Nonandrogenic Anabolic Hormones Predict Risk of Frailty: European Male Ageing Study Prospective Data

J Clin Endocrinol Metab. 2017 Aug 1;102(8):2798-2806. doi: 10.1210/jc.2017-00090.

Abstract

Context: Low levels of nonandrogenic anabolic hormones have been linked with frailty, but evidence is conflicting and prospective data are largely lacking.

Objective: To determine associations between nonandrogenic anabolic hormones and prospective changes in frailty status.

Design/setting: A 4.3-year prospective observational study of community-dwelling men participating in the European Male Ageing Study.

Participants: Men (n = 3369) aged 40 to 79 years from eight European centers.

Main outcome measures: Frailty status was determined using frailty phenotype (FP; n = 2114) and frailty index (FI; n = 2444).

Analysis: Regression models assessed relationships between baseline levels of insulinlike growth factor 1 (IGF-1), its binding protein 3 (IGFBP-3), dehydroepiandrosterone sulfate (DHEA-S), 25-hydroxyvitamin D (25OHD), and parathyroid hormone (PTH), with changes in frailty status (worsening or improving frailty).

Results: The risk of worsening FP and FI decreased with 1 standard deviation higher IGF-1, IGFBP-3, and 25OHD in models adjusted for age, body mass index, center, and baseline frailty [IGF-1: odds ratio (OR) for worsening FP, 0.82 (0.73, 0.93), percentage change in FI, -3.7% (-6.0, -1.5); IGFBP-3: 0.84 (0.75, 0.95), -4.2% (-6.4, -2.0); 25OHD: 0.84 (0.75, 0.95); -4.4%, (-6.7, -2.0)]. Relationships between IGF-1 and FI were attenuated after adjusting for IGFBP-3. Higher DHEA-S was associated with a lower risk of worsening FP only in men >70 years old [OR, 0.57 (0.35, 0.92)]. PTH was unrelated to change in frailty status.

Conclusions: These longitudinal data confirm the associations between nonandrogenic anabolic hormones and the changes in frailty status. Interventional studies are needed to establish causality and determine therapeutic implications.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aging / metabolism*
  • Dehydroepiandrosterone Sulfate / metabolism*
  • Frail Elderly*
  • Humans
  • Insulin-Like Growth Factor Binding Protein 3 / metabolism*
  • Insulin-Like Growth Factor I / metabolism*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Odds Ratio
  • Parathyroid Hormone / metabolism*
  • Prospective Studies
  • Risk Assessment
  • Vitamin D / analogs & derivatives*
  • Vitamin D / metabolism

Substances

  • IGF1 protein, human
  • IGFBP3 protein, human
  • Insulin-Like Growth Factor Binding Protein 3
  • Parathyroid Hormone
  • Vitamin D
  • Dehydroepiandrosterone Sulfate
  • Insulin-Like Growth Factor I
  • 25-hydroxyvitamin D