Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, Massachusetts 02118, USA.
J Clin Endocrinol Metab. 2011 Aug;96(8):2464-74. doi: 10.1210/jc.2011-0143. Epub 2011 Jun 15.
Frailty, a syndrome of multiple morbidity, weakness, and immobility in aging, is an increasingly urgent threat to public health. Single measures of low serum androgen have been associated with frailty in men, but the contributory role of hormonal changes with time is unassessed.
The objective of the study was to examine, using longitudinal measurements, the relations of serum androgens, estrogens, gonadotropins, and SHBG to the prevalence and progression of frailty in older men.
Concord Health and Ageing in Men Project is an observational cohort study of 1705 men (aged 70 yr or older) living in the suburb of Concord, Sydney, Australia. Measurements were obtained at baseline (2005-2007) and 2-yr follow-up (2007-2009). Testosterone (T), dihydrotestosterone, estradiol, and estrone were obtained by liquid chromatography-tandem mass spectrometry, whereas SHBG, LH, and FSH were measured by immunoassay.
Subjects from the general community were sampled.
A total of 1645 subjects constituting a representative sample of community-dwelling men aged 70 yr old or older participated in the study.
The frailty syndrome was measured according to the Cardiovascular Health Study (CHS) and Study of Osteoporotic Fractures (SOF) indices.
Androgens and estrogens showed significant age-adjusted associations with concurrent frailty. Subjects in the lowest T quintile had 2.2-fold odds of exhibiting greater CHS frailty as compared with the highest T quintile (P < 0.001); results for dihydrotestosterone, estradiol, estrone, and calculated free T were similar, and were unchanged when the SOF frailty index was substituted for the CHS frailty index. A 1 sd, 2-yr decrease in T, calculated free T, or LH was associated with a 1.2- to 1.3-fold increase in the odds of progression (increase in severity) of frailty. The control for comorbid medical conditions did not affect results.
Age-related changes in blood androgens and estrogens may contribute to the development or progression of frailty in men.
衰弱是一种与衰老相关的多种疾病、虚弱和活动受限的综合征，它对公共健康构成了日益紧迫的威胁。男性血清雄激素水平低与衰弱有关，但随着时间的推移，激素变化的促成作用尚未得到评估。
本研究旨在通过纵向测量，研究血清雄激素、雌激素、促性腺激素和 SHBG 与老年男性衰弱的发生率和进展的关系。
Concord 健康与衰老男性项目是一项对居住在澳大利亚悉尼 Concord 郊区的 1705 名男性（年龄 70 岁或以上）进行的观察性队列研究。测量值在基线（2005-2007 年）和 2 年随访（2007-2009 年）时获得。采用液相色谱-串联质谱法测定睾酮（T）、二氢睾酮、雌二醇和雌酮，采用免疫分析法测定 SHBG、LH 和 FSH。
从一般社区中抽取样本。
共有 1645 名构成社区居住的 70 岁或以上男性代表性样本的受试者参加了这项研究。
衰弱综合征根据心血管健康研究（CHS）和骨质疏松性骨折研究（SOF）指数进行测量。
雄激素和雌激素与同时发生的衰弱有显著的年龄调整关联。与 T 最高五分位相比，T 最低五分位的受试者发生 CHS 衰弱的可能性高出 2.2 倍（P<0.001）；二氢睾酮、雌二醇、雌酮和计算出的游离 T 的结果相似，当 SOF 衰弱指数代替 CHS 衰弱指数时，结果仍然不变。T、游离 T 或 LH 每下降 1 个标准差，2 年内衰弱进展（严重程度增加）的可能性增加 1.2-1.3 倍。控制合并的医疗条件并不影响结果。
随着年龄的增长，血液雄激素和雌激素的变化可能导致男性衰弱的发生或进展。
