Get access

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

Authors

  • Abdelouahid Tajar PhD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • a Matthew D.L. O'Connell BSc,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • b Arnold B. Mitnitski PhD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • c Terence W. O'Neill MD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • a Samuel D. Searle BSc,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • c Ilpo T. Huhtaniemi MD, PhD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • d Joseph D. Finn BSc,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • b György Bartfai MD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • e Steven Boonen MD, PhD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • f Felipe F. Casanueva MD, PhD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • g Gianni Forti MD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • h Aleksander Giwercman MD, PhD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • i Thang S. Han MD, PhD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • j Krzysztof Kula MD, PhD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • k Fernand Labrie MD, PhD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • l Michael E.J. Lean MD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • m Neil Pendleton MD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • n Margus Punab MD, PhD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • o Alan J. Silman MD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • p Dirk Vanderschueren MD, PhD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • q Kenneth Rockwood MD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • c Frederick C.W. Wu MD,

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author
  • and b the European Male Aging Study Group

    1. From the aArthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, United Kingdom; bDepartment of Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Manchester, United Kingdom; cGeriatric Medicine Research Unit, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, Canada; dDepartment of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, United Kingdom; eDepartment of Obstetrics, Gynecology and Andrology, Albert Szent-György Medical University, Szeged, Hungary; Departments of fGeriatric Medicine and qAndrology and Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium; gDepartment of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain; hEndocrinology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy; iScanian Andrology Centre, Department of Urology, Malmö University Hospital, University of Lund, Malmö, Sweden; jDepartment of Endocrinology, University College London, London, United Kingdom; kDepartment of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland; lLaboratory of Molecular Endocrinology and Oncology, Laval University, Quebec City, Quebec, Canada; mDivision of Developmental Medicine, Human Nutrition Section, University of Glasgow, Glasgow, Scotland; nSchool of Community Based Medicine, University of Manchester, Salford Royal NHS Trust, Salford, United Kingdom; oAndrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia; and pArthritis Research United Kingdom, Chesterfield, United Kingdom.
    Search for more papers by this author

  • 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).

Address correspondence to Prof. Frederick C.W. Wu, The University of Manchester, Manchester Academic Health Science Centre, Department of Endocrinology, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL,United Kingdom. E-mail: frederick.wu@manchester.ac.uk

Abstract

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.

Get access to the full text of this article

Ancillary