Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria Australia.
ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia.
J Clin Endocrinol Metab. 2019 Dec 1;104(12):6291-6300. doi: 10.1210/jc.2019-00743.
There is a lack of understanding of what is normal in terms of sex steroid levels in older women.
To determine whether sex steroid levels vary with age in and establish reference ranges for women >70 years of age.
Cross-sectional, community-based study.
Included 6392 women ≥70 years of age.
Sex steroids measured by liquid chromatography-tandem mass spectrometry. A reference group, to establish sex steroid age-specific reference ranges, excluded women using systemic or topical sex steroid, antiandrogen or glucocorticoid therapy, or an antiglycemic agent.
The reference group of 5326 women had a mean age of 75.1 (±4.2) years, range of 70 to 94.7 years. Median values (range) were 181.2 pmol/L (3.7 to 5768.9) for estrone (E1), 0.38 nmol/L (0.035 to 8.56) for testosterone (T), 2.60 nmol/L (0.07 to 46.85) for dehydroepiandrosterone (DHEA), and 41.6 nmol/L (2.4 to 176.6) for SHBG. Estradiol and DHT were below method sensitivity in 66.1% and 72.7% of the samples, respectively. Compared with women aged 70 to 74 years, women aged ≥85 years had higher median levels of E1 (11.7%, P = 0.01), T (11.3%, P = 0.02), and SHBG (22.7%, P < 0.001) and lower DHEA (30% less, P < 0.001). Women with overweight and obesity had higher E1 (P < 0.001) and T (P < 0.03) and lower SHBG (P < 0.001) than did women with normal body mass index. Smokers had 17.2% higher median T levels (P = 0.005).
From the age of 70 years, T and E1 increase with age, despite a steady decline in DHEA. Whether E1 and T are biomarkers for longevity or contribute to healthy aging merits investigation.
人们对于老年女性的甾体激素水平的正常值缺乏了解。
确定女性 >70 岁时甾体激素水平是否随年龄变化，并建立其参考范围。
横断面、社区为基础的研究。
共纳入 6392 名 >70 岁的女性。
通过液相色谱-串联质谱法测定甾体激素。为建立甾体激素年龄特异性参考范围，排除了正在使用全身或局部甾体激素、抗雄激素或糖皮质激素、降血糖药物的女性。
纳入的 5326 名女性参考组的平均年龄为 75.1（±4.2）岁，年龄范围为 70 至 94.7 岁。中位数（范围）值为雌酮（E1）181.2 pmol/L（3.7 至 5768.9），睾酮（T）0.38 nmol/L（0.035 至 8.56），脱氢表雄酮（DHEA）2.60 nmol/L（0.07 至 46.85），性激素结合球蛋白（SHBG）41.6 nmol/L（2.4 至 176.6）。雌二醇和二氢睾酮在 66.1%和 72.7%的样本中低于方法检测下限。与 70 至 74 岁的女性相比，≥85 岁的女性 E1（11.7%，P = 0.01）、T（11.3%，P = 0.02）和 SHBG（22.7%，P < 0.001）的中位数水平较高，而 DHEA（低 30%，P < 0.001）的中位数水平较低。超重和肥胖的女性 E1（P < 0.001）和 T（P < 0.03）较高，SHBG（P < 0.001）较低，而体重指数正常的女性则相反。吸烟者的 T 中位数水平高 17.2%（P = 0.005）。
从 70 岁开始，尽管 DHEA 持续下降，T 和 E1 仍随年龄增长而增加。E1 和 T 是否为长寿的生物标志物，或是否有助于健康老龄化，值得进一步研究。
