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Higher testosterone levels may protect against frailty in men

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December 4, 2017

Frailty in aging men may be associated with low levels of free testosterone and high levels of sex hormone-binding globulin, follicle-stimulating hormone and luteinizing hormone, according to findings published in The Journal of Clinical Endocrinology & Metabolism.

Agnieszka Swiecicka, MD, a clinical research fellow at the University of Manchester in the United Kingdom, and colleagues evaluated data from the European Male Aging Study on 3,369 men (mean age, 58 years) from eight European centers to determine the associations between reproductive hormones and prospective changes in frailty status. Follow-up was a median 4.3 years.

The frailty index (n = 2,278) and frailty phenotype (n = 1,980) were used to determine frailty status.

Compared with participants who did not become frail during follow-up, those whose frailty status deteriorated were older and had lower baseline BMI, higher levels of SHBG, luteinizing hormone and follicle-stimulating hormone, and a higher prevalence of diabetes and cardiovascular disease. Participants whose frailty status improved were younger, had lower prevalence of CVD and lower baseline estradiol, SHBG and gonadotropin levels compared with participants who remained persistently frail or prefrail.

The likelihood of a worsening frailty index was associated with higher baseline levels of total testosterone (percent change in frailty index associated with 1 standard deviation higher hormone level, –3), free testosterone (percent change in frailty index associated with 1 standard deviation higher hormone level, –3.9) and dihydrotestosterone (percent change in frailty index associated with 1 standard deviation higher hormone level, –3.9) compared with lower levels in models adjusted for baseline frailty, age, study center and smoking status; only free testosterone remained a significant predictor after additional adjustment for BMI. In models adjusted for frailty index, higher baseline levels of SHBG, follicle-stimulating hormone and luteinizing hormone compared with lower levels were associated with a higher risk for worsening frailty index.

“These prospective data provide important insight into the potential role of reproductive hormones in the development, progression and recovery of frailty in aging men,” the researchers wrote. “The results cannot confirm a causal relationship between androgen status and progression of frailty, but the clear associations shown here make a strong case for definitive large interventional trials of testosterone therapy in frail men, to determine whether such treatment would be beneficial.” – by Amber Cox

Disclosures: Swiecicka reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

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