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Greater decline in testosterone associated with increased risk of mortality during follow-up period of up to 18 years

May 22, 2018

A study reported in the January 2018 issue of the European Journal of Endocrinology documented an association between increased testosterone decline in men and a greater risk of dying during a follow-up period of up to 18 years. Testosterone is a hormone that is involved not only in male reproductive function but also in bone mineralization, muscle growth, red blood cell formation, and cognitive function. Age-related decreases in testosterone have been associated with adverse effects in men’s health and well-being, including changes in body composition and mood.

The study included 1,167 men between the ages of 30 and 60 years who enrolled from 1982 to 1984 in the Danish Monitoring Trends and Determinants of Cardiovascular Disease (MONICA1) study. Blood samples collected at enrollment and at a follow-up examination from 1993 to 1994 were analyzed for serum testosterone, luteinizing hormone, and sex hormone–binding globulin.

Participants were followed for up to 18 years following the 1993–1994 examination, during which 421 deaths occurred. One hundred and six of the deaths were related to cancer, and 199 were caused by cardiovascular disease.

Men whose 10-year decline in testosterone was among the most pronounced experienced a significantly greater risk of dying from any cause over follow-up in comparison with most of the other participants. Those whose testosterone declined (on average) more than 1.0 nanomoles per liter (nmol/L) per year, which placed them below the 10th percentile, had a 60% greater risk of death during follow-up than those whose change in testosterone placed them between the 10th and 90th percentiles.

"Few other studies have looked at intra-individual declines in testosterone levels in aging men in relation to mortality," authors Stine A. Holmboe and colleagues noted. "Our findings suggest that a more pronounced age-related decline in testosterone is associated with mortality in men independent of baseline hormone level. A possible causal link between an increased tempo in age-related testosterone decline and subsequent health is unknown and remains to be investigated."

 
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