Low serum testosterone and estradiol predict mortality in elderly men.
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.
Tivesten
Asa
A
Wallenberg Laboratory for Cardiovascular Research, Bruna Stråket 16, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden. asa.tivesten@medic.gu.se
Vandenput
Liesbeth
L
Labrie
Fernand
F
Karlsson
Magnus K
MK
Ljunggren
Osten
O
Mellström
Dan
D
Ohlsson
Claes
C
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*
D013739:Testosterone; D004958:Estradiol