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  • 1
    Keywords: POPULATION ; ASSOCIATION ; WOMEN ; MEN ; POSTMENOPAUSAL WOMEN ; ELDERLY-MEN ; trabecular bone ; older men ; BONE ; BINDING GLOBULIN ; BODY-COMPOSITION ; FREE TESTOSTERONE ; SERUM TESTOSTERONE ; LONGITUDINAL CHANGES ; VERTEBRAL FRACTURES
    Abstract: Sex steroid hormones influence bone mineral density (BMD) in women, but are less well-studied in men. We evaluated the association of serum total and free sex steroid hormones and SHBG with osteopaenia in a nationally representative sample of men aged 20-90 years. BMD and sex steroid hormones were measured among participants in NHANES III, a cross-sectional study of the US population. A total of 1185 adult men in morning examination session of Phase I of NHANES III (1988-91). Relation of oestradiol (E-2), testosterone, and SHBG concentrations with BMD. Osteopaenia was defined as 1-2.5 SD below the mean for white men aged 20-29 years. Men in the lowest quartile of free E-2 had 70% increased odds (OR = 1.69, 95% CI 0.95-2.98) of osteopaenia compared with men in the highest quartile. Men in the lowest quartile of free testosterone had nearly four times the odds of osteopaenia than those in the highest quartile (OR = 3.82, 95% CI 1.87-7.78). Lower concentrations of SHBG appeared protective against osteopaenia (P-trend = 0.01). Neither total testosterone nor total E-2 was associated with BMD, although men with clinically low E-2 (〈 20 ng/l) had lower BMD (0.930 g/cm(2), 95% CI 0.88-0.98) than men with normal-range E-2 (1.024 g/cm(2), 95% CI 1.01-1.04; P = 0.004). Findings for free E-2 were most pronounced among elderly men, while the findings for free testosterone were most pronounced among younger men. In this nationally representative study, men with lower free E-2, lower free testosterone, and higher SHBG concentrations in circulation were more likely to have low BMD
    Type of Publication: Journal article published
    PubMed ID: 18485120
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  • 2
    Keywords: MODEL ; MODELS ; PHASE-I ; DISEASE ; POPULATION ; SAMPLE ; METABOLISM ; PATIENT ; kidney ; CONTRAST ; ASSOCIATION ; hormone ; PROGRESSION ; HEALTH ; DESIGN ; MEN ; PATHOGENESIS ; DAMAGE ; US ; DIET ; BLOOD-PRESSURE ; nutrition ; albumin ; SERUM ; ADULT ; CARDIOVASCULAR-DISEASE ; EGFR ; RENAL-DISEASE ; PHASE ; USA ; HORMONES ; TESTOSTERONE ; Phase I ; NUTRITION EXAMINATION SURVEY ; androgens ; SERUM CREATININE ; FREE TESTOSTERONE ; SERUM TESTOSTERONE ; GLOMERULAR-FILTRATION-RATE ; SERUM CYSTATIN-C ; 3 ; SEX-STEROID-HORMONES ; CREATININE ; REPRESENTATIVE SAMPLE ; Chronic kidney disease ; CKD ; CYSTATIN-C ; Kidney function ; Urinary albumin
    Abstract: P〉Context Sex steroid hormones may play a role in the pathogenesis of chronic kidney disease (CKD). Objective To determine whether sex steroid hormone concentrations are associated with kidney function or kidney damage in men in the general US population. We hypothesized that lower serum testosterone and E-2 concentrations are associated with CKD. Design patients and measurements Serum sex steroid hormones were measured by electrochemiluminescence immunoassays for 1470 men who attended the morning session of Phase I of the Third National Health and Nutrition Examination Survey (NHANES III). We used two measures of CKD, estimated glomerular filtration rate (eGFR) 〈 60 ml/min/1 center dot 73 m(2) calculated using serum creatinine or cystatin C levels and the abbreviated Modification of Diet in Renal Disease Study formulae and urinary albumin : creatinine ratio (UACR) 〉= 17 mg/g. Results Mean free testosterone concentration was higher in men with an eGFR 〈 60 ml/min/1 center dot 73 m(2) than in men with a higher eGFR. In multivariable adjusted models, the odds of an eGFR 〈 60 ml/min/1 center dot 73 m(2) or UACR 〉= 17 mg/g did not differ across tertiles of hormones with the exception of free E-2; those in the highest vs. lowest tertile had an elevated odds of decreased eGFR (OR: 3 center dot 04, 95% CI (1 center dot 22, 7 center dot 57); P-trend = 0 center dot 02). Conclusions In a nationally representative sample of US adult men, higher free E-2 concentration was significantly associated with an eGFR 〈 60 ml/min/1 center dot 73 m(2) as assessed by serum creatinine or cystatin C even after multivariable adjustment. These findings are in contrast to the hypothesis that oestrogens may protect against CKD, though reverse causation cannot be ruled out. Longitudinal investigation of the role of oestrogens in kidney haemodynamics, function, and pathophysiology is warranted
    Type of Publication: Journal article published
    PubMed ID: 19178534
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