Format

Send to

Choose Destination
J Clin Endocrinol Metab. 2015 Dec;100(12):4472-80. doi: 10.1210/jc.2015-2460. Epub 2015 Oct 21.

The Association of Reproductive Hormone Levels and All-Cause, Cancer, and Cardiovascular Disease Mortality in Men.

Author information

1
University Department of Growth and Reproduction (S.A.H., T.K.J., N.E.S., A.J., A.-M.A.), Rigshospitalet, 2100 Copenhagen, Denmark; Department of Biostatistics (E.V., T.S.), University of Copenhagen, Denmark; Research Centre for Prevention and Health (A.L., L.L.N.H.), The Capital Region, Denmark; Department of Clinical Experimental Research (A.L.), Rigshospitalet, Glostrup, Denmark; and Department of Clinical Medicine (A.L.), Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.

Abstract

CONTEXT:

Testosterone (T) levels have been associated with mortality, but controversy exists.

OBJECTIVE:

Our objective was to investigate associations between serum levels of total T, SHBG, free T, estradiol, LH and FSH, and subsequent mortality with up to 30 years of follow-up.

DESIGN:

This was a prospective cohort study consisting of men participating in four independent population-based surveys (MONICA I-III and Inter99) from 1982 to 2001 and followed until December 2012 with complete registry follow-up.

SETTING AND PARTICIPANTS:

A total of 5350 randomly selected men from the general population aged 30, 40, 50, 60, or 70 years at baseline participated.

MAIN OUTCOMES AND MEASURES:

All-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality were the main outcomes.

RESULTS:

A total of 1533 men died during the follow-up period; 428 from CVD and 480 from cancer. Cox proportional hazard models revealed that men in highest LH quartile had an increased all-cause mortality compared to lowest quartile (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.14-1.53). Likewise, increased quartiles of LH/T and estradiol increased the risk of all-cause mortality (HR, 1.23; 95% CI, 1.06-1.43; HR, 1.23; 95% CI 1.06-1.43). No association to T levels was found. Higher LH levels were associated with increased cancer mortality (HR, 1.42; 95% CI, 1.10-1.84) independently of smoking status. Lower CVD mortality was seen for men with T in the highest quartile compared to lowest (HR, 0.72; 95% CI, 0.53-0.98). Furthermore, negative trends were seen for SHBG and free T in relation to CVD mortality, however insignificant.

CONCLUSION:

The observed positive association of LH and LH/T, but not T, with all-cause mortality suggests that a compensated impaired Leydig cell function may be a risk factor for death by all causes in men. Our findings underpin the clinical importance of including LH measurement in the diagnostic work-up of male patients seeking help for possible androgen insufficiency.

PMID:
26488309
DOI:
10.1210/jc.2015-2460
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center