Haring R, Xanthakis V, Coviello A, Sullivan L, Bhasin S, Wallaschofski H, Murabito J M, Vasan R S
Preventive Medicine & Epidemiology Section and Section of General Internal Medicine.
Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
Int J Androl. 2012 Dec;35(6):775-782. doi: 10.1111/j.1365-2605.2012.01285.x. Epub 2012 May 29.
Low serum concentrations of sex steroids and gonadotropins in men have been associated with increased cardiometabolic risk and mortality, but the clinical correlates of these hormones in men over late adulthood are less clearly understood. We analysed up to five serial measurements of total testosterone (TT), dehydroepiandrosterone sulphate (DHEAS), follicle stimulating hormone (FSH), luteinizing hormone (LH) and total estradiol (EST) in older men in the original cohort of the Framingham Heart Study to determine the short- (2-years; 1,165 person-observations in 528 individuals) and long-term (up to 10-years follow-up; 2520 person-observations in 835 individuals with mean baseline age: 71.2 years) clinical correlates of these sex steroids and gonadotropins using multilevel modelling and Generalized Estimating Equations. Age, body mass index and pre-existing type 2 diabetes were inversely related to long-term TT concentrations, whereas higher systolic blood pressure showed a positive association. Furthermore, age and pre-existing cardiovascular disease (CVD) were inversely associated and HDL cholesterol concentrations positively associated with long-term DHEAS concentrations respectively. Analyses of short-term changes revealed age was inversely related to DHEAS, but positively related to FSH and LH concentrations. Our community-based study identified modifiable correlates of decreasing TT and DHEAS concentrations in elderly men, suggesting that maintenance of a low CVD risk factor burden may mitigate the age-related decline of these hormones over the late adulthood.
男性血清中性类固醇和促性腺激素浓度较低与心血管代谢风险及死亡率增加有关，但这些激素在老年男性中的临床相关性尚不清楚。我们分析了弗明汉心脏研究原始队列中老年男性的总睾酮（TT）、硫酸脱氢表雄酮（DHEAS）、促卵泡激素（FSH）、促黄体生成素（LH）和总雌二醇（EST）的多达五次连续测量值，以使用多水平建模和广义估计方程确定这些性类固醇和促性腺激素的短期（2年；528名个体中的1165人次观察）和长期（长达10年随访；835名个体中的2520人次观察，平均基线年龄：71.2岁）临床相关性。年龄、体重指数和已患2型糖尿病与长期TT浓度呈负相关，而收缩压较高则呈正相关。此外，年龄和已患心血管疾病（CVD）分别与长期DHEAS浓度呈负相关和正相关，HDL胆固醇浓度与长期DHEAS浓度呈正相关。短期变化分析显示，年龄与DHEAS呈负相关，但与FSH和LH浓度呈正相关。我们基于社区的研究确定了老年男性TT和DHEAS浓度降低的可改变相关因素，这表明维持低心血管疾病风险因素负担可能减轻这些激素在成年后期与年龄相关的下降。
