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Combination of low free testosterone and low vitamin D predicts mortality in older men referred for coronary angiography.
Clin Endocrinol (Oxf). 2012 Sep; 77(3):475-83.CE

Abstract

CONTEXT

Low levels of 25-hydroxyvitamin D [25(OH)D] and free testosterone (FT) are both associated with increased mortality. Experimental studies show a complex interplay of vitamin D and androgen metabolism suggesting that a deficiency of both hormones may be associated with a particularly adverse clinical outcome.

OBJECTIVE

To evaluate the impact of parallel FT and 25(OH)D deficiency in a large cohort of older men.

DESIGN

We measured total testosterone (TT), sex hormone-binding globulin and 25(OH)D levels in 2069 men who were routinely referred for coronary angiography (1997-2000).

MAIN OUTCOME MEASURES

Cox proportional hazard ratios (HRs) (with 95% confidence intervals) for mortality from all causes, cardiovascular and noncardiovascular causes according to combined deficiency of FT and 25(OH)D.

RESULTS

In multivariate-adjusted analyses, we found an increased risk for all-cause mortality, cardiovascular and noncardiovascular mortality for men in the lowest FT [HR 1·26 (1·03-1·54), 1·24 (0·96-1·60) and 1·39 (1·00-1·93), respectively] and 25(OH)D quartile [HR 1·77 (1·47-2·13), 1·65 (1·29-2·10) and 1·89 (1·38-2·60) respectively] compared with men in higher FT and 25(OH)D quartiles. There was no independent association of TT levels with mortality. Multivariate-adjusted HRs progressively increased with the number of hormones (FT and 25(OH)D) in the lowest quartile [0 vs 2 hormone deficiencies: 2·11 (1·60-2·79) for all cause, 1·77 (1·23-2·55) for cardiovascular and 2·33 (1·45-3·47) for noncardiovascular mortality, respectively].

CONCLUSION

A combined deficiency of FT and 25(OH)D is significantly associated with fatal events in a large cohort of men referred for coronary angiography.

Authors+Show Affiliations

Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria. elisabeth.lerchbaum@medunigraz.atNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22356136

Citation

Lerchbaum, Elisabeth, et al. "Combination of Low Free Testosterone and Low Vitamin D Predicts Mortality in Older Men Referred for Coronary Angiography." Clinical Endocrinology, vol. 77, no. 3, 2012, pp. 475-83.
Lerchbaum E, Pilz S, Boehm BO, et al. Combination of low free testosterone and low vitamin D predicts mortality in older men referred for coronary angiography. Clin Endocrinol (Oxf). 2012;77(3):475-83.
Lerchbaum, E., Pilz, S., Boehm, B. O., Grammer, T. B., Obermayer-Pietsch, B., & März, W. (2012). Combination of low free testosterone and low vitamin D predicts mortality in older men referred for coronary angiography. Clinical Endocrinology, 77(3), 475-83. https://doi.org/10.1111/j.1365-2265.2012.04371.x
Lerchbaum E, et al. Combination of Low Free Testosterone and Low Vitamin D Predicts Mortality in Older Men Referred for Coronary Angiography. Clin Endocrinol (Oxf). 2012;77(3):475-83. PubMed PMID: 22356136.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combination of low free testosterone and low vitamin D predicts mortality in older men referred for coronary angiography. AU - Lerchbaum,Elisabeth, AU - Pilz,Stefan, AU - Boehm,Bernhard O, AU - Grammer,Tanja B, AU - Obermayer-Pietsch,Barbara, AU - März,Winfried, PY - 2012/2/24/entrez PY - 2012/2/24/pubmed PY - 2013/1/18/medline SP - 475 EP - 83 JF - Clinical endocrinology JO - Clin Endocrinol (Oxf) VL - 77 IS - 3 N2 - CONTEXT: Low levels of 25-hydroxyvitamin D [25(OH)D] and free testosterone (FT) are both associated with increased mortality. Experimental studies show a complex interplay of vitamin D and androgen metabolism suggesting that a deficiency of both hormones may be associated with a particularly adverse clinical outcome. OBJECTIVE: To evaluate the impact of parallel FT and 25(OH)D deficiency in a large cohort of older men. DESIGN: We measured total testosterone (TT), sex hormone-binding globulin and 25(OH)D levels in 2069 men who were routinely referred for coronary angiography (1997-2000). MAIN OUTCOME MEASURES: Cox proportional hazard ratios (HRs) (with 95% confidence intervals) for mortality from all causes, cardiovascular and noncardiovascular causes according to combined deficiency of FT and 25(OH)D. RESULTS: In multivariate-adjusted analyses, we found an increased risk for all-cause mortality, cardiovascular and noncardiovascular mortality for men in the lowest FT [HR 1·26 (1·03-1·54), 1·24 (0·96-1·60) and 1·39 (1·00-1·93), respectively] and 25(OH)D quartile [HR 1·77 (1·47-2·13), 1·65 (1·29-2·10) and 1·89 (1·38-2·60) respectively] compared with men in higher FT and 25(OH)D quartiles. There was no independent association of TT levels with mortality. Multivariate-adjusted HRs progressively increased with the number of hormones (FT and 25(OH)D) in the lowest quartile [0 vs 2 hormone deficiencies: 2·11 (1·60-2·79) for all cause, 1·77 (1·23-2·55) for cardiovascular and 2·33 (1·45-3·47) for noncardiovascular mortality, respectively]. CONCLUSION: A combined deficiency of FT and 25(OH)D is significantly associated with fatal events in a large cohort of men referred for coronary angiography. SN - 1365-2265 UR - https://www.unboundmedicine.com/medline/citation/22356136/Combination_of_low_free_testosterone_and_low_vitamin_D_predicts_mortality_in_older_men_referred_for_coronary_angiography_ L2 - https://doi.org/10.1111/j.1365-2265.2012.04371.x DB - PRIME DP - Unbound Medicine ER -