The EMAS Group: Florence (Gianni Forti, Luisa Petrone, Giovanni Corona); Leuven (Dirk Vanderschueren, Steven Boonen, Herman Borghs); Lodz (Krzysztof Kula, Jolanta Slowikowska-Hilczer, Renata Walczak-Jedrzejowska); London (Ilpo Huhtaniemi); Malmö (Aleksander Giwercman); Manchester (Frederick Wu, Alan Silman, Terence O'Neill, Joseph Finn, Philip Steer, Abdelouahid Tajar, David Lee, Stephen Pye); Santiago (Felipe F Casanueva, Mary Lage); Szeged (György Bartfai, Imre Földesi, Imre Fejes); Tartu (Margus Punab, Paul Korrovitz); Turku (Min Jiang).
Frailty in Relation to Variations in Hormone Levels of the Hypothalamic–Pituitary–Testicular Axis in Older Men: Results From the European Male Aging Study
Version of Record online: 13 MAY 2011
© 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 59, Issue 5, pages 814–821, May 2011
How to Cite
Tajar, A., O'Connell, M. D.L., Mitnitski, A. B., O'Neill, T. W., Searle, S. D., Huhtaniemi, I. T., Finn, J. D., Bartfai, G., Boonen, S., Casanueva, F. F., Forti, G., Giwercman, A., Han, T. S., Kula, K., Labrie, F., Lean, M. E.J., Pendleton, N., Punab, M., Silman, A. J., Vanderschueren, D., Rockwood, K., Wu, F. C.W. and the European Male Aging Study Group (2011), Frailty in Relation to Variations in Hormone Levels of the Hypothalamic–Pituitary–Testicular Axis in Older Men: Results From the European Male Aging Study. Journal of the American Geriatrics Society, 59: 814–821. doi: 10.1111/j.1532-5415.2011.03398.x
- Issue online: 13 MAY 2011
- Version of Record online: 13 MAY 2011
- frailty index;
- hypothalamic–pituitary–testicular axis;
OBJECTIVES: To explore the associations between frailty and reproductive axis hormones (as an important regulatory system) in middle aged and older men.
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.