In:
Clinical Endocrinology, Wiley, Vol. 79, No. 5 ( 2013-11), p. 725-732
Abstract:
In men, testosterone ( T ) levels decline with age, and lower T predicts all‐cause and cardiovascular mortality. However, the associations of T and its metabolites, dihydrotestosterone ( DHT ) and estradiol ( E 2), with symptomatic peripheral arterial disease remain unclear. We assessed associations of T , DHT and E 2 with lower limb intermittent claudication in older men. Design Cross‐sectional study. Participants Community‐dwelling men aged 70–89 years resident in P erth, W estern A ustralia. Measurements Intermittent claudication was ascertained by the Edinburgh Claudication Questionnaire. Early morning, plasma T , DHT and E 2 were assayed using liquid chromatography–tandem mass spectrometry. Results There were 268 men with intermittent claudication and 2435 without claudication or any leg pain. Men with nonspecific leg pain ( n = 986) were excluded. After adjusting for age, smoking, BMI , waist/hip ratio, hypertension, dyslipidaemia, diabetes, creatinine and prevalent cardiovascular disease ( CVD ), higher T was associated with reduced risk of having claudication (per 1 SD increase, odds ratio [ OR ] = 0·80, 95% confidence interval [ CI ] = 0·69–0·94, P = 0·006; quartiles, Q4/Q1, OR = 0·54, 95% CI = 0·36–0·81). Higher DHT was associated with reduced risk of having claudication (per 1 SD increase, OR = 0·86, 95% CI = 0·73–1·00, P = 0·048; Q4/Q1, OR = 0·64, 95% CI = 0·43–0·95). E2 was not associated with claudication (per 1 SD increase, OR = 0·96, 95% CI = 0·83–1·11, P = 0·565; Q4/Q1, OR = 0·88, 95% CI = 0·60–1·29). Conclusions Lower T or DHT levels, but not E 2, are associated with symptoms of intermittent claudication in older men. Reduced exposure to androgens may represent a causal factor or biomarker for symptomatic peripheral arterial disease. Further studies are needed to examine underlying mechanisms and evaluate therapeutic options in ageing men.
Type of Medium:
Online Resource
ISSN:
0300-0664
,
1365-2265
DOI:
10.1111/cen.2013.79.issue-5
Language:
English
Publisher:
Wiley
Publication Date:
2013
detail.hit.zdb_id:
2004597-9
Permalink
