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游离睾酮水平低预示着死于心血管疾病,但不是其他原因:男性健康研究。

Low free testosterone predicts mortality from cardiovascular disease but not other causes: the Health in Men Study.

机构信息

Western Australian Centre for Health and Ageing, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia.

出版信息

J Clin Endocrinol Metab. 2012 Jan;97(1):179-89. doi: 10.1210/jc.2011-1617. Epub 2011 Oct 19.

Abstract

CONTEXT

Low testosterone is associated with all-cause mortality, but the relationship with cause-specific mortality is uncertain.

OBJECTIVE

Our objective was to explore associations between testosterone and its related hormones and cause-specific mortality.

DESIGN

This was a population-based cohort study.

SETTING AND PARTICIPANTS

Demographic and clinical predictors of mortality, and testosterone, SHBG, and LH were measured from 2001-2004 in 3637 community-dwelling men aged 70-88 yr (mean, 77 yr).

MAIN OUTCOME MEASURE

Cause of death was obtained via electronic record linkage until December 31, 2008.

RESULTS

During a mean follow-up period of 5.1 yr, there were 605 deaths. Of these, 207 [34.2%; 95% confidence interval (CI) = 30.4-38.1%] were due to cardiovascular disease (CVD), 231 to cancer (38.2%; 95% CI = 34.3-42.1%), 130 to respiratory diseases (21.5%; 95% CI = 18.2-24.8%), and 76 to other causes (12.6%; 95% CI = 9.9-15.2%). There were 39 deaths attributable to both cancer and respiratory diseases. Lower free testosterone (hazard ratio = 1.62; 95% CI = 1.20-2.19, for 100 vs. 280 pmol/liter), and higher SHBG and LH levels were associated with all-cause mortality. In cause-specific analyses, lower free testosterone (sub-hazard ratio = 1.71; 95% CI = 1.12-2.62, for 100 vs. 280 pmol/liter) and higher LH predicted CVD mortality, while higher SHBG predicted non-CVD mortality. Higher total testosterone and free testosterone levels (sub-hazard ratio = 1.96; 95% CI = 1.14-3.36, for 400 vs. 280 pmol/liter) were associated with mortality from lung cancer.

CONCLUSIONS

Low testosterone predicts mortality from CVD but is not associated with death from other causes. Prevention of androgen deficiency might improve cardiovascular outcomes but is unlikely to affect longevity otherwise.

摘要

背景

低睾酮与全因死亡率相关,但与特定病因死亡率的关系尚不确定。

目的

本研究旨在探讨睾酮及其相关激素与特定病因死亡率之间的关系。

设计

这是一项基于人群的队列研究。

地点和参与者

2001-2004 年间,对 3637 名居住在社区、年龄在 70-88 岁(平均 77 岁)的男性进行了死亡率的人口统计学和临床预测因素以及睾酮、SHBG 和 LH 的检测。

主要观察指标

通过电子病历链接获得死亡原因,截至 2008 年 12 月 31 日。

结果

在平均 5.1 年的随访期间,共有 605 人死亡。其中,207 人(34.2%;95%置信区间[CI]为 30.4%-38.1%)死于心血管疾病(CVD),231 人死于癌症(38.2%;95%CI 为 34.3%-42.1%),130 人死于呼吸系统疾病(21.5%;95%CI 为 18.2%-24.8%),76 人死于其他原因(12.6%;95%CI 为 9.9%-15.2%)。有 39 人死于癌症和呼吸系统疾病。较低的游离睾酮(危险比=1.62;95%CI=1.20-2.19,100 比 280 pmol/L)和较高的 SHBG 和 LH 水平与全因死亡率相关。在病因特异性分析中,较低的游离睾酮(亚危险比=1.71;95%CI=1.12-2.62,100 比 280 pmol/L)和较高的 LH 预测 CVD 死亡率,而较高的 SHBG 预测非 CVD 死亡率。较高的总睾酮和游离睾酮水平(亚危险比=1.96;95%CI=1.14-3.36,400 比 280 pmol/L)与肺癌死亡率相关。

结论

低睾酮预测 CVD 死亡率,但与其他原因导致的死亡无关。预防雄激素缺乏可能改善心血管结局,但不太可能对寿命产生其他影响。

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