Ferrucci Luigi, Maggio Marcello, Bandinelli Stefania, Basaria Shehzad, Lauretani Fulvio, Ble Alessandro, Valenti Giorgio, Ershler William B, Guralnik Jack M, Longo Dan L
Clinical Research Branch, Longitudinal Studies Section, National Institute on Aging, Baltimore, MD 21225, USA.
Arch Intern Med. 2006 Jul 10;166(13):1380-8. doi: 10.1001/archinte.166.13.1380.
Anemia is a frequent feature of male hypogonadism and anti-androgenic treatment. We hypothesized that the presence of low testosterone levels in older persons is a risk factor for anemia.
Testosterone and hemoglobin levels were measured in a representative sample of 905 persons 65 years or older without cancer, renal insufficiency, or anti-androgenic treatments. Hemoglobin levels were reassessed after 3 years.
At baseline, 31 men and 57 women had anemia. Adjusting for confounders, we found that total and bioavailable testosterone levels were associated with hemoglobin levels in women (P = .001 and P = .02, respectively) and in men (P<.001 and P = .03, respectively). Men and women in the lowest quartile of total and bioavailable testosterone were more likely than those in the highest to have anemia (men, 14/99 vs 3/100; odds ratio [OR], 5.4; 95% confidence interval [CI], 1.4-21.8 for total and 16/99 vs 1/99; OR, 13.1; 95% CI, 1.5-116.9 for bioavailable testosterone; women, 21/129 vs 12/127; OR, 2.1; 95% CI, 0.9-5.0 for total and 24/127 vs 6/127; OR, 3.4; 95% CI, 1.2-9.4 for bioavailable testosterone). Among nonanemic participants and independent of confounders, men and women with low vs normal total and bioavailable testosterone levels had a significantly higher risk of developing anemia at 3-year follow-up (21/167 vs 28/444; relative risk, 2.1; 95% CI, 1.1-4.1 for total and 26/143 vs 23/468; relative risk, 3.9; 95% CI, 1.9-7.8 for bioavailable testosterone).
Older men and women with low testosterone levels have a higher risk of anemia.
贫血是男性性腺功能减退和抗雄激素治疗的常见特征。我们推测老年人睾酮水平低是贫血的一个危险因素。
在905名65岁及以上无癌症、肾功能不全或未接受抗雄激素治疗的代表性样本中测量睾酮和血红蛋白水平。3年后重新评估血红蛋白水平。
基线时，31名男性和57名女性患有贫血。在对混杂因素进行校正后，我们发现总睾酮水平和生物可利用睾酮水平与女性（分别为P = 0.001和P = 0.02）和男性（分别为P<0.001和P = 0.03）的血红蛋白水平相关。总睾酮和生物可利用睾酮处于最低四分位数的男性和女性比处于最高四分位数的男性和女性更易患贫血（男性，总睾酮：14/99 vs 3/100；比值比[OR]，5.4；95%置信区间[CI]，1.4 - 21.8；生物可利用睾酮：16/99 vs 1/99；OR，13.1；95% CI，1.5 - 116.9；女性，总睾酮：21/129 vs 12/127；OR，2.1；95% CI，0.9 - 5.0；生物可利用睾酮：24/127 vs 6/127；OR，3.4；95% CI，1.2 - 9.4）。在非贫血参与者中，且不考虑混杂因素，总睾酮和生物可利用睾酮水平低的男性和女性在3年随访时发生贫血的风险显著高于正常水平者（总睾酮：21/167 vs 28/444；相对风险，2.1；95% CI，1.1 - 4.1；生物可利用睾酮：26/143 vs 23/468；相对风险，3.9；95% CI，1.9 - 7.8）。
睾酮水平低的老年男性和女性患贫血的风险更高。
