title: Low serum testosterone and estradiol predict mortality in elderly men.
abstract: BACKGROUND
  Age-related reduction of serum testosterone may contribute to the signs and symptoms of aging, but previous studies report conflicting evidence about testosterone levels and male mortality. No large prospective cohort study has determined a possible association between serum estradiol and mortality in men.
  
  
  OBJECTIVE
  The main objective was to examine the association between serum testosterone and estradiol and all-cause mortality in elderly men.
  
  
  METHODS
  We used specific gas chromatography-mass spectrometry to analyze serum sex steroids at baseline in older men who participated in the prospective population-based MrOS Sweden cohort (n = 3014; mean age, 75 yr; range, 69-80 yr).
  
  
  METHODS
  All-cause mortality by serum testosterone and estradiol levels.
  
  
  RESULTS
  During a mean follow-up period of 4.5 yr, 383 deaths occurred. In multivariate hazards regression models, low levels (within quartile 1 vs. quartiles 2-4) of both testosterone [hazard ratio (HR), 1.65; 95% confidence interval (CI), 1.29-2.12] and estradiol (HR, 1.54; 95% CI, 1.22-1.95) associated with mortality. A model including both hormones showed that both low testosterone (HR, 1.46; 95% CI, 1.11-1.92) and estradiol (HR, 1.33; 95% CI, 1.02-1.73) predicted mortality. Risk of death nearly doubled (HR, 1.96; 95% CI, 1.46-2.62) in subjects with low levels of both testosterone and estradiol compared with subjects within quartiles 2-4 of both hormones.
  
  
  CONCLUSIONS
  Elderly men with low serum testosterone and estradiol have increased risk of mortality, and subjects with low values of both testosterone and estradiol have the highest risk of mortality.
authors.affiliation: Wallenberg Laboratory for Cardiovascular Research, Bruna Stråket 16, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden. asa.tivesten@medic.gu.se
authors.forename: Asa
authors.initials: A
authors.lastname: Tivesten
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Vandenput
authors.forename: Fernand
authors.initials: F
authors.lastname: Labrie
authors.forename: Magnus K
authors.initials: MK
authors.lastname: Karlsson
authors.forename: Osten
authors.initials: O
authors.lastname: Ljunggren
authors.forename: Dan
authors.initials: D
authors.lastname: Mellström
authors.forename: Claes
authors.initials: C
authors.lastname: Ohlsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood*; D006801:Humans; D008297:Male; D009026:Mortality; D011379:Prognosis; D012307:Risk Factors; D013739:Testosterone / Q000097:blood*
chemical_list: D013739:Testosterone; D004958:Estradiol