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Low Free Testosterone Predicts Mortality from Cardiovascular Disease But Not Other Causes: The Health in Men Study.
MedLine Citation:
PMID:  22013106     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Context:Low testosterone is associated with all-cause mortality, but the relationship with cause-specific mortality is uncertain.Objective:Our objective was to explore associations between testosterone and its related hormones and cause-specific mortality.Design:This was a population-based cohort study.Setting and Participants:Demographic and clinical predictors of mortality, and testosterone, SHBG, and LH were measured from 2001-2004 in 3637 community-dwelling men aged 70-88 yr (mean, 77 yr).Main Outcome Measure:Cause of death was obtained via electronic record linkage until December 31, 2008.Results:During a mean follow-up period of 5.1 yr, there were 605 deaths. Of these, 207 [34.2%; 95% confidence interval (CI) = 30.4-38.1%] were due to cardiovascular disease (CVD), 231 to cancer (38.2%; 95% CI = 34.3-42.1%), 130 to respiratory diseases (21.5%; 95% CI = 18.2-24.8%), and 76 to other causes (12.6%; 95% CI = 9.9-15.2%). There were 39 deaths attributable to both cancer and respiratory diseases. Lower free testosterone (hazard ratio = 1.62; 95% CI = 1.20-2.19, for 100 vs. 280 pmol/liter), and higher SHBG and LH levels were associated with all-cause mortality. In cause-specific analyses, lower free testosterone (sub-hazard ratio = 1.71; 95% CI = 1.12-2.62, for 100 vs. 280 pmol/liter) and higher LH predicted CVD mortality, while higher SHBG predicted non-CVD mortality. Higher total testosterone and free testosterone levels (sub-hazard ratio = 1.96; 95% CI = 1.14-3.36, for 400 vs. 280 pmol/liter) were associated with mortality from lung cancer.Conclusions:Low testosterone predicts mortality from CVD but is not associated with death from other causes. Prevention of androgen deficiency might improve cardiovascular outcomes but is unlikely to affect longevity otherwise.
Authors:
Zoë Hyde; Paul E Norman; Leon Flicker; Graeme J Hankey; Osvaldo P Almeida; Kieran A McCaul; S A Paul Chubb; Bu B Yeap
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-19
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  -     ISSN:  1945-7197     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Western Australian Centre for Health and Ageing (Z.H., L.F., O.P.A., K.A.M.), Centre for Medical Research, Western Australian Institute for Medical Research, and Schools of Medicine and Pharmacology (Z.H., L.F., G.J.H., K.A.M., S.A.P.C., B.B.Y.), Surgery (P.E.N.), and Psychiatry and Clinical Neurosciences (O.P.A.), University of Western Australia, Crawley, Western Australia 6009, Australia; Departments of Neurology (G.J.H.) and Psychiatry (O.P.A.), Royal Perth Hospital, Perth, Western Australia 6001, Australia; and PathWest (S.A.P.C.), Department of Biochemistry, and Department of Endocrinology and Diabetes (B.B.Y.), Fremantle Hospital, Fremantle, Western Australia 6959, Australia.
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