title: Endocrinology of Aging From a Muscle Function Point of View: Results From the Toledo Study for Healthy Aging.
abstract: BACKGROUND
  Aging is a process that involves a reduction in muscle strength and anabolic hormone concentrations, which impacts significantly on health.
  
  
  OBJECTIVE
  To study the hormone/total strength (H/TS) ratio as a proxy of anabolic insensitivity status in elders, and its relationship with disability, hospitalization, and mortality risk.
  
  
  METHODS
  A total of 1462 persons aged ≥65 years from the Toledo Study of Healthy Aging participated in this study. Serum concentrations of insulin like growth factor 1, total and free testosterone, dehydroepiandrosterone, dehydroepiandrosterone sulfate, and 17β-estradiol were measured. Total maximal voluntary isometric strength was obtained (handgrip, shoulder, hip, and knee) using standardized techniques and equipment. Physical activity was recorded by physical activity scale for the elderly questionnaire. Associations of the H/TS ratio with hospitalization and mortality were assessed using logistic regression models, and participants stratified into quartiles for each H/TS ratio.
  
  
  RESULTS
  In women, all individual ratio H/TS models showed a strong to moderate increased risk for death and hospitalization. In men, all models revealed a significant positive association of the ratio H/TS with mortality rate but not for hospitalization (P < .01). Participants who have 2 or more H/TS ratios in the worst quartile increased the risk of hospitalization and mortality at least by 2-fold.
  
  
  CONCLUSIONS
  We demonstrate the main role that muscle function plays in the relationship between the hormonal status and hospitalization and mortality risk; this could be taken into consideration as a way to classify patients for hormonal therapy.
authors: ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences-INEF, Technical University of Madrid, Madrid, Spain; Hospital Virgen del Valle (Complejo Hospitalario de Toledo), Red Española de Investigación en Fragilidad y Envejecimiento (RETICEF), Toledo, Spain.
authors: Amelia
authors: A
authors: Guadalupe-Grau
authors: Fundación para la Investigación Biomédica, Hospital Universitario de Getafe, Madrid, Spain.
authors: Jose Antonio
authors: JA
authors: Carnicero
authors: Hospital Virgen del Valle (Complejo Hospitalario de Toledo), Red Española de Investigación en Fragilidad y Envejecimiento (RETICEF), Toledo, Spain.
authors: Jose
authors: J
authors: Losa-Reyna
authors: Department of Physiology, Medical School, University Complutense of Madrid, Madrid, Spain.
authors: Jesús
authors: J
authors: Tresguerres
authors: Department of Physiology, Faculty of Medicine, University of Valencia, Fundación Investigación Hospital Clinico Universitario/INCLIVA, Valencia, Spain.
authors: Maria Del Carmen
authors: MD
authors: Gómez-Cabrera
authors: Geriatric Department, Complejo Hospitalario de Toledo, Toledo, Spain.
authors: Carmen
authors: C
authors: Castillo
authors: Geriatric Department, Complejo Hospitalario de Toledo, Toledo, Spain.
authors: Ana
authors: A
authors: Alfaro-Acha
authors: Geriatric Department, Complejo Hospitalario de Toledo, Toledo, Spain.
authors: Cristina
authors: C
authors: Rosado-Artalejo
authors: Geriatric Department, Hospital Universitario de Getafe, Madrid, Spain.
authors: Leocadio
authors: L
authors: Rodriguez-Mañas
authors: Geriatric Department, Complejo Hospitalario de Toledo, Toledo, Spain. Electronic address: franjogarcia@telefonica.net.
authors: Francisco José
authors: FJ
authors: García-García
mesh_terms: D000368:Aged; D004703:Endocrine System / Q000378:metabolism*; D005260:Female; D000073656:Healthy Aging; D006760:Hospitalization; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000378:metabolism* / Q000502:physiology*; D013030:Spain
keywords: Aging; anabolic status; disability; hospitalization; mortality; muscular strength