Objective: Lower levels of anabolic hormones in older age are well documented. Several studies suggested that low insulin-like growth factor I (IGF-I) or testosterone levels were related to increased mortality. The aim of the present study was to investigate the combined influence of low IGF-I and low testosterone on all-cause mortality in men.
Methods and results: From two German prospective cohort studies, the DETECT study and SHIP, 3942 men were available for analyses. During 21,838 person-years of follow-up, 8.4% (n = 330) of men died. Cox model analyses with age as timescale and adjusted for potential confounders revealed that men with levels below the 10th percentile of at least one hormone [hazard ratio (HR) 1.38 (95% confidence-interval (CI) 1.06–1.78), p = 0.02] and two hormones [HR 2.88 (95% CI 1.32–6.29), p < 0.01] showed a higher risk of all-cause mortality compared to men with non-low hormones. The associations became non-significant by using the 20th percentile as cut-off showing that the specificity increased with lower cut-offs for decreased hormone levels. The inclusion of both IGF-I and total testosterone in a mortality prediction model with common risk factors resulted in a significant integrated discrimination improvement of 0.5% (95% CI 0.3–0.7%, p = 0.03).
Conclusions: Our results prove that multiple anabolic deficiencies have a higher impact on mortality than a single anabolic deficiency and suggest that assessment of more than one anabolic hormone as a biomarker improve the prediction of all-cause mortality.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:27096 |
| Date | January 2012 |
| Creators | Friedrich, Nele, Schneider, Harald J., Haring, Robin, Nauck, Matthias, Völzke, Henry, Kroemer, Heyo K., Dörr, Marcus, Klotsche, Jens, Jung-Sievers, Caroline, Pittrow, David, Lehnert, Hendrik, März, Winfried, Pieper, Lars, Wittchen, Hans-Ulrich, Wallaschofski, Henri, Stalla, Günter K. |
| Publisher | Technische Universität Dresden |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Source | Steroids, Bd. 77 (2012), Nr. 1–2, S. 52-58, ISSN: 0039-128X |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 10.1016/j.steroids.2011.10.005 |
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