Yuki Atsumu, Ando Fujiko, Otsuka Rei, Shimokata Hiroshi
Faculty of Education, Kochi University, Kochi, Japan.
Geriatr Gerontol Int. 2015 Mar;15(3):326-33. doi: 10.1111/ggi.12278. Epub 2014 Mar 14.
Sarcopenia accelerates frailty syndrome, and adversely affects activities of daily living and quality of life. The aim of the present study was to assess longitudinal relationships between baseline androgen and muscle mass changes in Japanese women.
Data were collected from 539 community-dwelling, Japanese women aged 40-79 years at baseline who participated in both baseline and follow-up examinations of a longitudinal study of aging (mean duration 8.3 years). Appendicular skeletal muscle mass was measured with dual-energy X-ray absorptiometry at baseline and follow-up examinations. The cut-off point for sarcopenia was a skeletal muscle index (appendicular skeletal muscle mass/height(2) ) <5.46 kg/m(2) . Participants with sarcopenia at baseline were excluded. Thus, 430 women were included. Total testosterone, free testosterone and dehydroepiandrosterone-sulphate were measured by radioimmunoassay at baseline. The androgens were categorized into three groups by serum levels. Multiple logistic regression models were fit to determine the associations between androgens and sarcopenia while controlling for baseline age, body mass index, leisure-time physical activity, nutritional intakes (total energy, total protein, vitamin D), serum C-reactive protein levels, medical histories (heart disease, osteoporosis, rheumatoid arthritis), menopause and smoking habit.
The fully adjusted odds ratio of sarcopenia for the low-free testosterone group (<0.7 pg/mL) compared with the high-free testosterone group (≥1.2 pg/mL) was 3.59 (95% confidence interval 1.25-10.34). Sarcopenia was not significantly related to total testosterone or dehydroepiandrosterone-sulphate.
A low-free testosterone level appears to be a significant predictor of the risk for loss of appendicular muscle in Japanese women.
肌肉减少症会加速衰弱综合征，并对日常生活活动及生活质量产生不利影响。本研究旨在评估日本女性基线雄激素水平与肌肉量变化之间的纵向关系。
数据收集自539名居住在社区、年龄在40 - 79岁的日本女性，她们参与了一项衰老纵向研究的基线和随访检查（平均时长8.3年）。在基线和随访检查时，采用双能X线吸收法测量四肢骨骼肌量。肌肉减少症的切点为骨骼肌指数（四肢骨骼肌量/身高²）<5.46 kg/m²。排除基线时患有肌肉减少症的参与者。因此，纳入了430名女性。在基线时通过放射免疫分析法测量总睾酮、游离睾酮和硫酸脱氢表雄酮。根据血清水平将雄激素分为三组。采用多因素logistic回归模型来确定雄激素与肌肉减少症之间的关联，同时控制基线年龄、体重指数、休闲时间体力活动、营养摄入（总能量、总蛋白、维生素D）、血清C反应蛋白水平、病史（心脏病、骨质疏松症、类风湿关节炎）、绝经状态和吸烟习惯。
与高游离睾酮组（≥1.2 pg/mL）相比，低游离睾酮组（<0.7 pg/mL）发生肌肉减少症的完全调整优势比为3.59（95%置信区间1.25 - 10.34）。肌肉减少症与总睾酮或硫酸脱氢表雄酮无显著相关性。
低游离睾酮水平似乎是日本女性四肢肌肉量丢失风险的重要预测指标。
