Serum sex steroid hormones and lower urinary tract symptoms in Third National Health and Nutrition Examination Survey (NHANES III).
OBJECTIVE
To evaluate the association of circulating sex steroid hormones and sex hormone binding globulin (SHBG) with lower urinary tract symptoms (LUTS).


METHODS
We included 260 men, 60 years old or older, who participated in Phase 1 (1988 to 1991) of the Third National Health and Nutrition Examination Survey and for whom surplus serum was available. We measured the serum concentrations of testosterone, androstanediol glucuronide (AAG), estradiol, and SHBG. Free testosterone was calculated from the circulating testosterone, SHBG, and albumin. The cases (n = 128) were men with two to four symptoms (nocturia, hesitancy, incomplete emptying, and weak stream), but who had never undergone noncancer prostate surgery. The controls (n = 132) were men who neither had symptoms nor had undergone noncancer prostate surgery. We adjusted for age, race/ethnicity, waist circumference, cigarette smoking, alcohol consumption, and physical activity in logistic regression models and used sampling weights.


RESULTS
The cases had statistically significantly greater AAG and estradiol concentrations than did the controls. After multivariate adjustment, the men in the top tertile of AAG (odds ratio 2.62, 95% confidence interval 1.12 to 6.14) had a greater risk of LUTS compared with men in the bottom two tertiles. Also, men with a greater estradiol concentration (odds ratio 1.78, 95% confidence interval 0.91 to 3.49) and a greater estradiol/SHBG molar ratio (odds ratio 2.41, 95% confidence interval 1.39 to 4.17) had a greater risk of LUTS than did men with lower concentrations. No consistent associations were seen for circulating testosterone, free testosterone, or SHBG.


CONCLUSIONS
In this cross-sectional study representative of older U.S. men, circulating AAG, a metabolite of dihydrotestosterone, and estradiol were associated with an increased risk of having LUTS.
Rohrmann
Sabine
S
Division of Clinical Epidemiology, German Cancer Research Center, Heidelberg, Germany.
Nelson
William G
WG
Rifai
Nader
N
Kanarek
Norma
N
Basaria
Shehzad
S
Tsilidis
Konstantinos K
KK
Smit
Ellen
E
Giovannucci
Edward
E
Platz
Elizabeth A
EA
D015113:Androstane-3,17-diol / Q000031:analogs & derivatives* / Q000097:blood; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053448:Prostatism / Q000097:blood*; D012738:Sex Hormone-Binding Globulin / Q000032:analysis*; D013739:Testosterone / Q000097:blood*
D012738:Sex Hormone-Binding Globulin; D015113:Androstane-3,17-diol; C028895:androstane-3,17-diol glucuronide; D013739:Testosterone; D004958:Estradiol