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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.

Original publication

DOI

10.1111/j.1532-5415.2011.03398.x

Type

Journal article

Journal

Journal of the American Geriatrics Society

Publication Date

05/2011

Volume

59

Pages

814 - 821

Addresses

Arthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, UK.

Keywords

European Male Aging Study Group, Testis, Pituitary Gland, Hypothalamo-Hypophyseal System, Hypothalamus, Humans, Dehydroepiandrosterone Sulfate, Testosterone, Follicle Stimulating Hormone, Luteinizing Hormone, Sex Hormone-Binding Globulin, Biological Markers, Geriatric Assessment, Health Status Indicators, Questionnaires, Regression Analysis, Prospective Studies, Cross-Sectional Studies, Motor Activity, Aging, Aged, Frail Elderly, Europe, Male