Relationship between higher estradiol levels and 9-year mortality in older women: the Invecchiare in Chianti study.
OBJECTIVE
To investigate the relationship between total estradiol (E2) levels and 9-year mortality in older postmenopausal women not taking hormone replacement therapy (HRT).


METHODS
Population-based study of persons living in the Chianti geographic area (Tuscany, Italy).


METHODS
Community.


METHODS
A representative sample of 509 women aged 65 and older with measures of total E2.


METHODS
Serum total E2 was measured at the University of Parma using ultrasensitive radioimmunoassay (RIA).


RESULTS
Women who died (n=135) during 9 years of follow up were older; had higher total E2 levels; and were more likely to have evidence of stroke, hypertension, diabetes mellitus, and congestive heart failure at baseline than survivors. Higher E2 levels were associated with a greater likelihood of death (hazard ratio (HR)=1.03, 95% confidence interval (CI)=1.01-1.06), and the relationship was independent of age, waist:hip ratio, C-reactive protein, education, cognitive function, physical activity, caloric intake, smoking, and chronic disease (HR=1.08 pg/mL, 95% CI=1.03-1.13, P=.003). The excessive risk of death associated with higher total E2 was not attenuated after adjustment for total testosterone (HR=1.12, 95% CI=1.02-1.18, P<.001) and after further adjustment for insulin resistance evaluated using the homeostasis model assessment (HR=1.07, 95% CI=1.03-1.17, P<.001). Total E2 was highly predictive of death after more than 5 years (HR=1.42: CI 1.01-1.91, P=.04) and not predictive of death for less than 5 years (P=.78).


CONCLUSIONS
Higher total E2 concentration predicts mortality in older women not taking HRT.
Maggio
Marcello
M
Department of Internal Medicine and Biomedical Sciences, Section of Geriatrics, University of Parma, Parma, Italy.
Ceda
Gian Paolo
GP
Lauretani
Fulvio
F
Bandinelli
Stefania
S
Ruggiero
Carmelinda
C
Guralnik
Jack M
JM
Metter
E Jeffrey
EJ
Ling
Shari M
SM
Paolisso
Giuseppe
G
Valenti
Giorgio
G
Cappola
Anne R
AR
Ferrucci
Luigi
L
D000368:Aged; D000369:Aged, 80 and over; D004958:Estradiol / Q000097:blood*; D005260:Female; D006801:Humans; D009026:Mortality / Q000639:trends; D013997:Time Factors
D004958:Estradiol