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- Title
Endogenous Serum Testosterone and Estradiol and All-Cause Mortality in Older Men: The Honolulu-Asia Aging Study.
- Authors
Cholitkul, Suteevan; Launer, Lenore; Cholitkul, Suwitda; Bell, Christina; Chen, Randi; Abbott, Robert; Petrovitch, Helen; Ross, G. Webster; Blanchette, Patricia; White, Lon; Masaki, Kamal
- Abstract
Introduction Serum testosterone gradually declines with age in men. Low endogenous testosterone has been associated with cardiovascular events, whereas high endogenous estrogen has been linked to risk of stroke and coronary heart disease in elderly men. We studied the associations between endogenous serum testosterone and estradiol and mortality in elderly men. Methods The Honolulu-Asia Aging Study is a longitudinal cohort study of elderly Japanese-American men in Hawai'i, a continuation of the Honolulu Heart Program that began in 1965. At examinations that were conducted between 1991 and 1993, serum testosterone and estradiol levels were measured in 3,168 men aged 71 to 93 years. Subjects were divided into quintiles based on levels of bioavailable testosterone and estradiol. Data on all-cause mortality were available through December 2007, providing 16 years of follow-up. This study was approved by the IRB of Kuakini Medical Center. Results Men in the lowest quintile of bioavailable testosterone were significantly more likely to die during follow-up compared to those in the highest quintile (84.7% vs 69.7%, p < 0.0001). Using Cox proportional hazards models adjusting for age, BMI, hypertension, diabetes, pack-years smoking, physical activity index, cholesterol, alcohol consumption, and prevalent coronary heart disease, stroke, cancer and dementia at baseline, men in the lowest quintile of bioavailable testosterone levels had a significantly higher risk of all-cause mortality compared to those in the highest quintile (RR = 1.29, 95% CI = 1.12-1.48, p < 0.001). Conversely, men in the highest quintile of bioavailable estradiol levels had a significantly higher risk of all-cause mortality compared to those in the lowest quintile (RR = 1.19, 95% CI = 1.04-1.37, p = 0.012) adjusting for the above factors. Conclusions Low endogenous testosterone and high endogenous estradiol levels were associated with an increased risk of all-cause 16-year mortality in elderly Japanese-American. These findings should be confirmed by other prospective studies.
- Subjects
TESTOSTERONE; ESTRADIOL; OLDER men; CEREBROVASCULAR disease; CORONARY disease; DISEASES in older people
- Publication
Hawaii Medical Journal, 2009, Vol 68, Issue 8, p193
- ISSN
0017-8594
- Publication type
Article