Islam Rakibul M, Bell Robin J, Handelsman David J, Robinson Penelope J, Wolfe Rory, Davis Susan R
Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia.
ANZAC Research Institute, University of Sydney, Concord, NSW, Australia.
Clin Endocrinol (Oxf). 2021 Mar;94(3):443-448. doi: 10.1111/cen.14401. Epub 2021 Jan 2.
Sex steroid levels in women vary with increasing age from the age of 70 years (70+). Whether this reflects change within individuals with age or a survival advantage is not known. This study aimed to determine the stability of circulating sex steroids and SHBG over time in individual women aged 70+.
A prospective cohort study.
400 women, aged 70+ not using any sex steroid, anti-androgen/oestrogen or glucocorticoid therapy.
Sex steroid concentrations, measured by liquid chromatography-tandem mass spectrometry and sex hormone-binding globulin (SHBG) by immunoassay, in paired blood samples drawn 3 years apart and analysed together.
400 women, median (IQR) age 78.0 (8.6) years, were included in the analysis. Mean testosterone concentrations were statistically significantly higher in follow-up samples compared with baseline. The change was modest (mean change 31 pmol/L, 95% confidence interval (CI) 2.4-59.8; p = .034), and an increase was not observed in all women. There was a statistically significant decline in mean body mass index (mean change -0.4 kg/m , 95% CI 0.6 to -0.3; p < .001) and a significant increase in the mean serum SHBG concentration (mean change 4.0 nmol/L, 95% CI 2.7-5.4; p < .001). The change observed in testosterone was not explained by the observed change in SHBG. There was no significant change in the mean oestrone or dehydroepiandrosterone concentration.
Testosterone concentrations in women aged 70+ were more likely to increase than decrease. Whether increasing testosterone concentrations in older women confer a survival advantage needs investigation.
70岁及以上女性的性类固醇水平随年龄增长而变化。这是反映个体随年龄的变化还是生存优势尚不清楚。本研究旨在确定70岁及以上女性个体循环性类固醇和性激素结合球蛋白（SHBG）随时间的稳定性。
一项前瞻性队列研究。
400名70岁及以上未使用任何性类固醇、抗雄激素/雌激素或糖皮质激素治疗的女性。
通过液相色谱-串联质谱法测定性类固醇浓度，通过免疫测定法测定性激素结合球蛋白（SHBG），对间隔3年采集的配对血样进行分析。
400名女性纳入分析，年龄中位数（四分位间距）为78.0（8.6）岁。随访样本中的平均睾酮浓度与基线相比在统计学上显著更高。变化幅度较小（平均变化31 pmol/L，95%置信区间（CI）2.4 - 59.8；p = 0.034），并非所有女性都出现升高。平均体重指数有统计学显著下降（平均变化 -0.4 kg/m²，95% CI 0.6至 -0.3；p < 0.001），平均血清SHBG浓度有显著升高（平均变化4.0 nmol/L，95% CI 2.7 - 5.4；p < 0.001）。观察到的睾酮变化无法用SHBG的变化来解释。平均雌酮或脱氢表雄酮浓度无显著变化。
70岁及以上女性的睾酮浓度升高的可能性大于降低。老年女性睾酮浓度升高是否具有生存优势需要进一步研究。
