Healthier lifestyle predicts higher circulating testosterone in older men: the Health In Men Study (original) (raw)
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American Journal of Epidemiology, 1997
The present study examined lifestyle and behavioral correlates of the change in total testosterone over 13 years in 66 men aged 41-61 years who were former participants of the Multiple Risk Factor Intervention Trial (MRFIT) at the Pittsburgh, Pennsylvania, center. The authors also determined in these men if changes in total testosterone are related to changes in cardiovascular disease risk factors. The mean total testosterone level was 751 (standard deviation, 248) ng/dl at baseline and decreased by 41 (standard deviation, 314) ng/dl during follow-up. The correlation between measures was r = 0.44 (p < 0.001). In multivariate analysis, higher type A coronary-prone behavior score, greater pack-years of cigarette smoking, and the MRFIT special intervention group were associated with larger decreases in total testosterone. Age, body weight, weight change, leisure time activity level, and alcohol intake were not related to the change in total testosterone. The decrease in endogenous testosterone was associated with an increase in triglycerides and a decrease in high density lipoprotein cholesterol in multivariate analysis controlling for obesity and other lifestyle covariates. There was little relation between change in testosterone and change in total and low density lipoprotein cholesterol or blood pressure. This longitudinal study confirms a gradual decline in total testosterone levels with advancing age in older men and provides evidence that lifestyle and psychosocial factors are related to this decline. Decreases in endogenous testosterone levels with age in men are associated with potentially unfavorable changes in triglycerides and high density lipoprotein cholesterol.
European Journal of Endocrinology, 2009
Objective: Insulin resistance is associated with metabolic syndrome and type 2 diabetes, representing a risk factor for cardiovascular disease. This relationship may be modulated to some extent by agerelated changes in sex hormone status. We examined whether lower testosterone or sex hormonebinding globulin (SHBG) levels in older men are associated with insulin resistance independently of measures of central obesity. Design: Cross-sectional analysis of 2470 community-dwelling non-diabetic men aged R70 years. Methods: Age, body mass index (BMI) and waist circumference were measured. Early morning sera were assayed for total testosterone, SHBG, LH and insulin levels. Free testosterone was calculated using mass action equations, and insulin resistance was assessed using a homeostatic model (HOMA2-IR). Results: Total testosterone, free testosterone and SHBG declined progressively across increasing quintiles of HOMA2-IR (all P!0.001) and correlated inversely with log HOMA2-IR (rZK0.27, K0.14 and K0.24 respectively, all P!0.001). After adjusting for age, BMI, waist circumference, highdensity lipoprotein and triglyceride levels, total testosterone was independently associated with log HOMA2-IR (bZ0.05, P!0.001), while SHBG was not. Serum total testosterone !8 nmol/l was associated with HOMA2-IR in the highest quintile (odds ratio (OR) 1.67, 95% confidence interval (CI) 1.02-2.73) as was total testosterone R8 and !15 nmol/l (OR 1.29, 95% CI 1.03-1.63). Conclusions: In older men, lower total testosterone is associated with insulin resistance independently of measures of central obesity. This association is seen with testosterone levels in the low to normal range. Further studies are needed to evaluate interventions that raise testosterone levels in men with reduced insulin sensitivity.
European Journal of Endocrinology, 2007
Objective: An age-related decline in serum total and free testosterone concentration may contribute to ill health in men, but limited data are available for men O70 years of age. We sought to determine the distribution and associations of reduced testosterone concentrations in older men. Design: The Health in Men Study is a community-representative prospective cohort investigation of 4263 men aged R70 years. Cross-sectional hormone data from 3645 men were analysed. Methods: Early morning sera were assayed for total testosterone, sex hormone binding globulin (SHBG) and LH. Free testosterone was calculated using the Vermeulen method. Results: Mean (GS.D.) serum total testosterone was 15.4G5.6 nmol/l (444G162 ng/dl), SHBG 42.4G 16.7 nmol/l and free testosterone 278G96 pmol/l (8.01G2.78 ng/dl). Total testosterone correlated with SHBG (Spearman's rZ0.6, P!0.0001). LH and SHBG increased with age (rZ0.2, P!0.0001 for both). Instead of declining, total testosterone increased marginally (rZ0.04, PZ0.007) whilst free testosterone declined with age (rZK0.1, P!0.0001). Free testosterone was inversely correlated with LH (rZK0.1, P!0.0001). In multivariate analyses, increasing age, body mass index (BMI) and LH were associated with lower free testosterone. Conclusions: In men aged 70-89 years, modulation of androgen action may occur via an age-related increase in SHBG and reduction in free testosterone without a decline in total testosterone concentration. Increasing age, BMI and LH are independently associated with lower free testosterone. Further investigation would be required to assess the clinical consequences of low serum free testosterone, particularly in older men in whom total testosterone may be preserved.
The Journals of Gerontology, 2017
To determine whether calculated free testosterone (cFT) provides prognostic information independent of serum T for predicting morbidity and mortality in older men in cross-sectional and 5-year longitudinal analyses. We studied men aged ≥70 years at baseline (n = 1,705), 2-year and 5-year measuring serum T (liquid chromatography-mass spectrometry), SHBG (immunoassay), cFT (an assumption-free empirical formula) together with 24 morbidity and 4 mortality outcomes. For cross-sectional and longitudinal analyses we employed a joint prediction model using generalized estimating equation models adjusted for age, smoking, comorbidities, and body mass index (BMI) with men having both normal T and normal cFT as referent group. Most morbidity and mortality outcomes were predicted by a combination of low T and cFT (LL). By contrast, only a single morbidity outcome in cross-sectional and none in longitudinal analysis was predicted by low T/normal cFT (LN) or normal T/low cFT (NL) without significant LL associations (isolated discordance). While for the few outcomes that predicted morbidity in men with discordances (LN or NL), these predictions only occurred when LL was also significant. Hence, for morbidity or mortality prediction in older men, discordance between cFT and T is unusual and isolated discordance is rare, so that cFT provides minimal independent prognostic information over serum T.
Clinical Endocrinology, 2012
Objective To determine serum concentrations, intra-individual variability and impact of age-related co-morbidities on serum testosterone (T), dihydrotestosterone (DHT), estradiol (E 2) and estrone (E 1) in older men. Design Observational, repeated measures study. Participants Men (n = 325) with 40 years and older selfreporting very good or excellent health. Measurements Standardized history, physical examination and collection of nine blood samples at fixed time intervals were measured over 3 months (three at 20 min intervals on days 1 (fasting) and 2 (non-fasting), one at days 7, 30 and 90). Serum T, DHT, E 2 and E 1 (n = 2900, > 99% of scheduled samples) measured by liquid chromatography-tandem mass spectrometry (LC-MS) were analysed by linear mixed model analysis with fasting, age and obesity as covariables. Results Mean serum T did not vary with age (P = 0•76) but obesity (À0•35 nM per body mass index (BMI) unit, P < 0•0001) and ex-smoker status (À1•6 nM, P < 0•001) had significant effects. Serum DHT was increased with age (+0•011 nM per year, P = 0•001) but decreased with obesity (À0•05 nM per BMI unit, P < 0•0001). Serum E 2 did not vary with age (P = 0•31) or obesity (P = 0•12). Overnight fasting increased (by 9-16%, all P < 0•001) and reduced variability in morning serum T, DHT, E 2 and E 1. Non-fasting serum T and DHT were stable over time (day, week, month or 3 months; P > 0•28). Conclusions Serum T, DHT and E 2 displayed no decrease associated with age among men over 40 years of age who selfreport very good or excellent health although obesity and exsmoking status were associated with decreased serum androgens (T and DHT) but not E 2. These findings support the interpretation that the age-related decline in blood T accompanying non-specific symptoms in older men may be due to accumulating age-related co-morbidities rather than a symptomatic androgen deficiency state.
2013
BACKGROUND: The prevalence of the metabolic syndrome (MetS) increases with age. Among other changes, testosterone levels decline with age. The relationship between testosterone levels and MetS components in older subjects has not been clearly defined until today. OBJECTIVES: The aim of this work was to evaluate the relationship between total serum testosterone levels and MetS and its components. METHODS: The working sample consisted of 467 elderly individuals (mean age 75 ± 6 years old, n = 220 men) from Ikaria Island, Greece. MetS was defined according to the NCEP ATPIII criteria. RESULTS: MetS prevalence was 52% in men and 64% in women. Those with MetS had lower testosterone levels; a 10 ng/dl increase in testosterone was associated with a 3% reduction in odds of having MetS in men (95% CI: 0.95-0.99), but not in women. This remained the result after various adjustments had been made, including daily hours of sleep. Testosterone was inversely associated with abnormal waist circumference, highsensitivity C-reactive protein (hs-CRP), insulin, and HDL cholesterol levels in men only. When lipid categories, hs-CRP, BMI, and insulin resistance levels were taken into account, testosterone lost its significance in predicting MetS (p > 0.20), suggesting that these markers possess a mediating effect. CONCLUSIONS: In elderly men, low serum testosterone was associated with MetS. Lipids, BMI, inflammation, and insulin resistance levels seem to explain this relationship, suggesting a potential mediating effect. This finding may support a research hypothesis relating serum testosterone to cardiovascular disease, which requires further research.
Serum testosterone levels correlate with haemoglobin in middle-aged and older men
Internal Medicine Journal, 2009
Background: Lower testosterone levels are associated with anaemia in older men and women. The relation between testosterone and haemoglobin (Hb) in younger and middle-aged men is less well defined. The aim of the study was to examine the association between testosterone and Hb levels in men spanning middle to older ages.
2000
We used longitudinal data from the Massachusetts Male Aging Study, a large population-based random-sample cohort of men aged 40 -70 yr at baseline, to establish normative age trends for serum level of T and related hormones in middle-aged men and to test whether general health status affected the age trends. Of 1,709 men enrolled in 1987-1989, 1,156 were followed up 7-10 yr afterward. By repeated-measures statistical analysis, we estimated simultaneously the cross-sectional age trend of each hormone between subjects within the baseline data, the cross-sectional trend between subjects within the follow-up data, and the longitudinal trend within subjects between baseline and follow-up. Total T declined cross-sectionally at 0.8%/yr of age within the follow-up data, whereas both free and albumin-bound T declined at about 2%/yr, all significantly more steeply than within the baseline data. Sex hormone-binding globulin increased cross-sectionally at 1.6%/yr in the follow-up data, sim-ilarly to baseline. The longitudinal decline within subjects between baseline and follow-up was considerably steeper than the cross-sectional trend within measurement times for total T (1.6%/yr) and bioavailable T (2-3%/yr). Dehydroepiandrosterone, dehydroepiandrosterone sulfate, cortisol, and estrone showed significant longitudinal declines, whereas dihydrotestosterone, pituitary gonadotropins, and PRL rose longitudinally.