Sex-Specific Differences in the Effect of Free Testosterone on Sarcopenia Components in Older Adults.

Hyung Eun Shin,Jeremy D. Walston,Chang Won Won,Miji Kim

doi:10.3389/fendo.2021.695614

Hyung Eun Shin, Jeremy D. Walston + Show 2 more

Open Access

https://doi.org/10.3389/fendo.2021.695614

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Abstract

ObjectiveThe association of free testosterone (FT) with sarcopenia and its components is well known in men but incompletely understood in women. We examined the association of baseline FT with the prevalence and incidence of sarcopenia and its components in community-dwelling older adults.DesignCross-sectional and longitudinal analysis from the prospective population-based Korean Frailty and Aging Cohort Study.MethodsA total of 1,879 community-dwelling older adults aged 70–84 years were enrolled for cross-sectional analysis and 1,583 subjects who participated in the 2-year follow-up survey were included for longitudinal analysis. Baseline FT levels was measured by radioimmunoassay. Skeletal muscle mass, handgrip strength, and physical performance tests were measured at baseline and after 2-year follow-up. Sarcopenia was defined by the diagnostic criteria of the Asian Working Group for Sarcopenia (AWGS).ResultsContinuous FT levels was positively associated with the prevalence of sarcopenia in men (odds ratio [OR]=0.95; 95% confidence interval [CI]=0.89–1.00)] and women (OR=0.64, 95% CI=0.42–0.99) after adjusting for multiple confounders. In prospective analysis, low FT levels was associated with a decrease in handgrip strength in women (β=-0.61; p=0.010) and a reduction in Timed “Up and Go” (TUG) test (β=0.53; p=0.008) in men after 2 years. No significant correlations were found between FT levels and the incidence of sarcopenia.ConclusionsLow levels of FT may be a significant determinant of decreases in muscle strength in women and declines in physical performance in men after 2 years. Low FT do not predict loss of muscle mass in both men and women.

Highlights

Sarcopenia, or the loss of skeletal muscle mass and strength with age, accelerates the risk of adverse health outcomes, such as functional impairment, falls, disability, and mortality in older adults [1, 2]
The aim of this study is to examine the association of baseline Free testosterone (FT) levels with prevalence and incidence of sarcopenia and its components in community-dwelling older adults using a crosssectional and longitudinal design
A total of 1,237 participants were included in the incidence of sarcopenia analyses and 1,583 participants were included in analysis for change in muscle mass, muscle strength and physical performance after 2 years

Summary

Introduction

Sarcopenia, or the loss of skeletal muscle mass and strength with age, accelerates the risk of adverse health outcomes, such as functional impairment, falls, disability, and mortality in older adults [1, 2]. The etiology of sarcopenia is complex and multifactorial, and includes factors such as advancing age, poor nutritional status, inactivity, pro-inflammatory state, oxidative stress, insulin resistance, and hormonal changes [4,5,6]. Growth hormone, DHEA-S and loss of sex hormones, including testosterone, have all been implicated [7,8,9]. Free testosterone (FT) is a physiologically active fraction of testosterone that is available for tissues [13]. Measurement of FT levels can provide a better estimate of biological activities of testosterone

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