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Low levels of bioavailable testosterone are independently associated with a greater level of frailty in elderly men, according to researchers from California Pacific Medical Center, San Francisco.
The team assessed cross-sectional and longitudinal associations between frailty and sex hormones (estradiol, bioavailable estradiol, testosterone, bioavailable testosterone, and sex hormone binding globulin) in 1,469 men who were at least 65 years old at baseline.
They measured weakness (lowest 20 percent in grip strength), slowness (slowest 20 percent in walking speed), activity level (lowest 20 percent by questionnaire), shrinking/sarcopenia (worst lean body mass for height and percent fat), and exhaustion. Men with three or more of these factors were considered frail; those with two were considered intermediate, and those who did not meet the criteria for any of the factors were considered robust.
About 11 percent of men in the lowest quartile of bioavailable testosterone (<165 ng/dL) were frail at the baseline exam, compared with 5.4 percent in the highest quartile (241.9 ng/dL or greater). In multivariate cross-sectional analyses, men in the lowest quartile of bioavailable testosterone had a 1.39-fold increased likelihood of greater frailty status compared to men in the highest quartile.
In age-adjusted longitudinal analyses, men in the lowest versus the highest quartile of bioavailable testosterone had a 1.51-fold increased likelihood of greater frailty status 4.1 years after baseline. However, this association was largely attenuated on multivariate analysis.
The researchers did not see an association between frailty and any of the other hormones that they measured.
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