Frailty in Relation to Variations in Hormone Levels of the Hypothalamic-Pituitary-Testicular Axis in Older Men: Results From the European Male Aging Study

被引：49

作者：

Tajar, Abdelouahid ^{[1
]}

O'Connell, Matthew D. L. ^{[2
]}

Mitnitski, Arnold B. ^{[3
,4
]}

O'Neill, Terence W. ^{[1
]}

Searle, Samuel D. ^{[3
,4
]}

Huhtaniemi, Ilpo T. ^{[5
]}

Finn, Joseph D. ^{[2
]}

Bartfai, Gyoergy ^{[6
]}

Boonen, Steven ^{[7
]}

Casanueva, Felipe F. ^{[9
]}

Forti, Gianni ^{[10
]}

Giwercman, Aleksander ^{[11
]}

Han, Thang S. ^{[12
]}

Kula, Krzysztof ^{[13
]}

Labrie, Fernand ^{[14
]}

Lean, Michael E. J. ^{[15
]}

Pendleton, Neil ^{[16
]}

Punab, Margus ^{[17
]}

Silman, Alan J. ^{[18
]}

Vanderschueren, Dirk ^{[8
]}

Rockwood, Kenneth ^{[3
,4
]}

Wu, Frederick C. W. ^{[2
]}

机构：

[1] Univ Manchester, Arthritis Res United Kingdom Epidemiol Unit, Manchester M13 9WL, Lancs, England

[2] Univ Manchester, Manchester Acad Hlth Sci Ctr, Dept Med, Manchester Royal Infirm, Manchester M13 9WL, Lancs, England

[3] Dalhousie Univ, Geriatr Med Res Unit, Halifax, NS, Canada

[4] Queen Elizabeth 2 Hlth Sci Ctr, Halifax, NS, Canada

[5] Univ London Imperial Coll Sci Technol & Med, Dept Surg & Canc, London, England

[6] Albert Szent Gyorgyi Med Univ, Dept Obstet Gynecol & Androl, H-6701 Szeged, Hungary

[7] Katholieke Univ Leuven, Dept Geriatr Med, Leuven, Belgium

[8] Katholieke Univ Leuven, Dept Androl & Endocrinol, Leuven, Belgium

[9] Univ Santiago de Compostela, CIBER Fisiopatol Obesidad & Nutr, Inst Salud Carlos 3, Complejo Hosp,Univ Santiago,Dept Med, Santiago De Compostela, Spain

[10] Univ Florence, Dept Clin Physiopathol, Endocrinol Unit, Florence, Italy

[11] Lund Univ, Malmo Univ Hosp, Scanian Androl Ctr, Dept Urol, Malmo, Sweden

[12] UCL, Dept Endocrinol, London, England

[13] Med Univ Lodz, Dept Androl & Reprod Endocrinol, Lodz, Poland

[14] Univ Laval, Lab Mol Endocrinol & Oncol, Quebec City, PQ, Canada

[15] Univ Glasgow, Div Dev Med, Human Nutr Sect, Glasgow, Lanark, Scotland

[16] Univ Manchester, Sch Community Based Med, Salford Royal NHS Trust, Salford, Lancs, England

[17] Univ Tartu, Androl Unit, United Labs, EE-50090 Tartu, Estonia

[18] Arthritis Res United Kingdom, Chesterfield, Derby, England

来源：

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY | 2011年 / 59卷 / 05期

关键词：

frailty index; hypothalamic-pituitary-testicular axis; testosterone; epidemiology; EMAS; DEHYDROEPIANDROSTERONE-SULFATE; FREE TESTOSTERONE; BINDING GLOBULIN; ELDERLY-MEN; HEALTH; INDEX; AGE; HYPOGONADISM; PARADIGM;

D O I：

10.1111/j.1532-5415.2011.03398.x

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

OBJECTIVES: To explore the associations between frailty and reproductive axis hormones (as an important regulatory system) in middle aged and older men. DESIGN: Cross-sectional. SETTING: The European Male Aging Study. PARTICIPANTS: Three thousand two hundred nineteen community-dwelling European men aged 40 to 79. MEASUREMENTS: Interviewer-assisted questionnaires to assess physical activity, health status, and mood were administered. Testosterone (T), luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone sulfate (DHEAS), and sex hormone-binding globulin (SHBG) were measured in a fasting morning blood sample. Frailty was assessed as an index (FI) according to the number (out of 43 possible) of health deficits (symptoms, signs, and functional impairments). Relationships between FI and hormone levels (as outcomes) were explored using regression models. RESULTS: Mean FI was 0.12 +/- 0.11 (range 0-0.67) was highest in the oldest group. After adjustment for confounders, higher levels of FI were significantly associated with lower levels of total T, free T, and DHEAS and higher levels of gonadotropins and SHBG; a 1-standard deviation cross-sectional increase in FI was associated with a regression coefficient of -0.30 nmol/L (95% confidence interval (CI) = -0.53 to = -0.07) decrease in total T and 0.66 U/L (95% CI = 0.48-0.83) increase in LH. CONCLUSIONS: The associations between high FI, high gonadotropins, and well-maintained circulating T suggest that these changes are markers of aging-related disruptions of multiple physiological regulation, of which alterations in pituitary-testicular function represent a sensitive marker rather than an underlying pathogenic mechanism for frailty. J Am Geriatr Soc 59:814-821, 2011.

引用

页码：814 / 821

页数：8

共 43 条

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