Low serum testosterone and mortality in older men - PubMed (original) (raw)

Low serum testosterone and mortality in older men

Gail A Laughlin et al. J Clin Endocrinol Metab. 2008 Jan.

Abstract

Context: Declining testosterone levels in elderly men are thought to underlie many of the symptoms and diseases of aging; however, studies demonstrating associations of low testosterone with clinical outcomes are few.

Objective: The objective of the study was to examine the association of endogenous testosterone levels with mortality in older community-dwelling men.

Design, setting, and participants: This was a prospective, population-based study of 794 men, aged 50-91 (median 73.6) yr who had serum testosterone measurements at baseline (1984-1987) and were followed for mortality through July 2004.

Main outcome measure: All-cause mortality by serum testosterone level was measured.

Results: During an average 11.8-yr follow-up, 538 deaths occurred. Men whose total testosterone levels were in the lowest quartile (<241 ng/dl) were 40% [hazards ratio (HR) 1.40; 95% confidence interval (CI) 1.14-1.71] more likely to die than those with higher levels, independent of age, adiposity, and lifestyle. Additional adjustment for health status markers, lipids, lipoproteins, blood pressure, glycemia, adipocytokines, and estradiol levels had minimal effect on results. The low testosterone-mortality association was also independent of the metabolic syndrome, diabetes, and prevalent cardiovascular disease but was attenuated by adjustment for IL-6 and C-reactive protein. In cause-specific analyses, low testosterone predicted increased risk of cardiovascular (HR 1.38; 95% CI 1.02-1.85) and respiratory disease (HR 2.29; 95% CI 1.25-4.20) mortality but was not significantly related to cancer death (HR 1.34; 95% CI 0.89-2.00). Results were similar for bioavailable testosterone.

Conclusions: Testosterone insufficiency in older men is associated with increased risk of death over the following 20 yr, independent of multiple risk factors and several preexisting health conditions.

PubMed Disclaimer

Figures

Figure 1

Figure 1

All-cause mortality according to deciles of total testosterone adjusting for age, BMI, waist to hip ratio, current smoking, alcohol use, and exercise. The squares represent point estimates for HRs, the lines indicate 95% CIs. The median total testosterone values for deciles 1–10 were 171, 209, 241, 266, 288, 314, 338, 370, 422, and 507 ng/dl, respectively.

Comment in

Similar articles

Cited by

References

    1. Bhasin S, Singh AB, Mac RP, Carter B, Lee MI, Cunningham GR 2003 Managing the risks of prostate disease during testosterone replacement therapy in older men: recommendations for a standardized monitoring plan. J Androl 24:299–311 - PubMed
    1. Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR 2001 Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab 86:724–731 - PubMed
    1. Orwoll E, Lambert LC, Marshall LM, Blank J, Barrett-Connor E, Cauley J, Ensrud K, Cummings SR 2006 Endogenous testosterone levels, physical performance, and fall risk in older men. Arch Intern Med 166:2124–2131 - PubMed
    1. Amin S, Zhang Y, Felson DT, Sawin CT, Hannan MT, Wilson PW, Kiel DP 2006 Estradiol, testosterone, and the risk for hip fractures in elderly men from the Framingham Study. Am J Med 119:426–433 - PubMed
    1. Ferrucci L, Maggio M, Bandinelli S, Basaria S, Lauretani F, Ble A, Valenti G, Ershler WB, Guralnik JM, Longo DL 2006 Low testosterone levels and the risk of anemia in older men and women. Arch Intern Med 166:1380–1388 - PMC - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources