老年睾酮：新西兰纵向队列研究：高龄生命与生活研究（Te Puāwaitanga o Ngā Tapuwae Kia Ora Tonu）。
Testosterone in advance age: a New Zealand longitudinal cohort study: Life and Living in Advanced Age (Te Puāwaitanga o Ngā Tapuwae Kia Ora Tonu).
机构信息
Freemasons' Department of Geriatric Medicine, University of Auckland, Auckland, New Zealand.
School of Population Health, University of Auckland, Auckland, New Zealand.
出版信息
BMJ Open. 2017 Nov 12;7(11):e016572. doi: 10.1136/bmjopen-2017-016572.
OBJECTIVES
Serum testosterone (T) levels in men decline with age. Low T levels are associated with sarcopenia and frailty in men aged 80 years. T levels have not previously been directly associated with disability in older men. We explored associations between T levels, frailty and disability in a cohort of octogenarian men.
SETTING
Data from all men from Life and Living in Advanced Age Cohort Study in New Zealand, a longitudinal cohort study in community-dwelling older adults.
PARTICIPANTS
Community-dwelling (80 years) adult men excluding those receiving T treatment or with prostatic carcinoma.
OUTCOMES MEASURES
Associations between baseline total testosterone (TT) and calculated free testosterone (fT), frailty (Fried scale) and disability (Nottingham Extended Activities of Daily Living scale (NEADL)) (baseline and 24 months) were examined using multivariate regression and Wald's χ techniques. Subjects with the lowest quartile of baseline TT and fT values were compared with those in the upper three quartiles.
RESULTS
Participants: 243 men, mean (SD) age 83.7 (2.0) years. Mean (SD) TT=17.6 (6.8) nmol/L and fT=225.3 (85.4) pmol/L. On multivariate analyses, lower TT levels were associated with frailty: β=0.41, p=0.017, coefficient of determination (R)=0.10 and disability (NEADL) (β=-1.27, p=0.017, R=0.11), low haemoglobin (β=-7.38, p=0.0016, R=0.05), high fasting glucose (β=0.38, p=0.038, R=0.04) and high C reactive protein (CRP) (β=3.57, p=0.01, R=0.06). Low fT levels were associated with frailty (β=0.39, p=0.024, R=0.09) but not baseline NEADL (β=-1.29, p=0.09, R=0.09). Low fT was associated with low haemoglobin (β=-7.83, p=0.0008, R=0.05) and high CRP (β=2.86, p=0.04, R=0.05). Relationships between baseline TT and fT, and 24-month outcomes of disability and frailty were not significant.
CONCLUSIONS
In men over 80 years, we confirm an association between T levels and baseline frailty scores. The new finding of association between T levels and disability is potentially relevant to debates on T supplementation in older men, though, as associations were not present at 24 months, further work is needed.
目的
男性的血清睾酮（T）水平随年龄增长而下降。低 T 水平与 80 岁男性的肌肉减少症和虚弱有关。T 水平以前与老年男性的残疾没有直接关联。我们在 80 岁男性的队列中探讨了 T 水平、虚弱和残疾之间的关系。
地点
来自新西兰生命与高级年龄队列研究的所有男性的数据，这是一项针对社区居住老年人的纵向队列研究。
参与者
社区居住（80 岁）成年男性，不包括接受 T 治疗或患有前列腺癌的男性。
结局测量
使用多元回归和 Wald's χ 技术检查基线总睾酮（TT）和计算的游离睾酮（fT）、虚弱（Fried 量表）和残疾（诺丁汉扩展日常生活活动量表（NEADL））（基线和 24 个月）之间的关系。将基线 TT 和 fT 值最低四分位数的受试者与其他三分位值的受试者进行比较。
结果
参与者：243 名男性，平均（SD）年龄 83.7（2.0）岁。平均（SD）TT=17.6（6.8）nmol/L 和 fT=225.3（85.4）pmol/L。在多元分析中，较低的 TT 水平与虚弱有关：β=0.41，p=0.017，决定系数（R）=0.10，残疾（NEADL）（β=-1.27，p=0.017，R=0.11），低血红蛋白（β=-7.38，p=0.0016，R=0.05），高空腹血糖（β=0.38，p=0.038，R=0.04）和高 C 反应蛋白（CRP）（β=3.57，p=0.01，R=0.06）。低 fT 水平与虚弱有关（β=0.39，p=0.024，R=0.09），但与基线 NEADL 无关（β=-1.29，p=0.09，R=0.09）。低 fT 与低血红蛋白（β=-7.83，p=0.0008，R=0.05）和高 CRP（β=2.86，p=0.04，R=0.05）有关。基线 TT 和 fT 与 24 个月残疾和虚弱结局之间的关系并不显著。
结论
在 80 岁以上的男性中，我们证实了 T 水平与基线虚弱评分之间的关联。T 水平与残疾之间的新关联可能与老年男性补充 T 的争论有关，但由于 24 个月时没有关联，因此需要进一步研究。
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