Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Am J Epidemiol. 2010 Mar 1;171(5):583-92. doi: 10.1093/aje/kwp415. Epub 2010 Jan 18.
The association of sex hormone levels with mortality over a median of 16 years of follow-up was evaluated in a prospective cohort study. The study included 1,114 US men who participated in phase 1 (1988-1991) of the Third National Health and Nutrition Examination Survey Mortality Study and had no history of cardiovascular disease or cancer at baseline. Multivariable adjusted hazard ratios for all-cause mortality associated with a decrease in hormone concentration equal to the difference between the 90th and 10th percentiles of the sex hormone distributions were estimated by using proportional hazards regression. The hazard ratios associated with low free testosterone and low bioavailable testosterone levels were 1.43 (95% confidence interval (CI): 1.09, 1.87) and 1.52 (95% CI: 1.15, 2.02), respectively, for follow-up between baseline and year 9; they were 0.94 (95% CI: 0.51, 1.72) and 0.98 (95% CI: 0.56, 1.72), respectively, for follow-up between year 9 and year 18. Men with low free and bioavailable testosterone levels may have a higher risk of mortality within 9 years of hormone measurement. Future studies should be conducted to fully characterize the association of low free and bioavailable testosterone concentrations and mortality in men and to describe the mechanism underlying the association.
在一项前瞻性队列研究中，评估了性激素水平与中位随访 16 年期间死亡率的相关性。该研究包括 1114 名美国男性，他们参加了第三轮全国健康和营养调查死亡率研究的第 1 阶段（1988-1991 年），并且在基线时没有心血管疾病或癌症病史。使用比例风险回归估计与激素浓度降低相关的全因死亡率的多变量调整风险比，激素浓度降低等于性激素分布的第 90 百分位和第 10 百分位之间的差异。游离睾酮和生物可利用睾酮水平低与随访期间（从基线到第 9 年）的风险比分别为 1.43（95%置信区间（CI）：1.09，1.87）和 1.52（95%CI：1.15，2.02）；与随访期间（从第 9 年到第 18 年）的风险比分别为 0.94（95%CI：0.51，1.72）和 0.98（95%CI：0.56，1.72）。游离睾酮和生物可利用睾酮水平低的男性在激素测量后 9 年内死亡的风险可能更高。未来的研究应该进行，以充分描述游离睾酮和生物可利用睾酮浓度与男性死亡率之间的关联，并描述关联的潜在机制。
