Dataset Information

Sex hormones and frailty in older men: the osteoporotic fractures in men (MrOS) study.

ABSTRACT:

Context

As men age, the prevalence of frailty increases whereas levels of androgens decline. Little is known about the relation between these factors.

Objective

The aim of this study was to assess cross-sectional and longitudinal associations of estradiol, bioavailable estradiol, testosterone, bioavailable testosterone (bioT), and SHBG with frailty status.

Design and setting

The Osteoporotic Fractures in Men (MrOS) study was conducted at six U.S. clinical centers.

Participants

A total of 1469 community-dwelling men at least 65 yr old with baseline data participated; 1245 men had frailty status reassessed 4.1 yr later.

Main outcome measure

Proportional odds models estimated the likelihood of greater frailty status. Frail men had at least three of the following: weakness, slowness, low activity, exhaustion, and shrinking/sarcopenia; intermediate men had one or two criteria; and robust men had none. At follow-up, death was included as an additional ordinal outcome. Sex hormones were assayed by spectrometry/chromatographic methods.

Results

In cross-sectional analyses, men in the lowest quartile of bioT had 1.39-fold (95% confidence interval, 1.02, 1.91) increased odds of greater frailty status compared to men in the highest quartile after adjustment for covariates including age, body size, health status, and medical conditions. In age-adjusted longitudinal analyses, men in the lowest quartile of bioT had 1.51-fold (95% confidence interval, 1.10, 2.07) increased odds of greater frailty status 4.1 yr later. This association was largely attenuated by adjustment for covariates. No other hormones were associated in a cross-sectional or longitudinal manner with frailty status after adjustment.

Conclusions

Low levels of bioT were independently associated with worse baseline frailty status. Frailty status should be considered as an outcome in trials of testosterone supplementation.

SUBMITTER: Cawthon PM

PROVIDER: S-EPMC2758722 | biostudies-literature | 2009 Oct

REPOSITORIES: biostudies-literature

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Publications

Sex hormones and frailty in older men: the osteoporotic fractures in men (MrOS) study.

Cawthon Peggy M PM Ensrud Kristine E KE Laughlin Gail A GA Cauley Jane A JA Dam Thuy-Tien L TT Barrett-Connor Elizabeth E Fink Howard A HA Hoffman Andrew R AR Lau Edith E Lane Nancy E NE Stefanick Marcia L ML Cummings Steven R SR Orwoll Eric S ES

The Journal of clinical endocrinology and metabolism 20090908 10

<h4>Context</h4>As men age, the prevalence of frailty increases whereas levels of androgens decline. Little is known about the relation between these factors.<h4>Objective</h4>The aim of this study was to assess cross-sectional and longitudinal associations of estradiol, bioavailable estradiol, testosterone, bioavailable testosterone (bioT), and SHBG with frailty status.<h4>Design and setting</h4>The Osteoporotic Fractures in Men (MrOS) study was conducted at six U.S. clinical centers.<h4>Partic ...[more]

PMID: 19737923

Similar Datasets

Project description:Although prior falls are a well-established predictor of future fracture, there is currently limited evidence regarding the specific value of falls history in fracture risk assessment relative to that of other clinical risk factors and bone mineral density (BMD) measurement. We therefore investigated, across the three Osteoporotic Fractures in Men (MrOS) Study cohorts, whether past falls predicted future fracture independently of FRAX and whether these associations varied with age and follow-up time. Elderly men were recruited from MrOS Sweden, Hong Kong, and USA. Baseline data included falls history (over the preceding 12 months), clinical risk factors, BMD at femoral neck, and calculated FRAX probabilities. An extension of Poisson regression was used to investigate the associations between falls, FRAX probability, and incident fracture, adjusting for age, time since baseline, and cohort in base models; further models were used to investigate interactions with age and follow-up time. Random-effects meta-analysis was used to synthesize the individual country associations. Information on falls and FRAX probability was available for 4365 men in USA (mean age 73.5 years; mean follow-up 10.8 years), 1823 men in Sweden (mean age 75.4 years; mean follow-up 8.7 years), and 1669 men in Hong Kong (mean age 72.4 years; mean follow-up 9.8 years). Rates of past falls were similar at 20%, 16%, and 15%, respectively. Across all cohorts, past falls predicted incident fracture at any site (hazard ratio [HR] = 1.69; 95% confidence interval [CI] 1.49, 1.90), major osteoporotic fracture (MOF) (HR = 1.56; 95% CI 1.33, 1.83), and hip fracture (HR = 1.61; 95% CI 1.27, 2.05). Relationships between past falls and incident fracture remained robust after adjustment for FRAX probability: adjusted HR (95% CI) any fracture: 1.63 (1.45, 1.83); MOF: 1.51 (1.32, 1.73); and hip: 1.54 (1.21, 1.95). In conclusion, past falls predicted incident fracture independently of FRAX probability, confirming the potential value of falls history in fracture risk assessment. © 2017 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals Inc.

Dataset Information

Sex hormones and frailty in older men: the osteoporotic fractures in men (MrOS) study.

Context

Objective

Design and setting

Participants

Main outcome measure

Results

Conclusions

Publications

Sex hormones and frailty in older men: the osteoporotic fractures in men (MrOS) study.

Similar Datasets

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