Szulc Pawel, Claustrat Bruno, Delmas Pierre D
INSERM 831 Research Unit, University of Lyon, Hôpital Edouard Herriot, Place d'Arsonval, Lyon, France.
Clin Endocrinol (Oxf). 2009 Oct;71(4):594-602. doi: 10.1111/j.1365-2265.2009.03530.x. Epub 2009 Jan 22.
To examine the association of serum hormone levels with all-cause mortality in older community-dwelling men.
Single centre cohort study.
Men aged 50 and older, insured by Société de Secours Minière de Bourgogne (Montceau les Mines, France). Among 3400 men invited to participate, 782 volunteers had serum hormone measurements and were followed up for 10 years. No exclusion criteria were used.
Nonsurvivors (n = 182) were older, had more comorbidities and lower physical performance. The lowest quartile of 25-hydroxycholecalciferol (25OHD) level predicted mortality [HR = 1.44, 95% confidence interval (CI): 1.03-2.03, P < 0.05] regardless of age, BMI, smoking, physical activity, vitamin D supplementation, and health status; mainly for the first 3 years. The 17beta-E(2) level predicted mortality independent of confounders after the third year (HR = 1.21 per 1 SD increase, 95% CI: 1.09-1.35, P < 0.001). In the fully adjusted models, risk of death increased per quartiles of 17beta-E(2) (trend -P < 0.001) and was higher in the third and the fourth quartiles compared with the lowest quartile (HR = 1.80, 95% CI: 1.09-2.98, P < 0.05 and HR = 2.83, 95% CI: 1.71-4.67, P < 0.001). Concentrations of testosterone and PTH did not predict mortality independent of the model.
In older men, increased 17beta-E(2) level predicted mortality after 3 years of follow-up. Thus, high 17beta-E(2) level may reflect presence of risk factors precipitating development of diseases. Low 25OHD level predicted mortality more weakly, mainly for the first 3 years of the follow-up, and was strongly influenced by the confounding variables. Thus, low 25OHD level may reflect poor current health status and unhealthy lifestyle.
研究老年社区男性血清激素水平与全因死亡率之间的关联。
单中心队列研究。
年龄在50岁及以上，由法国勃艮第矿业互助社（蒙索莱米讷）承保的男性。在3400名受邀参与研究的男性中，782名志愿者进行了血清激素检测，并随访10年。未采用排除标准。
非幸存者（n = 182）年龄更大，合并症更多，身体机能更低。无论年龄、体重指数、吸烟、身体活动、维生素D补充情况及健康状况如何，25-羟胆钙化醇（25OHD）水平处于最低四分位数均预示着更高的死亡率[风险比（HR）= 1.44，95%置信区间（CI）：1.03 - 2.03，P < 0.05]；主要在随访的前3年。17β-雌二醇（E2）水平在第3年后独立于混杂因素预示着死亡率（每增加1个标准差，HR = 1.21，95% CI：1.09 - 1.35，P < 0.001）。在完全调整模型中，17β-E2每增加一个四分位数，死亡风险增加（趋势P < 0.001），与最低四分位数相比，第三和第四四分位数的死亡风险更高（HR = 1.80，95% CI：1.09 - 2.98，P < 0.05；HR = 2.83，95% CI：1.71 - 4.67，P < 0.001）。睾酮和甲状旁腺激素的浓度在模型中不能独立预测死亡率。
在老年男性中，随访3年后，17β-E2水平升高预示着更高的死亡率。因此，高17β-E2水平可能反映了促使疾病发生的危险因素的存在。低25OHD水平对死亡率的预测作用较弱，主要在随访的前3年，且受混杂变量的影响较大。因此，低25OHD水平可能反映了当前较差的健康状况和不健康的生活方式。
