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Sex-specific associations of circulating testosterone levels with all-cause and cause-specific mortality.

循环睾酮水平与全因和病因特异性死亡率的性别特异性关联。

  • 影响因子:0
  • DOI:10.1530/EJE-20-1253
  • 作者列表:"Wang J","Fan X","Yang M","Song M","Wang K","Giovannucci E","Ma H","Jin G","Hu Z","Shen H","Hang D
  • 发表时间:2021-05-01
Abstract

Objective:Testosterone is a critical determinant of health in both genders. However, the relationship between circulating levels of testosterone and mortality remains undetermined. Methods:We examined the associations of serum total testosterone (TT) and free testosterone (FT) with all-cause and cause-specific mortality in 154 965 men and 93 314 postmenopausal women from UK Biobank. Cox regression models were used to calculate the hazard ratios (HR) and 95% CIs. Given multiple testing, P < 0.005 was considered statistically significant. Results:Over a median follow-up of 8.9 (inter-quartile range: 8.3-9.5) years, we documented 5754 deaths in men, including 1243 (21.6%) from CVD and 2987 (51.9%) from cancer. In postmenopausal women, 2435 deaths occurred, including 346 (14.2%) from CVD and 1583 (65.0%) from cancer. TT and FT concentrations were inversely associated with all-cause mortality in men, with the multivariable HR of 0.82 (95% CI: 0.75-0.91) and 0.80 (95% CI: 0.73-0.87) for the highest (Q5) vs the lowest quintile (Q1), respectively. In postmenopausal women, TT concentrations showed a positive association with all-cause mortality (HR for Q5 vs Q1 = 1.20, 95% CI: 1.06-1.37). Furthermore, higher TT and FT concentrations were associated with a lower risk of cancer mortality in men (both P for trend = 0.001), whereas TT concentrations were suggestively associated with a higher risk of cancer mortality in postmenopausal women (P for trend = 0.03). Conclusions:Our findings suggest that high levels of circulating testosterone may be beneficial for all-cause and cancer mortality in men but detrimental in postmenopausal women.

摘要

目的: 睾酮是两性健康的关键决定因素。然而,睾酮的循环水平与死亡率之间的关系仍未确定。 方法: 我们检测了来自英国生物样本库的154 965名男性和93 314名绝经后女性的血清总睾酮 (TT) 和游离睾酮 (FT) 与全因和病因特异性死亡率的关系。Cox回归模型用于计算风险比 (HR) 和95% ci。考虑到多重检验,P <0.005被认为是统计学上显著的。 结果: 在8.9 (四分位距: 8.3-9.5) 年的中位随访期间,我们记录了5754例男性死亡,其中1243例 (21.6%) 死于CVD,2987例 (51.9%) 死于癌症。在绝经后妇女中,发生了2435例死亡,其中346例 (14.2%) 死于CVD,1583例 (65.0%) 死于癌症。TT和FT浓度与男性全因死亡率呈负相关,最高 (Q5) 与最低 (Q1) 的多变量HR分别为0.82 (95% CI: 0.75-0.91) 和0.80 (95% CI: 0.73-0.87)。在绝经后妇女中,TT浓度与全因死亡率呈正相关 (Q5与Q1的HR = 1.20,95% CI: 1.06-1.37)。此外,较高的TT和FT浓度与男性较低的癌症死亡风险相关 (趋势P = 0.001),而TT浓度与绝经后女性较高的癌症死亡风险相关 (趋势P = 0.03)。 结论: 我们的研究结果表明,高水平的循环睾酮可能对男性的全因和癌症死亡率有益,但对绝经后女性有害。

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