title: Frailty in relation to variations in hormone levels of the hypothalamic-pituitary-testicular axis in older men: results from the European male aging study.
abstract: OBJECTIVE
  To explore the associations between frailty and reproductive axis hormones (as an important regulatory system) in middle aged and older men.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  The European Male Aging Study.
  
  
  METHODS
  Three thousand two hundred nineteen community-dwelling European men aged 40 to 79.
  
  
  METHODS
  Interviewer-assisted questionnaires to assess physical activity, health status, and mood were administered. Testosterone (T), luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone sulfate (DHEAS), and sex hormone-binding globulin (SHBG) were measured in a fasting morning blood sample. Frailty was assessed as an index (FI) according to the number (out of 43 possible) of health deficits (symptoms, signs, and functional impairments). Relationships between FI and hormone levels (as outcomes) were explored using regression models.
  
  
  RESULTS
  Mean FI was 0.12 ± 0.11 (range 0-0.67) was highest in the oldest group. After adjustment for confounders, higher levels of FI were significantly associated with lower levels of total T, free T, and DHEAS and higher levels of gonadotropins and SHBG; a 1-standard deviation cross-sectional increase in FI was associated with a regression coefficient of -0.30 nmol/L (95% confidence interval (CI)=-0.53 to -0.07) decrease in total T and 0.66 U/L (95% CI=0.48-0.83) increase in LH.
  
  
  CONCLUSIONS
  The associations between high FI, high gonadotropins, and well-maintained circulating T suggest that these changes are markers of aging-related disruptions of multiple physiological regulation, of which alterations in pituitary-testicular function represent a sensitive marker rather than an underlying pathogenic mechanism for frailty.
authors.affiliation: Arthritis Research United Kingdom Epidemiology Unit, University of Manchester, Manchester, UK.
authors.forename: Abdelouahid
authors.initials: A
authors.lastname: Tajar
authors.forename: Matthew D L
authors.initials: MD
authors.lastname: O'Connell
authors.forename: Arnold B
authors.initials: AB
authors.lastname: Mitnitski
authors.forename: Terence W
authors.initials: TW
authors.lastname: O'Neill
authors.forename: Samuel D
authors.initials: SD
authors.lastname: Searle
authors.forename: Ilpo T
authors.initials: IT
authors.lastname: Huhtaniemi
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Finn
authors.forename: György
authors.initials: G
authors.lastname: Bartfai
authors.forename: Steven
authors.initials: S
authors.lastname: Boonen
authors.forename: Felipe F
authors.initials: FF
authors.lastname: Casanueva
authors.forename: Gianni
authors.initials: G
authors.lastname: Forti
authors.forename: Aleksander
authors.initials: A
authors.lastname: Giwercman
authors.forename: Thang S
authors.initials: TS
authors.lastname: Han
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kula
authors.forename: Fernand
authors.initials: F
authors.lastname: Labrie
authors.forename: Michael E J
authors.initials: ME
authors.lastname: Lean
authors.forename: Neil
authors.initials: N
authors.lastname: Pendleton
authors.forename: Margus
authors.initials: M
authors.lastname: Punab
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Silman
authors.forename: Dirk
authors.initials: D
authors.lastname: Vanderschueren
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rockwood
authors.forename: Frederick C W
authors.initials: FC
authors.lastname: Wu
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D015415:Biomarkers / Q000097:blood*; D003430:Cross-Sectional Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005060:Europe; D005640:Follicle Stimulating Hormone / Q000097:blood; D016330:Frail Elderly; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D007031:Hypothalamus / Q000378:metabolism; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D009043:Motor Activity; D010902:Pituitary Gland / Q000378:metabolism; D011446:Prospective Studies; D012044:Regression Analysis; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D011795:Surveys and Questionnaires; D013737:Testis / Q000378:metabolism; D013739:Testosterone / Q000097:blood
chemical_list: D015415:Biomarkers; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone