细胞色素P450 c19基因多态性与老年男性骨质疏松关系的研究

目的 探讨CYP19基因多态性与老年男性的性激素水平及骨质疏松的关系。方法 182例老年男性患者测定腰椎及髋部骨密度，根据骨密度分为骨密度减低（包括骨质疏松及骨量减少）组94例和正常组88例。所有受试者测CYP19基因外显子3G—A的基因多态性；同时测定血清总睾酮（TT）、雌二醇（E2）、硫酸脱氢表雄酮（DHEAS）、性激素结合球蛋白（SHBG），血清白蛋白。并计算游离睾酮（FT）、生物有效性睾酮（Bio—T）、游离雄激素指数（FAI）、游离雌二醇（FE2）、生物有效性雌二醇（Bio-E2）、TT/E2、FT/FE2及Bio-T／Bio-E2。结果 正常的老年男性与骨密度降低的老年男性比较，CYP19从型基因型频率明显增高，GA型与GG型明显降低（P=0．001）；CYP19基因GA型、GG型的老年男性，腰椎（L2-4）、股骨颈、Wards和粗隆的骨密度明显低于从型（P〈0．01，P〈0．05）；CYP19基因多态性与腰椎（L2-4）、股骨颈、和粗隆的骨密度均密切相关（P值分别为0．003、0．001、0．013），但Wards的骨密度与CYP19基因型无关（P=0．094）；各种性激素与CYP19基因型均无相关性（P〉0．05）；经逐步LOGISTIC回归分析筛选危险因素，BMI为老年男性骨质疏松的保护性因素（P=0．004），CYP19G等位基因及骨折史是老年男性骨质疏松的风险因素（P=0．0285，P=0．0031），对老年男性骨质疏松的影响的大小顺序为，CYP19基因型，BMI及骨折史。结论 在汉族老年男性人群中，CYP19基因的GA型与GG型可导致腰椎、股骨颈、Wards及粗隆的骨密度降低。CYP19pA基因多态性与汉族老年男性原发性骨质疏松症密切相关，CYP19基因可作为研究我国老年男性骨质疏松症病因学的候选基因。     

老年男性性激素与骨密度测定

目的　为了解老年男性的骨密度和性激素水平,以探讨性激素在老年男性骨质疏松症发病机理中的作用。方法　６３ 例老年男性分为骨质疏松组与非骨质疏松组,测定骨密度（ＢＭＤ）、血清睾酮（Ｔ）、雌二醇（Ｅ２）、黄体生成素（ＬＨ）、促卵泡刺激素（ＦＳＨ）水平,并与３７ 例青年男性对照。结果　老年男性之ＢＭ Ｄ、Ｔ、Ｅ２ 明显低于青年对照组,而ＬＨ、ＦＳＨ 增高明显。老年男性骨质疏松症的发病率为３９．６８％ 。骨质疏松组与非骨质疏松组比较,Ｔ、Ｅ２ 明显降低,ＬＨ、ＦＳＨ 明显增高,尤以Ｔ 降低明显。结论　由于增龄性激素不足引致骨丢失,雄激素降低可能是老年男性骨质疏松症的主要原因。     

血清睾酮与老年男性原发性骨质疏松症的关系

目的 探讨血清睾酮与老年男性原发性骨质疏松的关系，为防治老年男性原发性骨质疏松症提供理论依据。方法 双能X线骨密度仪测定腰椎(L1-4)骨密度；全自动生化分析法测定尿钙、肌酐；AKP用比色法，Ca、Mg用MTB法，P用磷酸亚铁胺法；放射免疫法测定血清E2、T、BGP、CT、PTH-m。获得的参数骨质疏松组与正常对照组比较。结果 男性原发性骨质疏松组骨代谢生化指标与同年龄同性别的对照组比较，血清Ca、P、Mg、Cu以及PTH-m、E2、AKP、BGP两组差异无显著性；血清降钙素显著降低；尿钙与肌酐比值非常明显地增多；男性主导性激素睾酮骨质疏松组非常明显地低于对照组。结论 老年男性原发性骨质疏松的发病因素虽然是多方面的，但血清睾酮水平的降低是老年男性骨质疏松症发病的一个非常重要的原因。     

中老年人性激素与骨密度关系初步探讨

本文诵过对332例正常中老年人血清性激素放射免疫分析与单光子骨密度的测定旨在探讨中老年人骨矿物质丢失与血清性激素水平的关系。结果表明男性145人中12人(8．3%)血清睾酮含量低于正常标准．这12人骨密度明显低于正常标准，女性187人中75人(40％)血清雌二醇含量低于正常标准，而这75人中49人骨密度明显低于正常。血清睾酮含量低于正常标准之男性全部显示骨密度明显降低(100%)而女性仅49人(65％）显示骨密度明显降低。故可以认为中老年人骨矿物质丢失量与血清性激素含量呈负相关。     

血清雌二醇和游离睾酮与老年男性骨密度的相关性

目的探讨老年男性血清雌二醇(E2)和游离睾酮(FT)与骨密度(BMD)的关系。方法采用双能X线法检测192例老年男性骨密度,根据其骨密度值分为骨量正常组、骨量减少组和骨质疏松组;免疫放射法检测血清E2、睾酮(T)、FT、性激素结合球蛋白(SHBG)、脱氢表雄酮硫酸酯(DHEAS)水平。比较各组间激素的差异及分析激素与骨密度的关系。结果 3组间E2、FT水平存在明显差异(P0.05);经年龄、体质量和BMI校正后,E2与各部位BMD正相关,FT与各部位(腰椎和华氏三角除外)BMD正相关;E2四分位BMD,在第1和第4间距差异有统计学意义(P0.05),在第1、2之间,3、4之间无差异(P0.05)。结论血清E2、FT水平与老年男性骨密度呈正相关;E2对骨密度的影响存在阈值,检测血清E2、FT水平可预防老年男性的骨量丢失。     

性激素及甲状旁腺激素与老年男性骨转换生化指标的相关性分析

目的:探讨老年男性血清性激素及甲状旁腺激素与骨转换生化指标的相关性。方法:收集2011年5~6月在我院常规年度体检年龄≥60岁的老年男性465例,年龄60~93岁。测定血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、睾酮(T)、性激素结合球蛋白(SHBG);血清甲状旁腺激素(PTH)、25-羟化维生素D3(25(OH)D3);骨转换生化指标(I型胶原羧基末端肽:CTX;骨钙素:OC;Ⅰ型前胶原氨基末端前肽:PINP);并计算游离睾酮(FT)、生物可利用睾酮(BT)、睾酮分泌指数(TSI)和游离睾酮指数(FTI);分析各指标与老年男性骨转换生化指标的相关性。结果:老年男性血清FSH、LH、SHBG水平随年龄增加而升高,而FT、BT、TSI、FTI、PTH及CTX、OC和PINP随增龄呈下降趋势,80岁以后下降较为显著(P0.05)。PTH与CTX、OC和PINP均呈正相关(r=0.227,0.269,0.162;P0.01),校正年龄因素后,相关性仍然存在;SHBG与OC负相关(r=-0.100,P0.05)。各骨转换指标随PTH四分位水平升高而增加,第一分位与第四分位之间均存在显著差异(P0.01)。多元逐步回归结果显示,年龄与CTX、OC和PINP负相关(β=-0.126,-0.141,-0.122;P0.05),PTH与CTX、OC和PINP正相关(β=0.196,0.279,0.189;P0.001),SHBG与OC负相关(β=-0.100,P0.05)。结论:增龄是老年男性骨转换减低的根本原因,血清PTH和SHBG水平与骨转换生化指标相关。     

中老年男性血清睾酮、游离睾酮、双氢睾酮和性激素结合球蛋白含量的变化

目的 观察中老年男性血清睾酮(T)、游离睾酮(FT)、双氢睾酮(DUT)和性激素结合球蛋白(SHBG)的浓度,研究雄激素与增龄的关系。方法 129例45岁以上健康男性,可能有影响雄激素分泌的疾病和药物者已除外。按年龄分为4组。采用酶标免疫法测定T、FT、DHT和SHBG血清浓度。数据用SPSS软件包分析处理。结果 各年龄组之间,T的差别有显著性意义(P<0.05);而FT、DHT和SHBG的差别都具有非常显著性意义(P<0.01)。除了T(P>0.05),增龄与血清FT、DHT和SHBG浓度均明显相关(P<0.01)。结论 男性在中老年期随着年龄的增长,血清T浓度变化不明显,而FT和DHT浓度明显下降,SHBG浓度则明显上升。     

河北某地社区中老年健康男性血清生殖激素水平变化研究

目的:以社区人群为基础,研究中老年健康男性血清生殖激素水平随增龄的变化规律以及比较不同年龄组之间或同年龄组在城镇与农村居民之间的差异。方法:采用整群及年龄分层抽样方法,抽取了社区健康中老年男性434例,年龄分布40～69岁;其中城镇居民198例、农村居民236例,分别测定血清总睾酮(tT)、黄体生成素(LH)、性激素结合球蛋白(SHBG)浓度,计算得出游离睾酮(fT)浓度、生物可利用睾酮(Bio-T)浓度、睾酮分泌指数(TSI)、游离睾酮指数(fTI)。同时测定同一地区59例20～39岁男性生殖激素水平作为对照组。结果:中老年男性血清tT水平随增龄没有明显变化,而LH、SHBG水平逐渐增高,fT、Bio-T、TSI、fTI则逐步降低。采用Kruskal-WallisH检验,4个年龄组(20～39岁、40～49岁、50～59岁、60～69岁)之间,tT没有统计学差异(P>0.05),其他参数均有显著性差异(P<0.01)。tT水平与年龄、LH均没有相关性(P>0.05);LH和SHBG与年龄、SHBG与LH呈显著正相关(P<0.01),而fT、Bio-T、TSI、fTI与年龄、LH呈显著负相关(P<0.01)。按年龄配对Wilcoxon符号秩和检验,40～49岁组城镇与农村居民之间LH、TSI、fTI有显著性差异(P<0.05),fT、Bio-T有极显著性差异(P<0.01);对照组、50～59岁和60～69岁组,城镇与农村居民之间7项参数均无统计学差异(P>0.05)。40～49岁组LH、SHBG的升高率及fT、Bio-T、TSI、fTI的下降率,农村大于城镇居民;相反,在50～59岁和60～69岁组,城镇则大于农村居民。结论:中老年男性血清tT水平随增龄没有明显改变,而LH、SHBG、fT、Bio-T、TSI、fTI则随年龄呈现梯度性变化。许多参数在不同年龄组之间或城镇与农村居民之间存在着统计学差异。     

新疆老年男性骨转化生化标志物及性激素与骨质疏松症的相关性研究

目的探讨新疆老年男性骨转换生化标志物及性激素水平与原发性骨质疏松症的关系。方法采用双能X线骨密度仪检测146例老年男性患者腰椎、左侧股骨骨密度(BMD),平均年龄:72.4±7.9岁,基于骨密度T值分为骨量正常组(75例)和骨量异常组(71例),采用酶联免疫法测定Ⅰ型前胶原氨基端原肽(PINP)和Ⅰ型胶原C末端肽(CTX),放射免疫法测定雌二醇(E2)和睾酮(T),比较两组骨转换生化指标和性激素水平是否存在差异及其与骨密度的相关性。结果 1 PINP与CTX在骨量正常组和骨量异常组差异均无统计学意义(P0.05);两者偏相关分析呈显著正相关(r=0.746 P=0.000)。2雌二醇、睾酮在两组中比较,差异有统计学意义(P0.05)。骨量异常组雌二醇(17.48±7.61)低于骨量正常组(21.31±11.43),t=2.391,P=0.018;骨量异常组睾酮(3.50±1.02)低于骨量正常组(3.98±1.43),t=2.331,P=0.021。3汉族人群左侧髋关节骨密度高于维吾尔族人群,除Inter Tro部位外,差异均有统计学意义(P0.05);年龄与髋关节各部位骨密度呈显著负相关。结论性激素水平降低可能是影响男性骨量减少的一个重要危险因素,而雌激素可能占主要地位;随着年龄的增加,老年男性髋关节骨密度呈下降趋势,测定左侧髋关节骨密度对诊断骨质疏松症有着重要意义。     

老年男性骨质疏松与同型半胱氨酸、甲状旁腺素、睾酮水平的相关研究

目的探讨老年男性骨质疏松与血清同型半胱氨酸、甲状旁腺素、睾酮是否具有相关性。方法选择60岁以上老年男性148例。采用美国数字化双能X线骨密度仪测定其腰椎及股骨颈部位的骨密度值,并根据骨密度水平分为三组,为骨质疏松组(T-2.5)、骨量减少组(-2.5T-1.0),正常骨量组(T-1.0),检测血清同型半胱氨酸、甲状旁腺素及睾酮水平。结果骨质疏松组血清同型半胱氨酸、甲状旁腺素水平明显高于骨量减少组(P0.05)及正常骨量组(P0.01),而睾酮水平明显低于骨量减少组(P0.05)及正常骨量组(P0.01)。血清同型半胱氨酸、甲状旁腺素水平与骨密度值呈正相关,睾酮与骨密度值呈负相关。结论血清同型半胱氨酸、甲状旁腺素水平升高及睾酮水平下降可造成骨量减少和骨形成障碍,最终导致骨质疏松形成。高同型半胱氨酸是骨质疏松的一个独立危险因素。因此监测血清同型半胱氨酸、甲状旁腺素、睾酮水平对早期发现骨质疏松并阻止其进一步发生发展起着重要作用,降低高同型半胱氨酸、调节甲状旁腺素水平,增加睾酮水平可能成为骨质疏松治疗中的一种新方法之一。     

Hormone levels in middle-aged and elderly men with and without erectile dysfunction in Taiwan

The change in sexual hormones with age in middle-aged and elderly Chinese men, with and without erectile dysfunction (ED), was investigated. Total testosterone (TT), free testosterone (FT), dehydroepiandrosterone sulfate (DHEAS), and sex hormone-binding globulin (SHBG) were determined from fasting serum samples by radioimmunoassay in 627 middle-aged and elderly ethnic Chinese men with and without ED. Calculated FT was derived from TT and SHBG. Patients with ED were subdivided into groups having low serum TT (<2.7 ng/ml) and normal TT (> or =2.7 ng/ml). FT and DHEAS declined and SHBG rose with age in both normal patients and in patients with ED. TT and SHBG were lower in patients with ED than in normal subjects at all ages. In contrast to findings in previous studies, levels of FT were higher in patients with ED than in normal subjects. Hormonal changes in this Chinese population generally mirrored those in previously studied ethnic populations, except for higher FT in patients with ED. This suggests that hormonal levels in patients with ED may vary in different populations. The significance and reproducibility of this finding remains to be determined.     

Influence of ageing and some lifestyle factors on male gonadal function: a study in Bulgaria

There are few systematic studies on the relationship between blood testosterone concentrations and the symptoms of androgen deficiency in ageing males. To assess the changes in sex hormone levels with age in relation with some lifestyle factors, the serum levels of total testosterone (TT), sex-hormone binding globulin (SHBG), luteinising hormone (LH) and follicle stimulating hormone (FSH) were measured in 33 men, age range 40-89 years. In addition, free testosterone (FT) and the free androgen index (FAI) were calculated. Seventeen healthy men under 40 years were involved as controls. The men over 40 years revealed significantly decreased TT, FT and FAI, and in the subgroup of men over 60 years, FSH and SHBG were significantly increased. Pearson's analysis showed that TT levels were significantly correlated with body mass index (BMI) (r = -0.464, P < 0.01) and body weight (r = -0.413, P < 0.05). SHBG levels were significantly correlated not only with age (r = +0.407, P < 0.05), but also with LH (r = +0.605, P < 0.001) and alcohol consumption (r = +0.382, P < 0.05). In conclusion, the TT, FT and FAI decreased in males over 40 years, but the alterations in hormone levels with age are more pronounced in men over 60 years. The important determinants of sex hormones are age, BMI and some lifestyle factors.     

Association of hypogonadism symptoms and serum hormones in aging males

The association between hypogonadism symptoms and the levels of serum hormones are still in debate. To investigate the relationship between hypogonadism symptoms and serum hormones in middle-aged and elderly Chinese men, this community-based cross-sectional study was conducted based on a total of 965 ageing men. The ageing males’ symptom (AMS) scale, International Index of Erectile Function-5 (IIEF-5), International Prostate Symptom Score (IPSS) questionnaires and related variables were assessed. Blood tests for total testosterone (TT), sex hormone-binding globulin (SHBG) and luteinising hormone (LH) were performed. Serum level of free testosterone (FT) and bioavailable testosterone (Bio-T) was calculated. The mean age was 56.34 ± 8.85 years. Total AMS score was significantly associated with all five serum hormones (LH: p < 0.001; SHBG: p < 0.001; TT: p =.043; FT: p = 0.007; Bio-T: p < 0.001). We identified sexual and somatic symptoms were obviously related to five serum hormones, while psychological symptoms seemed to have no association with serum hormones. After adjusting for age and BMI, multiple linear regression analysis indicated that LH had positive correlations with total AMS score, somatic and sexual symptom score (p < 0.05). In conclusion, LH and SHBG had the strongest correlation hypogonadism and might be used as early predictors for symptomatic hypogonadism in the near future.     

Do differences in age specific androgenic steroid hormone levels account for differing prostate cancer rates between Arabs and Caucasians?

OBJECTIVE: Factors responsible for the low incidence of clinical prostate cancer in the Arab population remain unclear, but may be related to differences in androgenic steroid hormone metabolism between Arabs and other populations, especially as prostate cancer is believed to be androgen dependent. We therefore measured the levels of serum androgenic steroids and their binding proteins in Arab men and compared results obtained with values reported for Caucasian populations to determine if any differences could at least partially account for differences in incidence of prostate cancer rates between the two populations. METHODS: Venous blood samples were obtained from 327 unselected apparently healthy indigenous Arab men (Kuwaitis and Omanis) aged 15-79 years. Samples were also obtained from 30 Arab men with newly diagnosed prostate cancer. Serum levels of total testosterone (TT), sex hormone binding globulin (SHBG), derived free androgen index (FAI); adrenal C19 -steroids, dehydroepiandrosterone sulfate (DHEAS) and androstenedione (ADT) were determined by chemiluminescent immunoassay. Age specific reference intervals, mean and median for each analyte were determined. Frequency distribution pattern for each hormone was plotted. The reference range for hormones with normal distribution was mean +/- 2SD and 2.5-97.5% for those with non-normal distribution. The mean serum levels of the hormones in Arab men with prostate cancer were compared with values in healthy age-matched Arab men. RESULTS: There was a significant decrease between the 21-29 years age group and the 70-79 years age group for TT (-38.77%), DHEAS (-70%), ADT (-36%) and FAI (-63.25%), and an increase for SHBG (+64%). The calculated reference ranges are TT (2.73-30.45 nmol/L), SHBG (6.45-65.67 nmol/L), FAI (14.51-180.34), DHEAS (0.9-11.0 micromol/L) and ADT (0.54-4.26 ng/mL). The mean TT, SHBG, DHEAS and ADT in Arab men were significantly lower than those reported for Caucasians especially in the 21-29 years age group. Arab men with newly diagnosed prostate cancer had higher serum TT (P < 0.7), ADT (P < 0.2), SHBG (P < 0.2) and lower DHEAS (P < 0.008) compared to aged matched controls. CONCLUSIONS: Serum TT, SHBG, DHEAS and ADT levels are significantly lower in Arab men compared to those reported for Caucasian men, especially in early adulthood. Arab men with newly diagnosed prostate cancer have higher circulating androgens compared to healthy controls. We suggest that low circulating androgens and their adrenal precursors in Arab men when compared to Caucasians may partially account for the relatively lower risk for prostate cancer among Arab men.     

Prostate Cancer Risk: The Significance of Differences in Age Related Changes in Serum Conjugated and Unconjugated Steroid Hormone Concentrations Between Arab and Caucasian Men

Introduction: Factors responsible for the low incidence of clinical prostate cancer (3–8/100,000 men/year) in the Arab population remain unclear, but may be related to changes in steroid hormone metabolism. We compared the levels of serum conjugated and unconjugated steroids between Arab and Caucasian populations, to determine if these can provide a rational explanation for differences in incidence of prostate cancer between the two populations. Patients/Method: Venous blood samples were obtained from 329 unselected apparently healthy indigenous Arab men (Kuwaitis and Omanis) aged 15–80 years. Samples were also obtained from similar Arab men with newly diagnosed prostate cancer or benign prostatic hyperplasia (BPH). The samples were taken between 8:00 am and 12:00 noon. Serum levels of total testosterone, (TT), sex hormone binding globulin (SHBG), free androgen index (FAI); adrenal C₁₉-steroids, dehydroepiandrosterone sulphate (DHEAS) and androstenedione (ADT) were determined using Immulite kits (Diagnostic Systems Laboratories Inc, Webster Texas, USA). The results obtained in Arab men were compared with those reported for similarly aged Chinese, German and White USA men. Results: In all four ethnic groups, median TT and FAI declined with age, while SHBG increased with age. However, the mean TT and SHBG was significantly lower (p<0.01) and the FAI significantly higher in Arab men (p<0.01) compared to German men only in 21–30 years age group. In the other age groups the levels of TT and SHBG were higher in the Germans but the differences were not statistically significant. In all the racial groups serum levels of DHEAS and ADT reached a peak by about 20 years of life, and then declined progressively. The mean DHEAS in American Caucasians aged 20–29 years was 11.4 μmol/l compared to 6.22 μmol/l in the Arabs (p<0.001). The mean DHEAS in USA Caucasians aged 70–79 years was 2.5 μmol/l compared to 1.8 μmol/l (p<0.03) in the Arabs. There was no significant difference in mean serum levels of DHEAS between German and USA men. Similarly, there was no significant difference in the level of the hormones between Arab and Chinese men. Arab men with newly diagnosed prostate cancer had high serum TT, SHBG and DHEAS compared to those without the disease. Conclusions: The mean TT and SHBG was significantly lower in Arab men compared to Caucasian men especially in early adulthood. Caucasians have significantly higher serum levels of the precursor androgens DHEAS and ADT especially in early adulthood compared to Arab men. These observations of low circulating androgens and their adrenal precursors in Arab men may partially account for the decreased risk for prostate cancer among Arab men.     

Survey for late-onset hypogonadism among old and middle-aged males in Shanghai communities

This study sought to investigate late-onset hypogonadism (LOH) in old and middle-aged males in Shanghai communities, using symptom score evaluation systems and measurements of sex hormone levels. One thousand cases of males aged 40-70 years were investigated. The aging male symptoms (AMS) scale and androgen deficiency in aging males (ADAM) questionnaire were used at the beginning of the investigation, followed by measurement of the sex hormone-related factors (total testosterone (TT), free testosterone (fT), sex hormone-binding globulin (SHBG) and bioavailability of testosterone (Bio-T)). There were 977 valid questionnaires. The LOH-positive rates shown by AMS and ADAM were 59.88% and 84.65%, respectively; values increased with the age of the patients. There were 946 results related to sex hormone measurements, which showed the following results: TT was not related to aging (P>0.05); levels of SHBG increased with age; and fT and Bio-T decreased with age. There was a significant difference in fT between LOH-positive and LOH-negative patients, as shown by the ADAM. In summary, TT levels were not related to aging, even though SHBG did increase while fT and Bio-T decreased with aging. Clinically, the diagnosis of LOH cannot be based on serum TT level.     

Does early morning versus late morning draw time influence apparent testosterone concentration in men aged > or =45 years? Data from the Hypogonadism In Males study

The Hypogonadism In Males study estimated the prevalence of hypogonadism in men aged > or =45 years. A sub-analysis of patients not receiving testosterone (T) therapy was conducted. Blood draw times were 0800-1000 and 1000-1200 hours. Total T (TT) was not influenced by draw time for any age group; however, significantly greater free T (FT) and bioavailable T (BAT) values were observed in the overall population for earlier draw times. Sex hormone-binding globulin (SHBG) values were significantly lower in men aged 45-64 years at the earlier draw time. In men aged > or =75 years, no significant differences in TT, FT, BAT or SHBG were observed on the basis of draw time. Early morning draw time may not be critical for capturing TT concentrations in men > or =45 years; however, when measuring FT or BAT, an early morning draw time may be preferable for men aged <75 years.     

Free testosterone is an independent predictor of BMD and prevalent fractures in elderly men: MrOS Sweden.

The role of androgens for bone health in elderly men is unclear. We show that free testosterone within the normal range is a predictor of BMD at predominantly cortical bone sites and of previous osteoporosis-related fractures in elderly Swedish men. INTRODUCTION: Osteoporosis-related fractures constitute a major health concern not only in women but also in men. Previous studies have clearly shown that serum levels of estradiol are associated with BMD, whereas more conflicting data have been presented regarding the predictive value of testosterone (T) for bone health in elderly men. The aim of this study was to investigate if serum levels of T are associated with BMD and/or prevalent fractures in a large cohort of elderly men. MATERIALS AND METHODS: In the Swedish part of the MrOS study (n = 2908; average age, 75.4 years), bone parameters were measured using DXA, and prevalent fractures were recorded using standardized questionnaires and by vertebral X-ray analyses. Serum levels of total T, total estradiol (E2), and sex hormone-binding globulin (SHBG) were measured by radioimmunoassay, and free T (FT) and free E2 (FE2) were derived from the mass action equations. Height, weight, age, physical activity, smoking habits, and calcium intake were included together with FT and FE2 in regression models for BMD. RESULTS: FT was an independent positive predictor of BMD in total body, total hip, femur trochanter, and arm but not in the lumbar spine. The highest independent predictive value of FT was found in the arm and the hip (with a relatively high content of cortical bone). FE2 was an independent predictor of BMD at all bone sites studied, and the highest predictive value was seen for lumbar spine (with relatively high content of trabecular bone) BMD. FT but not FE2 was a positive predictor of total body bone area and BMC. FT levels below the median were independent predictors of prevalent osteoporosis-related fractures (OR, 1.56; 95% CI, 1.14-2.14; p < 0.01) and X-ray-verified vertebral fractures (OR, 2.00; 95% CI, 1.34-2.86; p < 0.001). The predictive value of FT for prevalent fractures was not affected by adjustment for BMD. CONCLUSIONS: These findings show that variation of FT within the normal range is an independent but modest predictor of BMD at predominantly cortical bone sites and of previous osteoporosis-related fractures in elderly men. Our data indicate that not only estrogens but also androgens are of importance for bone health in elderly men. Longitudinal studies investigating the predictive value of T for fracture risk in elderly men are required.     

Low DHEAS levels are associated with depressive symptoms in elderly Chinese men: results from a large study

This study investigated the association between depressive symptoms in elderly Chinese men and the total testosterone, dehydroepiandrosterone (DHEA), DHEA sulphate (DHEAS), oestradiol and sex hormone-binding globulin (SHBG) levels, and the free androgen index. Cross-sectional data from 1147 community-dwelling elderly men, aged 65 and older, were used. Depressive symptoms were measured using the Chinese Geriatric Depression Scale (GDS). Total testosterone, free testosterone, DHEA, DHEAS, total oestradiol, the free androgen index and SHBG levels were assessed. DHEA was significantly associated with GDS score, and there was a trend towards DHEAS association, but this was not significant (β=-0.110, P=0.015; β=-0.074, P=0.055). However, no association was seen between depressive symptoms and total testosterone levels, free testosterone levels, oestradiol levels or SHBG levels. In terms of the presence of clinically relevant depressive symptoms, there were no statistically significant differences between patients in the lowest quartile of sex steroid hormone levels and those in other quartiles of sex steroid hormone levels. Similarly to Western studies, our study shows that DHEA and DHEAS levels are associated with depressive symptoms.     

The influence of age on bioavailable and free testosterone is independent of body mass index and glucose levels

Purpose  

To evaluate the influence of age on serum levels of total testosterone (TT), bioavailable testosterone (BT), free testosterone (FT), and sex-hormone binding globulin (SHBG), considering the presence of fasting blood glucose levels and body mass index (BMI) in a selected male population.