title: Longitudinal and cross-sectional relationships of circulating reproductive hormone levels to self-rated health and health-related quality of life in community-dwelling older men.
abstract: BACKGROUND
  Self-rated health and health-related quality of life are inversely associated with increased morbidity and mortality; however, the temporal relationship with reproductive hormones is poorly understood.
  
  
  OBJECTIVE
  The objective of the study was to examine relationships between reproductive hormones, self-rated health, and quality of life in older men at baseline as well as changes over a 2-year follow-up.
  
  
  METHODS
  One thousand six hundred thirty-seven men aged 70 years and older from the Concord Health and Ageing in Men Project were assessed at baseline and 1316 men returned for the 2-year follow-up. Serum T, dihydrotestosterone, estradiol, and estrone (E1) were measured by liquid chromatography-tandem mass spectrometry and SHBG, LH, and FSH by immunoassay. Logistic regression and multivariate linear regression models were performed.
  
  
  METHODS
  Self-rated health and health-related quality of life measures (12-Item Short Form Health Survey) were determined.
  
  
  RESULTS
  In the cross-sectional baseline data, univariate analyses revealed significant associations between many of the hormones and quality-of-life scores and self-rated health. In a multivariable analysis, the associations between T, E1, and calculated free T and self-rated health remained statistically significant. Compared with men in the highest T quartile, men in the lowest T quartile had an odds ratio of 1.47 (95% confidence interval 1.04-2.06) for reporting fair, poor, or very poor health vs excellent or good health. The findings for E1 and calculated free T were similar. In the longitudinal data, the only significant relationship was that between E1 and self-rated health. Compared with those in the highest E1 quartile, those in the lowest quartile experienced deterioration in self-rated health: adjusted odds ratio of 1.84 (95% confidence interval 1.10-3.06).
  
  
  CONCLUSIONS
  Low serum T and E1 are associated with poorer self-rated health in older men, whereas lower serum levels of E1 are predictive of subsequent deterioration in self-rated health over time. Therefore, serum E1 is a novel potential risk factor for poor self-rated health in older men that warrants further investigation.
authors.affiliation: School of Public Health (B.H., R.G.C.), University of Sydney, New South Wales 2006, Australia; Centre of Education and Research on Ageing (B.H., R.G.C., F.M.B, V.N., D.G.L.C., L.M.W.), and ANZAC Research Institute (R.G.C., D.G.L.C, M.J.S, D.J.H.), University of Sydney and Concord Hospital, Sydney, New South Wales 2139, Australia.
authors.forename: Benjumin
authors.initials: B
authors.lastname: Hsu
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Blyth
authors.forename: Vasi
authors.initials: V
authors.lastname: Naganathan
authors.forename: David G
authors.initials: DG
authors.lastname: Le Couteur
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Seibel
authors.forename: Louise M
authors.initials: LM
authors.lastname: Waite
authors.forename: David J
authors.initials: DJ
authors.lastname: Handelsman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood; D003430:Cross-Sectional Studies; D013196:Dihydrotestosterone / Q000097:blood*; D004958:Estradiol / Q000097:blood*; D004970:Estrone / Q000097:blood*; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D007986:Luteinizing Hormone / Q000097:blood*; D008297:Male; D011788:Quality of Life; D057566:Self Report; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D013739:Testosterone / Q000097:blood*
chemical_list: D012738:Sex Hormone-Binding Globulin; D013196:Dihydrotestosterone; D004970:Estrone; D013739:Testosterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone