-5.46 (test for trend, P < .001).Conclusions: Age-associated decline in anabolic hormone levels is a strong independent predictor of mortality in older men. Having multiple hormonal deficiencies rather than a deficiency in a single anabolic hormone is a robust biomarker of health status in older persons.