This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (26)  • Contact me when this article is cited  Related Content  • Related letter  • Similar articles in this journal  Topic Collections  • Men's Health  • Cardiovascular System  • Cardiovascular Disease/ Myocardial Infarction  • Alert me on articles by topic  Social Bookmarking   What's this?

Andre B. Araujo, PhD; Varant Kupelian, PhD; Stephanie T. Page, MD, PhD; David J. Handelsman, MB, BS, PhD; William J. Bremner, MD, PhD; John B. McKinlay, PhD

Arch Intern Med. 2007;167(12):1252-1260.

Background  Sex steroid levels are related to metabolic outcomes that could convey higher risk of premature death.

Methods  We examined whether total or free testosterone, dihydrotestosterone, and sex hormone–binding globulin levels are related to all-cause or cause-specific mortality in men. Data were obtained from the Massachusetts Male Aging Study, a population-based cohort study of 1709 men aged 40 to 70 years. Men were followed up for all-cause and cause-specific mortality.

Results  Complete data were available for 1686 men, with 395 deaths occurring during 15.3 years of follow-up. With age adjustment, dihydrotestosterone and sex hormone–binding globulin levels were associated with ischemic heart disease mortality, and free testosterone level was associated with respiratory mortality. In multivariate-adjusted models, higher free testosterone (P = .02) and lower dihydrotestosterone (P = .04) levels were significantly associated with ischemic heart disease mortality, although the latter association was not robust to differences in model selection. The relative risk of death from ischemic heart disease per 1-SD lower free testosterone level was 0.80 (95% confidence interval, 0.64-0.99). Free testosterone level was significantly associated with respiratory mortality (P = .002), with a multivariate-adjusted relative risk per 1-SD lower free testosterone level of 1.90 (95% confidence interval, 1.24-2.92). Total testosterone level was unrelated to mortality, and sex hormone–binding globulin was not significantly associated with mortality after multivariate adjustment.

Conclusions  In men, endogenous sex steroid levels seem to have relatively weak associations with mortality. These data provide little support for the hypothesis that endogenous sex steroid levels are associated with risk of premature death but suggest that further investigation of the relationship between sex steroids and mortality from ischemic heart disease and respiratory disease may be warranted.

Author Affiliations: New England Research Institutes, Watertown, Mass (Drs Araujo, Kupelian, and McKinlay); Department of Medicine, University of Washington, Seattle (Drs Page and Bremner); and ANZAC Research Institute, Department of Andrology, Concord Hospital, University of Sydney, Sydney, Australia (Dr Handelsman).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

RELATED LETTER

The Relationship Between Testosterone and Mortality in Men: A Debatable Issue
Thomas Paparrigopoulos, Elias Tzavellas, Dimitris Karaiskos, and Ioannis Liappas
Arch Intern Med. 2008;168(3):329-330.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Pulmonary Function in Long-Term Survivors of Testicular Cancer
Haugnes et al.
JCO 2009;27:2779-2786.
ABSTRACT | FULL TEXT  

Testosterone therapy in men
Theodoraki and Bouloux
Menopause Int 2009;15:87-92.
ABSTRACT | FULL TEXT  

Low Serum Testosterone Increases Mortality Risk among Male Dialysis Patients
Carrero et al.
J. Am. Soc. Nephrol. 2009;20:613-620.
ABSTRACT | FULL TEXT  

Men, Androgen Deficiency, and Pharmaceutical Promotion--Reply
Hall et al.
Arch Intern Med 2009;169:88-89.
FULL TEXT  

Low Testosterone and Risk of Premature Death in Older Men: Analytical and Preanalytical Issues in Measuring Circulating Testosterone
Platz
Clin. Chem. 2008;54:1110-1112.
FULL TEXT  

Lower sex hormone-binding globulin is more strongly associated with metabolic syndrome than lower total testosterone in older men: the Health in Men Study
Paul Chubb et al.
Eur J Endocrinol 2008;158:785-792.
ABSTRACT | FULL TEXT  

The Relationship Between Testosterone and Mortality in Men: A Debatable Issue
Paparrigopoulos et al.
Arch Intern Med 2008;168:329-330.
FULL TEXT  

The Relationship Between Testosterone and Mortality in Men: A Debatable Issue--Reply
Araujo et al.
Arch Intern Med 2008;168:330-330.
FULL TEXT  

Might Testosterone Actually Reduce Mortality?
Snyder
J. Clin. Endocrinol. Metab. 2008;93:32-33.
FULL TEXT  

Low Serum Testosterone and Mortality in Older Men
Laughlin et al.
J. Clin. Endocrinol. Metab. 2008;93:68-75.
ABSTRACT | FULL TEXT  

Testosterone Making an Entry Into the Cardiometabolic World
Basaria and Dobs
Circulation 2007;116:2658-2661.
FULL TEXT