title: Multiple hormonal deficiencies in anabolic hormones are found in frail older women: the Women's Health and Aging studies.
abstract: BACKGROUND
  Alterations in anabolic hormones are theorized to contribute to aging and frailty, with most studies focusing on the relationship between individual hormones and specific age-associated diseases. We hypothesized that associations with frailty would most likely manifest in the presence of deficits in multiple anabolic hormones.
  
  
  METHODS
  The relationships of serum levels of total IGF-1, DHEAS, and free testosterone (T) with frailty status (nonfrail, prefrail, or frail) were analyzed in 494 women aged 70-79 years enrolled in the Women's Health and Aging Studies I or II. Using multivariate polytomous regression, we calculated the odds of frailty for deficiency in each hormone (defined as the bottom quartile of the hormone) individually, as well as for a count of the hormones.
  
  
  RESULTS
  For each hormone, in adjusted analyses, those with the deficiency were more likely to be frail than those without the deficiency, although this did not achieve statistical significance (IGF-1: odds ratio [OR] 1.82, confidence interval [CI] 0.81-4.08; DHEAS: OR 1.68, CI 0.77-3.69; free T: OR 2.03, CI 0.89-4.64). Compared with those with no hormonal deficiencies, those with one deficiency were not more likely to be frail (OR 1.15, CI 0.49-2.68), whereas those with two or three deficiencies had a very high likelihood of being frail (OR 2.79, CI 1.06-7.32), in adjusted models.
  
  
  CONCLUSIONS
  The absolute burden of anabolic hormonal deficiencies is a stronger predictor of frailty status than the type of hormonal deficiency, and the relationship is nonlinear. These analyses suggest generalized endocrine dysfunction in the frailty syndrome.
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania School of Medicine, 415 Curie Blvd, Philadelphia, PA 19104, USA. acappola@mail.med.upenn.edu
authors.forename: Anne R
authors.initials: AR
authors.lastname: Cappola
authors.forename: Qian-Li
authors.initials: QL
authors.lastname: Xue
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging / Q000097:blood* / Q000502:physiology; D016001:Confidence Intervals; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006728:Hormones / Q000172:deficiency*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis* / Q000172:deficiency; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D013739:Testosterone / Q000097:blood*; D016387:Women's Health
chemical_list: D006728:Hormones; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D007334:Insulin-Like Growth Factor I