Abstract
ObjectivesAssociations between androgens and depressive symptoms were mostly reported from cross-sectional and patient-based studies.Study design/main outcome measuresLongitudinal data from 4,110 participants of the Study of Health in Pomerania were used to assess sex-specific associations of baseline total and free testosterone, androstenedione and sex hormone-binding globulin with incident depressive symptoms and cognitive status at 5- and 10-year follow-up.ResultsDespite sex-specific differences in depressive symptoms prevalence at baseline (women: 17.4%, men: 8.1%), cross-sectional analyses showed no associations between sex hormones and depressive symptoms. In age-adjusted longitudinal analyses, total testosterone was associated with incident depressive symptoms (relative risk at 5-year follow-up: 0.73, 95% confidence interval: 0.58–0.92). Similarly, age-adjusted analyses showed a positive association between sex hormone-binding globulin and cognitive status in men (β-coefficient per standard deviation: 0.44, 95% confidence interval: 0.13–0.74). In women, age-adjusted associations of androstenedione with baseline depressive symptoms (relative risk: 0.88, 95% confidence interval: 0.77–0.99) were found. None of the observed associations remained after multivariable adjustment.ConclusionsThe present population-based, longitudinal study revealed inverse associations between sex hormones and depressive symptoms. However, the null finding after multivariable adjustment suggests, that the observed associations were not independent of relevant confounders including body mass index, smoking and physical inactivity. Furthermore, the low number of incident endpoints in our non-clinical population-based sample limited the statistical power and reduced the chance to detect a statistically significant effect.
Highlights
Depression is widely recognized as a major health problem and potential risk factor for increased morbidity and decreased quality of life
Despite sex-specific differences in depressive symptoms prevalence at baseline, cross-sectional analyses showed no associations between sex hormones and depressive symptoms
In age-adjusted longitudinal analyses, total testosterone was associated with incident depressive symptoms
Summary
Depression is widely recognized as a major health problem and potential risk factor for increased morbidity and decreased quality of life. Associations between testosterone and depressive symptoms were observed in specific subpopulations and cross-sectional samples [3], lacking generalizability and conclusions about cause and effect. Both directions of associations were reported, with depressed males exhibiting lower testosterone concentrations compared to healthy controls [4], as well as free testosterone (fT) being related to adverse Beck Depression Inventory scores in older men [5]. Reported associations between low fT [3,6] and low total testosterone (TT) [7,8] and prevalence and incidence of depression or depressive symptoms in men were mainly reported in the elderly. Even in older men a study on androgen concentrations and androgen receptor polymorphism did not support a link between androgens and depressive symptoms based on the Geriatic Depression Scale [9]
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