title: Free testosterone levels are associated with mobility limitation and physical performance in community-dwelling men: the Framingham Offspring Study.
abstract: BACKGROUND
  Mobility limitation is associated with increased morbidity and mortality. The relationship between circulating testosterone and mobility limitation and physical performance is incompletely understood.
  
  
  OBJECTIVE
  Our objective was to examine cross-sectional and prospective relations between baseline sex hormones and mobility limitations and physical performance in community-dwelling older men.
  
  
  METHODS
  We conducted cross-sectional and longitudinal analyses of 1445 men (mean age 61.0 +/- 9.5 yr) who attended Framingham Offspring Study examinations 7 and 8 (mean 6.6 yr apart). Total testosterone (TT) was measured by liquid chromatography tandem mass spectrometry at examination 7. Cross-sectional and longitudinal analyses of mobility limitation and physical performance were performed with continuous (per SD) and dichotomized [low TT and free testosterone (FT) and high SHBG vs. normal] hormone levels.
  
  
  METHODS
  Self-reported mobility limitation, subjective health, usual walking speed, and grip strength were assessed at examinations 7 and 8. Short physical performance battery was performed at examination 7.
  
  
  RESULTS
  Higher continuous FT was positively associated with short physical performance battery score (beta = 0.13; P = 0.008), usual walking speed (beta = 0.02; P = 0.048), and lower risk of poor subjective health [odds ratio (OR) = 0.72; P = 0.01]. In prospective analysis, 1 SD increase in baseline FT was associated with lower risk of developing mobility limitation (OR = 0.78; 95% confidence interval = 0.62-0.97) and progression of mobility limitation (OR = 0.75; 95% confidence interval = 0.60-0.93). Men with low baseline FT had 57% higher odds of reporting incident mobility limitation (P = 0.03) and 68% higher odds of worsening of mobility limitation (P = 0.007).
  
  
  CONCLUSIONS
  Lower levels of baseline FT are associated with a greater risk of incident or worsening mobility limitation in community-dwelling older men. Whether this risk can be reduced with testosterone therapy needs to be determined by randomized trials.
authors.affiliation: Boston University School of Medicine, Section of Endocrinology, Diabetes, and Nutrition, 670 Albany Street, Second Floor, Boston, Massachusetts 02118-2393, USA.
authors.forename: Joanne B
authors.initials: JB
authors.lastname: Krasnoff
authors.forename: Shehzad
authors.initials: S
authors.lastname: Basaria
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Pencina
authors.forename: Guneet K
authors.initials: GK
authors.lastname: Jasuja
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.forename: Jagadish
authors.initials: J
authors.lastname: Ulloor
authors.forename: Anqi
authors.initials: A
authors.lastname: Zhang
authors.forename: Andrea
authors.initials: A
authors.lastname: Coviello
authors.forename: Margaret
authors.initials: M
authors.lastname: Kelly-Hayes
authors.forename: Ralph B
authors.initials: RB
authors.lastname: D'Agostino
authors.forename: Philip A
authors.initials: PA
authors.lastname: Wolf
authors.forename: Shalender
authors.initials: S
authors.lastname: Bhasin
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Murabito
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002851:Chromatography, High Pressure Liquid; D003430:Cross-Sectional Studies; D018737:Hand Strength / Q000502:physiology; D006262:Health; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D053580:Muscle Strength / Q000502:physiology*; D016017:Odds Ratio; D004856:Postural Balance / Q000502:physiology; D011446:Prospective Studies; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D053719:Tandem Mass Spectrometry; D013739:Testosterone / Q000097:blood*; D016138:Walking / Q000502:physiology
chemical_list: D012738:Sex Hormone-Binding Globulin; D013739:Testosterone
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