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Aging News & Information
Evidence Mounts that Low Testosterone Increases
Death Risk for Older Men
Studies rate death risk from 33 to 80% higher than
for normal levels
 Oct. 25, 2007 Several recent studies are making
it abundantly clear that a low testosterone level in older men increases
their risk of death. A study published this month says men 50 or older
with the lowest testosterone had a 40 percent higher death rate over 18
years. Another, published in August of last year, found men over 40 had
an 88 percent increase in death risk over eight years.
(For more on the August 2006 story, see link in
side bar.)
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Aging News & Information |
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When first reported in March, the author of the
study published this month in the Journal of Clinical Endocrinology &
Metabolism said low testosterone men had a 33 percent high risk of death
over. The difference apparently is where the low testosterone line was
drawn. The report of 40% higher risk applied to the lowest quarter in
the study group. The earlier 33% referred to the lowest one-third.
This study was fist presented last March by Gail
Laughlin, Ph.D., with the Department of Family and Preventive Medicine
at the University of California, San Diego, School of Medicine.
Laughlin, an assistant professor and study author,
said at that time The new study is only the second report linking
deficiency of this sex hormone with increased death from all causes,
over time, and the first to do so in relatively healthy men who are
living in the community.
We have followed these men for an average of 18
years and our study strongly suggests that the association between
testosterone levels and death is not simply due to some acute illness,
said Laughlin.
 In
the study, Laughlin and co-workers looked at death, no matter the cause,
in nearly 800 men, ages 50 to 91 years, who were living in Rancho
Bernardo, California. The participants have been members of the Rancho
Bernardo Heart and Chronic Disease Study since the 1970s.
At the beginning of the 1980s, almost one-third of
these men had suboptimal blood testosterone levels for men their age.
The group with low testosterone levels had a 33
percent greater risk of death during the next 18 years than the men with
higher testosterone. This difference was not explained by smoking,
drinking, physical activity level or pre-existing diseases (such as
diabetes or heart disease).
In this study, "low testosterone" levels were set
at the lower limit of the normal range for young adult men.
Testosterone declines slowly with aging in men and levels vary widely,
with many older men still having testosterone levels in the range of
young men. Twenty-nine percent of Rancho Bernardo men had low
testosterone.
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Senior Men Testosterone
Decline |
|
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 For
men 65-69 years of age, average testosterone levels fell from
503 ng/dL in 1988 to 423 ng/dL in 2003. A normal, healthy adult
male usually has blood total testosterone ranging from 300-1000
ng/dL.
Read related
report... |
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Distinguishing Factors
Men with low testosterone were more likely to have
elevated markers of inflammation, called inflammatory cytokines, which
contribute to many diseases. Another characteristic that distinguished
the men with low testosterone was a larger waist girth along with a
cluster of cardiovascular and diabetes risk factors related to this type
of fat accumulation.
Men with low testosterone are three times more
likely to have the metabolic syndrome than men with higher testosterone
levels; metabolic syndrome is the name for the presence of three or more
of these risk factors:
waist measurement more than 40 inches in men (more than 35 inches in
women),
low HDL (good) cholesterol,
high triglycerides (levels of fat in the blood),
high blood pressure
high blood glucose (blood sugar)
While the study lends support to the belief that
supplemental hormone therapy may help older men with low testosterone
levels, those who practice weight control and increase their physical
activity may also live longer.
Its
very possible that lifestyle determines what level of testosterone a
patient has, commented principal investigator, Elizabeth
Barrett-Connor, M.D., UCSD Distinguished Professor of Family and
Preventive Medicine and chief of the Division of Epidemiology. It may
be possible to alter the testosterone level by lowering obesity.
Barrett-Connor and Laughlin were also careful to
clarify what the study did not show.
The study did show there may be an association
between low testosterone levels and higher mortality. It did not show
that higher levels of testosterone are associated with decreased
mortality," explained Laughlin.
The study shows only an association between low
testosterone and earlier death - not a cause-and-effect relationship,
lead author Dr. Gail A. Laughlin told Reuters Health this week. What's
more, there was no evidence that having above-average testosterone
levels gave men any longevity advantage.
"We cannot recommend that any man take testosterone
based on these results," Laughlin stressed to Reuters.
Researchers agree only randomized
placebo-controlled clinical trials can determine whether testosterone
supplements can safely promote longer life. Such a trial is in the
planning stages at UCSD.
Barrett-Connor cautioned, We are very excited
about these findings, which have important implications, but we are not
ready to say that men should go out and get testosterone to prolong
their lives. Were not ready to take this to the prescribing
pharmacist.
Conventional wisdom is that women live longer
because estrogen is good and testosterone is bad, said Barrett-Connor.
We dont know. Maybe the decline in testosterone is healthy and comes
with older age. Maybe the decline is bad and is associated with chronic
diseases of aging.
The National Institute on Aging and the American
Heart Association funded the study.
The Rancho Bernardo Study
Dr. Elizabeth Barrett-Connor is founder and
director of the Rancho Bernardo Heart and Chronic Disease Study, now in
its 35th year. Since 1972, the RB study has greatly increased knowledge
of cardiovascular disease, diabetes, cancer, osteoporosis, exogenous and
endogenous hormones, and the connections between lifestyle, behavior and
health.
Six thousand residents, 82 percent of the original
population of adults in Rancho Bernardo, agreed to participate in this
history-making study and significant collection of data. Barrett-Connor
and a team of UCSD researchers have conducted clinical research visits
with the participants every four years for more than three decades.
The clinical research visits last three to four
hours, thoroughly examining the participants physical condition by
gathering information through bone and heart scans, blood samples, heart
disease risk factor measurements such as lipid levels and cognitive
function assessment.
The rate of follow-up with those who have moved or
died (through cooperation of family and friends), has been exceptionally
high.
A Living Legacy
The RB study has just been re-funded for what
Barrett-Connor predicts will be the final clinic visit. Another newly
funded grant from the National Institutes of Health (NIH) will allow
analysis of information gathered over the course of the study to provide
new insights on the link between heart disease risk and cognitive
function.
Although more than 400 scientific papers based on
RB data have already been published, its a wonderful legacy for
participants to realize that the knowledge gathered has not come close
to being exhausted. Its an enormous bank of data, said Laughlin.
Though we are beginning the final visits with the RB group, analyzing
the data from the RB study, including the new data being acquired at
this final visit, will continue to contribute to our knowledge about
healthy aging for years to come.
Barrett-Connor added, We must note that this would
not be possible without the remarkable contributions of our loyal
participants. They are really very special people.
Laughlin will present the findings to The Endocrine
Society Tuesday June 5th, 2007. The findings will be among selected
articles published in the distinguished The Endocrine Society's ENDO 07
Research Summaries Book . Journal of Clinical Endocrinology &
Metabolism, October 2007
>> Link to
Department of Family and Preventive Medicine at the University of
California, San Diego School of Medicine
>>
Link to Reuters Health story on Yahoo News
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