School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Department of Endocrinology and Diabetes, Alfred Health, Melbourne, Victoria, Australia.
J Gerontol A Biol Sci Med Sci. 2024 Apr 1;79(4). doi: 10.1093/gerona/glad287.
Blood concentrations of testosterone and estrone tend to increase in women aged ≥70 years, whereas concentrations of their precursor hormone dehydroepiandrosterone decline. It is unknown whether these changes influence physical function. We investigated whether concentrations of these hormones were associated with grip strength and self-reported physical function in community-dwelling older women.
A total of 9 179 Australian women, aged ≥70 years, were recruited to the ASPirin in Reducing Events in the Elderly (ASPREE) trial. Sex hormones were measured in Sex Hormones in Older Women, an ASPREE substudy, by liquid chromatography-tandem mass spectrometry in 6 358 women. The associations between hormone concentrations and physical function (handgrip strength and self-reported physical function assessed by SF-12v2 physical component summary [PCS]) were examined using multiple linear regression.
The median age of the 5,447 participants was 74.0 (interquartile range 71.7-77.6) years. Testosterone concentrations above the lowest quartile were associated with less decline in grip strength (mean -1.39 [95% CI -1.54 to -1.24] vs -1.75 [-2.00 to -1.50] kg, p = .02), and dehydroepiandrosterone concentrations above the lowest quartile were associated with less decline in grip strength (-1.39 [-1.54 to -1.25] vs -1.82 [-2.11 to -1.55] kg, p = .007) and PCS scores (-1.49 [-1.80 to -1.17] vs -2.33 [-2.93 to -1.72], p = .02) over 4 years, compared with those in the respective lowest quartile.
Low endogenous concentrations of testosterone and dehydroepiandrosterone were associated the greatest likelihood of physical function decline in community-based women aged ≥70 years. Further studies are warranted to determine whether testosterone and dehydroepiandrosterone therapy prevent functional decline in this at-risk group using sensitive measures of muscle strength and performance.
年龄≥70 岁的女性血液中睾丸激素和雌酮的浓度往往会升高，而其前体激素脱氢表雄酮的浓度则会下降。目前尚不清楚这些变化是否会影响身体功能。我们研究了这些激素的浓度是否与社区居住的老年女性的握力和自我报告的身体功能有关。
共有 9179 名年龄≥70 岁的澳大利亚女性参加了 ASPirin in Reducing Events in the Elderly (ASPREE) 试验。在 ASPREE 的一项子研究“老年女性性激素”中，通过液相色谱-串联质谱法测量了 6358 名女性的性激素。使用多元线性回归分析了激素浓度与身体功能（握力和 SF-12v2 生理成分综合评分 [PCS] 评估的自我报告身体功能）之间的关系。
5447 名参与者的中位年龄为 74.0（四分位距 71.7-77.6）岁。睾丸激素浓度高于最低四分位数与握力下降幅度较小有关（平均 -1.39 [95%CI -1.54 至 -1.24] 与 -1.75 [-2.00 至 -1.50] kg，p=0.02），而脱氢表雄酮浓度高于最低四分位数与握力下降幅度较小有关（-1.39 [-1.54 至 -1.25] 与 -1.82 [-2.11 至 -1.55] kg，p=0.007）和 PCS 评分（-1.49 [-1.80 至 -1.17] 与 -2.33 [-2.93 至 -1.72]，p=0.02）在 4 年内，与各自最低四分位数相比。
内源性睾丸激素和脱氢表雄酮浓度较低与社区≥70 岁女性身体功能下降的可能性最大。需要进一步的研究来确定睾丸激素和脱氢表雄酮治疗是否可以使用肌肉力量和性能的敏感测量来预防该高危人群的功能下降。
