Temporal trend in androgen status and androgen-sensitive outcomes in older men

Abstract

Context: Although androgen status decreases with aging in unselected men, the contemporaneous relationship over time between circulating hormones and androgen-sensitive outcomes has not been reported. Objectives: To investigate the temporal relationships between age-specific androgen status and muscle (mass, strength), hemoglobin, and prostate-specific antigen (PSA). Design, Setting and Participants: Men aged 70 years and older from the Concord Health and Ageing in Men Project study were assessed at baseline (2005-2007; n = 1705) and at 2-year (n = 1367) and 5-year follow-up (n = 958). Main Outcomes and Measures: At all assessments, serum T, dihydrotestosterone (DHT), estradiol (E2), and estrone (E1) were measured by liquid chromatography-tandem mass spectrometry, and serum SHBG, LH, and FSH were measured by immunoassay together with calculation of free T (cFT). Muscle mass, strength of upper (hand grip) and lower (walking speed) limbs, hemoglobin, and prostate size (serum PSA) were measured. Results: Serum hormones showed longitudinal, within-man decreases in serum T (-2.6%/y), DHT (-2.6%/y), E1 (-3.2%/y), and cFT (-2.8%/y) but increases in serum E2 (2.6%/y), SHBG (1.3%/y), LH (1.9%/y), and FSH (1.8%/y). Significant positive correlation was observed between changes in serum T with muscle mass, strength, and hemoglobin but not with PSA across the three time-points. Changes in serum DHT, cFT, and E1 had significant correlation with muscle mass, strength, and hemoglobin, but not with PSA. Conclusions: These extended observational data are consistent with the impact of reduced androgen status on some somatic features of male aging. However, they do not exclude reverse causality or independent effects of aging on both androgen status and androgen-sensitive outcomes.