Free testosterone levels are associated with mobility limitation and physical performance in community-dwelling men: the Framingham Offspring Study.
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.
Krasnoff
Joanne B
JB
Boston University School of Medicine, Section of Endocrinology, Diabetes, and Nutrition, 670 Albany Street, Second Floor, Boston, Massachusetts 02118-2393, USA.
Basaria
Shehzad
S
Pencina
Michael J
MJ
Jasuja
Guneet K
GK
Vasan
Ramachandran S
RS
Ulloor
Jagadish
J
Zhang
Anqi
A
Coviello
Andrea
A
Kelly-Hayes
Margaret
M
D'Agostino
Ralph B
RB
Wolf
Philip A
PA
Bhasin
Shalender
S
Murabito
Joanne M
JM
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
D012738:Sex Hormone-Binding Globulin; D013739:Testosterone
Eur J Endocrinol. 2003 Dec;149(6):583-9
14641001
Steroids. 2008 Dec 12;73(13):1286-92
18834895
J Am Geriatr Soc. 2006 May;54(5):743-9
16696738
Clin Endocrinol (Oxf). 2005 Aug;63(2):152-60
16060908
J Gerontol. 1994 Mar;49(2):M85-94
8126356
J Clin Endocrinol Metab. 2002 Feb;87(2):589-98
11836290
J Clin Endocrinol Metab. 2005 Mar;90(3):1502-10
15572415
Gerontology. 2006;52(6):359-65
16905887
Cell. 2005 Sep 9;122(5):751-62
16143106
Clin Endocrinol (Oxf). 2008 Jan;68(1):42-50
17666086
Am J Epidemiol. 1992 Apr 1;135(7):783-91
1595678
Am J Epidemiol. 1979 Sep;110(3):281-90
474565
Am J Epidemiol. 1997 Oct 15;146(8):609-17
9345114
J Am Geriatr Soc. 2008 Nov;56(11):2000-8
19016935
Am J Prev Med. 2007 Sep;33(3):214-8
17826582
J Clin Endocrinol Metab. 2003 Apr;88(4):1478-85
12679426
J Gerontol A Biol Sci Med Sci. 2005 Jul;60(7):840-6
16079205
Steroids. 2009 Jun;74(6):512-9
19321131
J Am Geriatr Soc. 2007 Apr;55(4):548-55
17397433
J Clin Endocrinol Metab. 2002 Dec;87(12):5649-57
12466367
Am J Epidemiol. 1996 Apr 15;143(8):766-78
8610686
J Clin Endocrinol Metab. 2008 Jul;93(7):2737-45
18270261
J Gerontol. 1966 Oct;21(4):556-9
5918309
J Appl Physiol (1985). 2003 Nov;95(5):1851-60
14555665
Arch Intern Med. 2006 Oct 23;166(19):2124-31
17060543
J Gerontol A Biol Sci Med Sci. 1995 Nov;50 Spec No:41-4
7493216
J Clin Endocrinol Metab. 2001 Feb;86(2):724-31
11158037
J Clin Endocrinol Metab. 2003 Jan;88(1):358-62
12519877
J Clin Endocrinol Metab. 2009 Jun;94(6):1923-30
19223518
JAMA. 2008 Jan 2;299(1):39-52
18167405
J Clin Endocrinol Metab. 2006 Feb;91(2):425-31
16332936
N Engl J Med. 1996 Jul 4;335(1):1-7
8637535
J Clin Endocrinol Metab. 1996 Oct;81(10):3469-75
8855787
Metabolism. 1997 Apr;46(4):410-3
9109845
Steroids. 2008 Dec 12;73(13):1311-7
18687348
Am J Physiol Endocrinol Metab. 2001 Dec;281(6):E1172-81
11701431
Mech Ageing Dev. 1999 Mar 1;107(2):123-36
10220041
J Clin Endocrinol Metab. 2009 Jun;94(6):1991-2001
19293261
N Engl J Med. 2006 Oct 19;355(16):1647-59
17050889
Ann Clin Biochem. 2009 Mar;46(Pt 2):137-43
19225026
J Clin Endocrinol Metab. 2003 Nov;88(11):5240-7
14602756
Scand J Rehabil Med. 1984;16(3):125-32
6494836
JAMA. 2000 Feb 9;283(6):763-70
10683055
Endocrinology. 2003 Nov;144(11):5081-8
12960001
Ann Intern Med. 2001 Oct 16;135(8 Pt 2):686-93
11601951
Am J Public Health Nations Health. 1951 Mar;41(3):279-81
14819398
J Clin Endocrinol Metab. 2005 Feb;90(2):678-88
15562020
J Clin Endocrinol Metab. 2007 Feb;92(2):405-13
17090633
J Clin Endocrinol Metab. 1999 Aug;84(8):2647-53
10443654
J Am Geriatr Soc. 2008 Nov;56(11):2118-23
18811607
J Clin Endocrinol Metab. 1999 Oct;84(10):3666-72
10523012
J Am Geriatr Soc. 1997 Mar;45(3):338-41
9063281
J Am Geriatr Soc. 2005 Jul;53(7):1217-21
16108942
J Clin Endocrinol Metab. 2009 Oct;94(10):3806-15
19737923
Am J Physiol Endocrinol Metab. 2002 Aug;283(2):E284-94
12110533
Endocrinology. 2009 Mar;150(3):1259-68
18948405
N Engl J Med. 1995 Mar 2;332(9):556-61
7838189