cron-web.org

[A1CR]

CRONies appear to generally have lower levels of sex
hormones. One CRONies previous
testosterone, free level was 12.2 pM versus the reference
range 23-83 pM
level on Aug. 6, 2004. Previous messages among the CRS's
message archives
included the http://tinyurl.com/hzpkj message, which
discussed the not
- http://tinyurl.com/eah9h paper. The original
report appears
to document the greater longevity of eunuchs, who may
represent a population
control for the effects of testosterone better than other
studies that may
be confounded by factors such as unknown pathological
conditions that may
predispose both low testosterone and pathologies. The below
new paper is
- and may represent an example of the latter
type of study.
Accounting for some known confounders reduced the risk of
having low
testosterone for dying.

Shores MM, Matsumoto AM, Sloan KL, Kivlahan DR.
Low Serum Testosterone and Mortality in Male Veterans.
Arch Intern Med. 2006 Aug 14;166(15):1660-1665.

PMID: 16908801 http://tinyurl.com/qmbqe

BACKGROUND: Low serum testosterone is a common condition
in aging associated with decreased muscle mass and insulin
resistance. This study evaluated whether low testosterone
levels are a risk factor for mortality in male veterans.
METHODS: We used a clinical database to identify men older
than 40 years with repeated testosterone levels obtained
from October 1, 1994, to December 31, 1999, and without
diagnosed prostate cancer. A low testosterone level was a
total testosterone level of less than 250 ng/dL (<8.7
nmol/L) or a free testosterone level of less than 0.75 ng/dL
(<0.03 nmol/L). Men were classified as having a low
testosterone level (166 [19.3%]), an equivocal testosterone
level (equal number of low and normal levels) (240 [28.0%]),
or a normal testosterone level (452 [52.7%]). The risk for
all-cause mortality was estimated using Cox proportional
hazards regression models, adjusting for demographic and
clinical covariates over a follow-up of up to 8 years.
RESULTS: Mortality in men with normal testosterone levels
was 20.1% (95% confidence interval [CI], 16.2%-24.1%) vs
24.6% (95% CI, 19.2%-30.0%) in men with equivocal
testosterone levels and 34.9% (95% CI, 28.5%-41.4%) in men
with low testosterone levels. After adjusting for age,
medical morbidity, and other clinical covariates, low
testosterone levels continued to be associated with
increased mortality (hazard ratio, 1.88; 95% CI, 1.34-2.63;
P<.001) while equivocal testosterone levels were not
significantly different from normal testosterone levels
(hazard ratio, 1.38; 95% CI, 0.99%-1.92%; P=.06). In a
sensitivity analysis, men who died within the first year (50
[5.8%]) were excluded to minimize the effect of acute
illness, and low testosterone levels continued to be
associated with elevated mortality. CONCLUSIONS: Low
testosterone levels were associated with increased mortality
in male veterans. Further prospective studies are needed to
examine the association between low testosterone levels and
mortality.

===================================================


... The lower limit of normal was defined as a total
testosterone level
of less than 250 ng/dL (<8.7 nM) or a free testosterone
level of less than
0.75 ng/dL (<0.03 nM). These levels were used as threshold
levels because
they have been identified as clearly low and generally
associated with
symptoms of hypogonadism, even in older men.4, 12 Men were
classified as
having low testosterone levels if they had 2 low
testosterone levels or if
more than 2 levels were measured; most of the levels were
low. Men were
classified as having equivocal testosterone levels if they
had at least 1
low and 1 normal level and if more than 2 levels were
obtained, they had an
equal number of low and normal testosterone levels. Men were
classified as
having normal testosterone levels if they had at least 2
normal testosterone
levels and if more than 2 levels were obtained, most were
normal. ...

Table 2. Crude and Multivariate-Adjusted Data for Mortality
Associated With
Testosterone Levels
===========================================================
Group---Crude Data Partially Adjusted Data* Fully Adjusted Data#
---HR (95% CI) P HR (95% CI) P HR (95% CI) P
===========================================================
Entire sample (N = 858)
Men with normal testosterone levels (n = 452) 1.00 NA
1.00 NA 1.00 NA
Men with equivocal testosterone levels (n = 240) 1.31
(0.94-1.82) .11
1.45 (1.04-2.02) .03 1.38 (0.99-1.92) .06
Men with low testosterone levels (n = 166) 1.88
(1.35-2.61) <.001 1.95
(1.39-2.72) <.001 1.88 (1.34-2.63) <.001
Sample excluding first-year deaths (N = 808)
Men with normal testosterone levels (n = 435) 1.00 NA
1.00 NA 1.00 NA
Men with equivocal testosterone levels (n = 224) 1.19
(0.82-1.74) .36
1.36 (0.93-1.98) .11 1.31 (0.89-1.92) .17
Men with low testosterone levels (n = 149) 1.65
(1.13-2.42) .01 1.71
(1.16-2.52) .007 1.68 (1.14-2.48) .009
===========================================================
Abbreviations: CI, confidence interval; HR, hazard
ratio; NA, data not
applicable.
* The partially adjusted model included the covariates
of age, medical
morbidity, body mass index (BMI), and glucocorticoid and
opiate treatment.
The average BMI was used to replace missing BMI data (n =
124). Similar
results were found when an analysis was done that excluded
subjects with
missing BMI data.
# The fully adjusted model included the covariates of
age, medical
morbidity, BMI, glucocorticoid and opiate treatment, race,
coronary artery
disease, chronic obstructive pulmonary disease, human
immunodeficiency
virus, diabetes mellitus, hyperlipidemia, and number of
testosterone levels
obtained. The average BMI was used to replace missing BMI
data (n = 123).
Similar results were found when an analysis was done that
excluded subjects
with missing BMI data.

-- A CRONie, -


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