TY - JOUR
T1 - Estradiol and metabolic syndrome in older Italian men
T2 - The InCHIANTI study
AU - Maggio, Marcello
AU - Lauretani, Fulvio
AU - Ceda, Gian Paolo
AU - Bandinelli, Stefania
AU - Basaria, Shehzad
AU - Paolisso, Giuseppe
AU - Giumelli, Claudio
AU - Luci, Michele
AU - Najjar, Samer S.
AU - Metter, E. Jeffrey
AU - Valenti, Giorgio
AU - Guralnik, Jack
AU - Ferrucci, Luigi
PY - 2010/3
Y1 - 2010/3
N2 - The increasing prevalence of metabolic syndrome (MS) with age in older men has been linked with decreasing testosterone levels. Interestingly, while testosterone levels decline with age, estradiol (E2) levels remain relatively stable, resulting in a decreased testosterone: E2 ratio. Because E2 levels tend to be elevated in morbid obesity, insulin resistance, and diabetes, it is reasonable to hypothesize that high E2 levels are associated with MS In older men. We studied the relationship of total and free E2 with MS after adjustment for multiple confounders, including age, BMI, smoking, alcohol consumption, physical activity, interleukln-6 (IL-6), fasting insulin, and testosterone. Men 65 years or older (age range, 65-96; n = 452) had complete data on E2, testosterone, fasting Insulin, sex hormone-binding globulin, IL-6, and albumin. Concentrations of free E2 and free testosterone were calculated using the mass action equations. MS was defined according to Adult Treatment Panel III (ATP-III). Participants with MS had significantly higher serum free and total E2 (P <.001) (P = .003). After adjusting for confounders, Including age, smoking, alcohol consumption, physical activity, log(IL-6), and log(insulln), participants with higher logftotal E2) (odds ratio [OR], 2.31; 95% confidence Interval [95% Cl], 1.39-4.70; P = .02) and higher log(free E2) (OR, 2.69; 1.38-5.24; P <.001) had an increased risk of having MS. Log(free E2) (P = .04) maintained significant correlation with MS, even after further adjustment for BMI. In older men, high E2 is Independently associated with MS. Whether confirmed In other studies, assessment of E2 should be also considered in older men. Whether changes In this hormonal pattern play a role in the development of MS should be further tested In longitudinal studies.
AB - The increasing prevalence of metabolic syndrome (MS) with age in older men has been linked with decreasing testosterone levels. Interestingly, while testosterone levels decline with age, estradiol (E2) levels remain relatively stable, resulting in a decreased testosterone: E2 ratio. Because E2 levels tend to be elevated in morbid obesity, insulin resistance, and diabetes, it is reasonable to hypothesize that high E2 levels are associated with MS In older men. We studied the relationship of total and free E2 with MS after adjustment for multiple confounders, including age, BMI, smoking, alcohol consumption, physical activity, interleukln-6 (IL-6), fasting insulin, and testosterone. Men 65 years or older (age range, 65-96; n = 452) had complete data on E2, testosterone, fasting Insulin, sex hormone-binding globulin, IL-6, and albumin. Concentrations of free E2 and free testosterone were calculated using the mass action equations. MS was defined according to Adult Treatment Panel III (ATP-III). Participants with MS had significantly higher serum free and total E2 (P <.001) (P = .003). After adjusting for confounders, Including age, smoking, alcohol consumption, physical activity, log(IL-6), and log(insulln), participants with higher logftotal E2) (odds ratio [OR], 2.31; 95% confidence Interval [95% Cl], 1.39-4.70; P = .02) and higher log(free E2) (OR, 2.69; 1.38-5.24; P <.001) had an increased risk of having MS. Log(free E2) (P = .04) maintained significant correlation with MS, even after further adjustment for BMI. In older men, high E2 is Independently associated with MS. Whether confirmed In other studies, assessment of E2 should be also considered in older men. Whether changes In this hormonal pattern play a role in the development of MS should be further tested In longitudinal studies.
KW - Androgen
KW - Andropausa
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U2 - 10.2164/jandrol.108.006098
DO - 10.2164/jandrol.108.006098
M3 - Article
C2 - 19059904
AN - SCOPUS:77950954211
SN - 0196-3635
VL - 31
SP - 155
EP - 162
JO - Journal of Andrology
JF - Journal of Andrology
IS - 2
ER -