Associations between blood concentrations of sex hormones and physical function in community-dwelling older women: a prospective cohort study

Yuanyuan Wang, Rakibul M Islam, Sultana Monira Hussain, John J McNeil, Susan R Davis
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Abstract

Background Blood concentrations of testosterone and oestrone tend to increase in women aged >70 years, while concentrations of their precursor hormone dehydroepiandrosterone decline. It is unknown whether these changes influence physical function. We investigated whether concentrations of these hormones were associated with grip strength and self-reported physical function in community-dwelling older women. Methods 9179 Australian women, aged >70 years, were recruited to the ASPREE trial. Sex hormones were measured in SHOW, an ASPREE sub-study, by liquid chromatography-tandem mass spectrometry in 6358 women. The associations between hormone concentrations and physical function [handgrip strength and self-reported physical function assessed by SF-12v2 physical component summary (PCS)] were examined using multiple linear regression. Results The median age of the 5447 participants was 74.0 (IQR 71.7-77.6) years. Testosterone concentrations above the lowest quartile were associated with less decline in grip strength [mean -1.39 (95% CI -1.54 to -1.24) versus -1.75 (-2.00 to -1.50) kg, p=0.02], and dehydroepiandrosterone concentrations above the lowest quartile were associated with less decline in grip strength [-1.39 (-1.54 to -1.25) versus -1.82 (-2.11 to -1.55) kg, p=0.007] and PCS scores [-1.49 (-1.80 to -1.17) versus -2.33 (-2.93 to -1.72), p=0.02] over four years, compared with those in the respective lowest quartile. Conclusions Low endogenous concentrations of testosterone and dehydroepiandrosterone were associated the greatest likelihood of physical function decline in community-based women aged >70 years. Further studies are warranted to determine whether testosterone and dehydroepiandrosterone therapy prevents functional decline in this at-risk group using sensitive measures of muscle strength and performance.
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居住在社区的老年妇女血液中性激素浓度与身体功能之间的关系:一项前瞻性队列研究
背景 70 岁女性血液中睾酮和雌酮的浓度呈上升趋势,而其前体激素脱氢表雄酮的浓度却在下降。目前还不清楚这些变化是否会影响身体机能。我们研究了这些激素的浓度是否与社区老年妇女的握力和自我报告的身体功能有关。方法 ASPREE 试验招募了 9179 名年龄为 70 岁的澳大利亚女性。在 ASPREE 子研究 SHOW 中,通过液相色谱-串联质谱法对 6358 名妇女的性激素进行了测定。采用多元线性回归法研究了激素浓度与身体功能(手握力和通过 SF-12v2 身体成分总表 (PCS) 评估的自我报告身体功能)之间的关系。结果 5447 名参与者的中位年龄为 74.0(IQR 71.7-77.6)岁。睾酮浓度高于最低四分位数与握力下降幅度较小有关[平均-1.39(95% CI -1.54 至-1.24)公斤对-1.75(-2.00 至-1.50)公斤,P=0.02],脱氢表雄酮浓度高于最低四分位数与握力下降幅度较小有关[-1.39 (-1.54 to -1.25) versus -1.82 (-2.11 to -1.55) kg, p=0.007]和 PCS 评分[-1.49 (-1.80 to -1.17) versus -2.33 (-2.93 to -1.72), p=0.02]在四年内的下降幅度较小。结论 在年龄为 70 岁的社区妇女中,内源性睾酮和脱氢表雄酮浓度低与身体机能下降的可能性最大有关。有必要开展进一步的研究,利用对肌肉力量和表现的敏感测量来确定睾酮和脱氢表雄酮疗法是否能预防这一高风险人群的功能衰退。
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