Low testosterone levels and the risk of anemia in older men and women.
BACKGROUND
Anemia is a frequent feature of male hypogonadism and anti-androgenic treatment. We hypothesized that the presence of low testosterone levels in older persons is a risk factor for anemia.


METHODS
Testosterone and hemoglobin levels were measured in a representative sample of 905 persons 65 years or older without cancer, renal insufficiency, or anti-androgenic treatments. Hemoglobin levels were reassessed after 3 years.


RESULTS
At baseline, 31 men and 57 women had anemia. Adjusting for confounders, we found that total and bioavailable testosterone levels were associated with hemoglobin levels in women (P = .001 and P = .02, respectively) and in men (P<.001 and P = .03, respectively). Men and women in the lowest quartile of total and bioavailable testosterone were more likely than those in the highest to have anemia (men, 14/99 vs 3/100; odds ratio [OR], 5.4; 95% confidence interval [CI], 1.4-21.8 for total and 16/99 vs 1/99; OR, 13.1; 95% CI, 1.5-116.9 for bioavailable testosterone; women, 21/129 vs 12/127; OR, 2.1; 95% CI, 0.9-5.0 for total and 24/127 vs 6/127; OR, 3.4; 95% CI, 1.2-9.4 for bioavailable testosterone). Among nonanemic participants and independent of confounders, men and women with low vs normal total and bioavailable testosterone levels had a significantly higher risk of developing anemia at 3-year follow-up (21/167 vs 28/444; relative risk, 2.1; 95% CI, 1.1-4.1 for total and 26/143 vs 23/468; relative risk, 3.9; 95% CI, 1.9-7.8 for bioavailable testosterone).


CONCLUSIONS
Older men and women with low testosterone levels have a higher risk of anemia.
Ferrucci
Luigi
L
Clinical Research Branch, Longitudinal Studies Section, National Institute on Aging, Baltimore, MD 21225, USA. ferruccilu@grc.nia.nih.gov
Maggio
Marcello
M
Bandinelli
Stefania
S
Basaria
Shehzad
S
Lauretani
Fulvio
F
Ble
Alessandro
A
Valenti
Giorgio
G
Ershler
William B
WB
Guralnik
Jack M
JM
Longo
Dan L
DL
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood*; D000740:Anemia / Q000097:blood* / Q000453:epidemiology; D001682:Biological Availability; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D013739:Testosterone / Q000097:blood*
D006454:Hemoglobins; D013739:Testosterone