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Accepted Preprint first posted online on 1 July 2008
European Journal of Endocrinology (2008) In press
DOI: 10.1530/EJE-07-0873
Copyright © 2008 by European Society of Endocrinology
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CLINICAL STUDY

The decline of serum testosterone levels in community-dwelling men over 70 years of age: descriptive data and predictors of longitudinal changes

Bruno Lapauw, Stefan Goemaere, Hans-Georg Zmierczak, Inge Van Pottelbergh, Ahmed Mahmoud, Youri Taes, Dirk De Bacquer, Stijn Vansteelandt and Jean-Marc Kaufman

B Lapauw, Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
S Goemaere, Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
H Zmierczak, Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
I Van Pottelbergh, Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
A Mahmoud, Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
Y Taes, Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
D De Bacquer, Department of Public Health, Ghent University Hospital, Ghent, Belgium
S Vansteelandt, Department of Applied Mathematics and Computer Science, Ghent University, Ghent, Belgium
J Kaufman, Department of Endocrinology, Ghent University Hospital, Ghent, Belgium

Correspondence: Bruno Lapauw, Email: Bruno.Lapauw{at}UGent.be

Abstract

Objective: This study was designed to assess longitudinal changes in serum T levels, explore relationships with aging, genetic-, health- and lifestyle-related factors and investigate predictors of changes in healthy elderly men.

Design: Population-based, longitudinal, 4-year observational study in 221 community-dwelling men aged 71–86 years at baseline.

Methods: Hormone levels assessed by immunoassay, anthropometry, questionnaires on general health, genetic polymorphisms. Predictors of changes in T levels explored using linear mixed-effects modeling for longitudinal analyses.

Results: TT, FT and BioT levels decreased with aging, decreases in BioT being most marked. No changes in SHBG or E2, while LH and FSH levels increased during follow-up. Subjects who gained weight displayed a greater decline in TT levels, mainly due to decreasing SHBG levels. However, baseline body composition was not predictive for subsequent changes in T levels. Baseline E2 (P=0.023–0.004), LH (P=0.046–0.005) and FSH (P<0.002) levels were independently positively associated with a faster decline in T fractions, although only FSH remained significant when adjusting for baseline T (P=0.041–0.035). Carriers of a "TA"-haplotype of the ER{alpha} PvuII and XbaI polymorphisms displayed a slower decline of TT and BioT (P=0.041–0.007).

Conclusions: In elderly men with already low serum T levels, a further decline was observed, independent from baseline age. The identification of FSH levels as a predictor of this decline appears to reflect the testicular mechanisms of aging-related changes in T production, whereas associations with E2 and ER{alpha} polymorphisms are suggestive for estrogen-related processes, possibly related to changes in the neuroendocrine regulation of T production.






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