Hsu Benjumin, Cumming Robert G, Naganathan Vasi, Blyth Fiona M, Le Couteur David G, Seibel Markus J, Waite Louise M, Handelsman David J
School of Public Health (B.H., R.G.C.), University of Sydney, Sydney 2006, New South Wales, Australia; Centre of Education and Research on Ageing (B.H., R.G.C., V.N., F.M.B., D.G.L.C., L.M.W.) and ANZAC Research Institute (R.G.C., D.G.L.C, M.J.S., D.J.H.), University of Sydney and Concord Hospital, Sydney 2139, New South Wales, Australia.
J Clin Endocrinol Metab. 2014 Sep;99(9):3310-8. doi: 10.1210/jc.2014-1124. Epub 2014 Mar 14.
The relationship between functional disability and reproductive hormones and whether it is mediated by muscle mass and strength in older men are unclear.
The objective of the study was to identify the relationships between hormones and change in functional disability over a 2-year follow-up and to examine whether muscle mass and strength explain any of the observed relationships.
DESIGN, SETTING, AND PARTICIPANTS: A total of 1318 men aged 70 years and older from the Concord Health and Ageing in Men Project study were assessed at both baseline and 2-year follow-up. T, DHT, estradiol (E2), and estrone (E1) were measured by liquid chromatography-tandem mass spectrometry and SHBG, LH, and FSH by immunoassay.
Functional disability was measured by basic Activities of Daily Living scale at both time points. Grip and quadricep strength were measured using dynamometers and lean (muscle) mass was determined by dual X-ray absorptiometry.
All hormones were significantly associated with functional decline in univariate analyses. Only T, E2, E1, and calculated free T remained associated in multivariate analyses. Men in the lowest T quartile (vs the highest quartile) had an increased risk functional decline (odds ratio 1.96, 95% confidence interval 1.01-3.82). Similar associations were observed in E2, E1, and calculated free T. When muscle variables were added into the multivariate model, the associations between these hormones and functional decline were no longer statistically significant.
Low T, E2, and E1 were significantly associated with prospective functional decline over 2 years. This relationship was no longer significant when muscle mass or strength were added, suggesting that the hormonal associations are mediated through their sequential effect on muscle mass and strength.
老年男性功能残疾与生殖激素之间的关系以及这种关系是否由肌肉量和力量介导尚不清楚。
本研究的目的是确定激素与2年随访期间功能残疾变化之间的关系，并检验肌肉量和力量是否能解释所观察到的任何关系。
设计、地点和参与者：共有1318名年龄在70岁及以上的男性参与了康科德男性健康与老龄化项目研究，在基线和2年随访时均接受了评估。通过液相色谱-串联质谱法测量睾酮（T）、双氢睾酮（DHT）、雌二醇（E2）和雌酮（E1），通过免疫测定法测量性激素结合球蛋白（SHBG）、促黄体生成素（LH）和促卵泡生成素（FSH）。
在两个时间点均通过日常生活基本活动量表测量功能残疾。使用测力计测量握力和股四头肌力量，通过双能X线吸收法测定瘦（肌肉）量。
在单变量分析中，所有激素均与功能下降显著相关。在多变量分析中，只有T、E2、E1和计算得出的游离T仍然相关。处于最低T四分位数的男性（与最高四分位数相比）功能下降风险增加（比值比1.96，95%置信区间1.01-3.82）。在E2、E1和计算得出的游离T中也观察到类似的关联。当将肌肉变量纳入多变量模型时，这些激素与功能下降之间的关联不再具有统计学意义。
低T、E2和E1与2年期间的前瞻性功能下降显著相关。当加入肌肉量或力量时，这种关系不再显著，表明激素关联是通过它们对肌肉量和力量的顺序作用介导的。
