Association between sex hormone levels and abnormal metabolism in a population of elderly Chinese men

Figures & data

Table 1. Characteristics of the study population and sex hormones.

		n	Mean ± SD	Range
General condition	Age (years)	337	72.92 ± 7.96	60–91
	BUN (mmol/l)	336	5.94 ± 1.28	2.80–11.00
	CR (μmol/l)	336	84.06 ± 13.48	18.00–110.00
	ALT (mmol/l)	336	19.84 ± 9.75	4.00–91.40
	AST (mmol/l)	336	21.99 ± 6.94	11.00–79.00
Sex hormones	FSH (IU/l)	336	16.89 ± 16.89	0.10–119.40
	LH (IU/l)	336	9.42 ± 6.29	0.10–45.69
	E2 (pmol/l)	335	28.51 ± 8.6	5.00–55.90
	E2/SHBG	335	0.64 ± 0.00	0.14–1.76
	PROG (pmol/l)	336	0.41 ± 0.18	0.01–1.09
	TT (nmol/l)	337	5.04 ± 1.93	0.03–11.16
	T/E2	335	0.18 ± 0.00	0.00–0.44
	FTI	337	0.10 ± 0.03	0.00–0.22
	TSI (pmol/IU)	336	0.69 ± 0.39	0.01–2.26
	PRL (pmol/l)	336	28.51 ± 8.60	0.00–55.90
	SHBG (nmol/l)	337	51.82 ± 21.42	11.38–172.50
	FT (nmol/ml)	337	0.22 ± 0.08	0.00–0.67
	BT (nmol/ml)	337	5.80 ± 1.91	0.01–11.1

Figure 1. Sex hormones (mean ± SD) and trendlines over different age categories. Mean ± SD are shown by curves for TT (pmol/l), E2 (pmol/l), SHBG (pmol/l), FT (nmol/ml), BT (nmol/ml), T/E2, FTI, E2/SHBG, TSI (pmol/IU), FSH (IU/l), LH (IU/l), PROG (pmol/l) and grouped by age among 337 men. p < 0.01 for all sex hormones that had a linear relation with age, including SHBG, FTI, E2/SHBG, TSI, FSH, LH and PROG.

Table 2. Metabolic indices by age category.

			Age (years)
		n	60–69	70–79	80–89	90 and over	p
Diseases		337	136	115	81	5	Model 1	Model 2
Cardiovascular disease	0	182 (54.01)	89 (65.40%)	57 (49.60%)	3 5(43.20%)	1 (20.00%)	<0.01	<0.01
	1	155 (45.99%)	47 (34.60%)	58 (50.40%)	46 (56.8%)	4 (80.00%)
Cerebrovascular disease	0	252 (74.78%)	113 (83.10%)	85 (73.90%)	51 (63.0%)	3 (60.00%)	<0.01	<0.01
	1	85 (25.22%)	23 (16.90%)	30 (26.10%)	30 (37.0%)	2 (40.00%)
Macrovascular disease	0	151 (44.81%)	79 (58.10%)	45 (39.10%)	26 (32.10%)	1 (20.00%)	<0.01	<0.01
	1	186 (55.19%)	57 (41.90%)	70 (60.90%)	55(67.90%)	4 (80.00%)
BMI (kg/m^2)		24.70 ± 2.91	25.12 ± 2.61	24.41 ± 3.04	24.44 ± 3.01	23.54 ± 5.04	0.15	0.10
BMI group† (n/%*)	0	134 (40.98%)	47 (34.81%)	53 (46.90%)	31 (41.89%)	3 (60%)	0.27	0.16
	1	152 (46.48%)	68 (50.37%)	46 (40.70%)	37 (50.00%)	1 (20%)
	2	41 (12.54%)	20 (14.81%)	14 (12.40%)	6 (8.11%)	1 (20%)
Hyperglycemia† (n/%*)	0	77 (22.85%)	36 (26.47%)	28 (24.35 %)	12 (14.81%)	1 (20.00%)	0.25	0.04
	1	156 (46.29%)	60 (44.12%)	58 (50.43 %)	36 (44.44 %)	2 (40.00%)
	2	104 (30.86%)	40 (29.41%)	29 (25.22 %)	33 (40.74 %)	2 (40.00%)
FBG (mmol/l)		5.74 ± 1.02	5.73 ± 0.96	5.66 ± 1.14	5.87 ± 0.93	5.73 ± 1.36	0.56	0.353
PBG (mmol/l)		8.35 ± 2.32	7.88 ± 2.09	8.13 ± 2.15	9.61 ± 2.53	6.49 ± 1.47	<0.01	<0.01
Hypertension† (n/%*)	0	90 (27.11%)	51 (37.5%)	25 (21.93)	16 (20%)	1 (20%)	0.01	<0.01
	1	242 (72.24%)	85 (62.5%)	89 (78.07%)	64 (80%)	4 (80%)
SBP (mmHg)		129.38 ± 17.13	126.24 ± 17.68	132.00 ± 16.83	130.91 ± 16.30	130.00 ± 11.73	0.05	<0.05
DBP (mmHg)		73.24 ± 9.47	75.72 ± 8.88	72.85 ± 9.64	70.15 ± 8.99	65.00 ± 11.18	<0.01	<0.01
Dyslipidemia† (n/%*)	0	85 (25.22%)	36 (26.47%)	23 (20%)	24 (29.63%)	2 (40%)	0.36	0.27
	1	252 (74.78%)	100 (73.53%)	92 (80%)	57 (70.37%)	3 (60%)
TC (mmol/l)		4.72 ± 0.90	4.85 ± 0.87	4.78 ± 0.98	4.66 ± 1.15	4.71 ± 1.10	0.34	0.42
TG (mmol/l)		1.43 ± 0.84	1.54 ± 0.88	1.43 ± 0.87	1.33 ± 0.85	1.23 ± 0.54	0.58	0.40
HDL (mmol/l)		1.31 ± 0.33	1.28 ± 0.30	1.34 ± 0.35	1.39 ± 0.38	1.47 ± 0.40	0.12	0.12
LDL (mmol/l)		2.96 ± 0.78	3.08 ± 0.78	2.97 ± 0.81	2.79 ± 0.85	2.83 ± 0.89	0.40	0.30
Hyperuricemia† (n/%*)	0	260 (77.38%)	104 (76.47%)	88 (76.52%)	67 (82.72%)	2 (40.00%)	0.14	0.50
	1	76 (22.55%)	32 (23.53%)	27 (23.48%)	14 (17.28%)	3 (60.00%)
UA (μmol/l)		356.63 ± 70.89	62.91 ± 5.39	76.10 ± 7.10	72.44 ± 8.10	98.73 ± 44.15	0.07	<0.05
Metbolic abnormal numbers (n/%*)	0	9 (2.65%)	3 (2.21%)	3 (2.61%)	3 (3.70%)	0 (0%)	0.59	0.42
	1	16 (4.74%)	8 (5.88%)	5 (4.35%)	3 (3.70%)	0 (0%)
	2	64 (18.99%)	28 (20.59%)	23 (20.0%)	10 (12.35%)	3 (60%)
	3	97 (28.78%)	40 (29.41%)	32 (27.83%)	25 (30.86%)	0 (0%)
	4	123 (37.98%)	49 (36.03%)	39 (33.91%)	34 (41.98%)	1 (20%)
	5	28 (8.30%)	8 (5.88%)	13 (11.30%)	6 (7.41%)	1 (20%)
MetS	0	210 (62.32%)	85 (62.5%)	74 (64.34%)	48 (59.26%)	3 (60.00%)	0.91	0.77
	1	127 (37.68%)	51 (37.5%)	41 (35.65%)	33 (40.74%)	2 (40.00%)

*Percentage of the same age group.

†For hyperglycemia: 0 indicates a normal glucose test result, 1 represents IGR, 2 indicates DM; for the BMI group category, 0 indicates normal weight, 1 represents over weight, 2 indicates obesity; for the other categories, 0 indicates a normal metabolic test result, 1 represents an abnormal metabolic test result.

Table 3. Sex hormone levels by abnormal metabolic test result category.

Category	n	E2	SHBG	E2/SHBG	TT	FTI	T/E2	TSI	FT	BT	FSH	LH	PROG
Metabolic syndrome
0	210	28.91 ± 8.37	57.22 ± 22.96	0.59 ± 0.00	5.48 ± 2.02	0.11 ± 0.03	0.20 ± 0.00	0.73 ± 0.42	0.24 ± 0.10	5.40 ± 2.03	16.32 ± 14.68	9.61 ± 5.93	0.43 ± 0.19
1	127	28.30 ± 8.28	42.71 ± 14.39	0.73 ± 0.00	4.37 ± 1.49	0.10 ± 0.03	0.16 ± 0.00	0.63 ± 0.33	0.18 ± 0.06	4.33 ± 1.48	17.57 ± 19.60	8.97 ± 6.38	0.39 ± 0.16
Model 1		0.52	<0.01	<0.01	<0.01	0.60	<0.01	0.15	<0.01	<0.01	0.64	0.24	0.94
Model 2		0.54	<0.01	<0.01	<0.01	0.13	<0.01	0.02	<0.01	<0.01	0.58	0.25	0.07
Model 5		0.59	<0.01	<0.01	<0.01	0.10	<0.01	0.02	<0.01	<0.01	0.63	0.23	0.07
Abnormal metabolism number*
0	9	28.18 ± 6.07	52.82 ± 23.23	0.68 ± 0.00	5.30 ± 2.17	0.11 ± 0.04	0.20 ± 0.00	0.86 ± 0.60	0.28 ± 0.17	5.25 ± 2.15	16.95 ± 19.10	8.10 ± 4.57	0.36 ± 0.13
1	16	29.39 ± 8.83	61.58 ± 36.66	0.59 ± 0.00	5.67 ± 2.56	0.10 ± 0.04	0.19 ± 0.00	0.68 ± 0.42	0.24 ± 0.11	5.62 ± 2.53	18.04 ± 17.32	12.22 ± 8.18	0.38 ± 0.11
2	64	29.07 ± 7.41	59.79 ± 22.48	0.58 ± 0.00	5.89 ± 2.04	0.11 ± 0.03	0.21 ± 0.00	0.81 ± 0.49	0.25 ± 0.09	5.83 ± 2.03	16.46 ± 16.00	9.66 ± 6.16	0.42 ± 0.16
3	97	28.37 ± 8.96	53.29 ± 20.12	0.61 ± 0.00	5.05 ± 1.82	0.10 ± 0.04	0.19 ± 0.00	0.69 ± 0.35	0.21 ± 0.08	5.00 ± 1.81	17.17 ± 18.27	9.35 ± 7.15	0.43 ± 0.20
4	123	28.98 ± 8.75	46.58 ± 17.81	0.69 ± 0.00	4.64 ± 1.80	0.11 ± 0.03	0.17 ± 0.00	0.63 ± 0.36	0.20 ± 0.09	4.61 ± 1.78	15.95 ± 13.08	9.35 ± 5.95	0.41 ± 0.19
5	28	27.30 ± 6.57	45.67 ± 19.35	0.70 ± 0.00	4.39 ± 1.39	0.10 ± 0.02	0.17 ± 0.00	0.59 ± 0.26	0.19 ± 0.06	4.35 ± 1.38	20.41 ± 26.47	8.34 ± 3.52	0.40 ± 0.15
Model 1		0.93	<0.01	0.14	<0.01	1.00	<0.01	0.02	<0.01	<0.01	0.84	0.48	0.78
Model 2		0.95	<0.01	0.04	<0.01	0.98	<0.01	0.02	<0.01	<0.01	0.83	0.16	0.73
Model 5		0.95	<0.01	0.03	<0.01	0.97	<0.01	0.02	<0.01	<0.01	0.026	0.15	0.73
BMI
0	134	28.68 ± 8.73	60.53 ± 23.42	0.55 ± 0.00	5.76 ± 1.94	0.10 ± 0.03	0.21 ± 0.00	0.75 ± 0.42	0.24 ± 0.08	5.71 ± 1.91	17.52 ± 14.22	9.95 ± 5.57	0.45 ± 0.19
1	152	28.57 ± 8.23	47.30 ± 18.24	0.69 ± 0.00	4.76 ± 1.75	0.11 ± 0.04	0.17 ± 0.00	0.67 ± 0.37	0.20 ± 0.08	4.69 ± 1.77	16.49 ± 19.16	9.30 ± 7.10	0.40 ± 0.17
2	41	28.61 ± 7.38	40.71 ± 14.48	0.78 ± 0.00	4.23 ± 1.72	0.11 ± 0.03	0.15 ± 0.00	0.63 ± 0.36	0.18 ± 0.08	4.17 ± 1.69	15.78 ± 16.11	7.60 ± 3.17	0.37 ± 0.16
Model 1		0.99	<0.01	<0.01	<0.01	0.33	<0.01	0.13	<0.01	<0.01	0.81	0.11	0.02
Model 2		0.98	<0.01	<0.01	<0.01	0.60	<0.01	0.03	<0.01	<0.01	0.99	0.18	<0.01
Model 5		0.99	<0.01	<0.01	<0.01	0.59	<0.01	0.03	<0.01	<0.01	0.99	0.18	<0.01
Hyperglycemia†
0	77	29.04 ± 7.26	52.65 ± 24.83	0.67 ± 0.00	5.21 ± 2.00	0.11 ± 0.04	0.19 ± 0.00	0.76 ± 0.44	0.23 ± 0.09	5.17 ± 1.98	14.30 ± 12.93	8.62 ± 5.79	0.38 ± 0.15
1	156	28.32 ± 8.52	52.70 ± 19.76	0.61 ± 0.00	5.21 ± 1.91	0.10 ± 0.03	0.19 ± 0.00	0.72 ± 0.40	0.22 ± 0.09	5.17 ± 1.90	17.05 ± 18.10	9.21 ± 5.64	0.42 ± 0.18
2	104	28.94 ± 0.83	49.90 ± 21.20	0.68 ± 0.00	4.66 ± 1.85	0.10 ± 0.04	0.17 ± 0.00	0.59 ± 0.32	0.20 ± 0.79	4.62 ± 1.83	18.55 ± 17.47	10.33 ± 7.41	0.44 ± 0.19
Model 1		0.77	0.55	0.21	0.05	0.48	0.02	<0.01	0.03	0.05	0.27	0.17	0.10
Model 2		0.77	0.08	0.10	0.02	0.91	0.02	0.02	0.04	0.07	0.714	0.39	0.06
Model 3		0.91	0.20	0.13	0.05	0.82	0.01	0.03	0.04	0.04	0.69	0.38	0.03
Model 4		0.93	0.08	0.15	0.02	0.88	0.01	0.02	0.03	0.04	0.7	0.37	0.06
Hypertension
0	93	28.75 ± 7.33	52.64 ± 20.70	0.65 ± 0.00	5.46 ± 1.89	0.11 ± 0.04	0.20 ± 0.00	0.80 ± 0.44	0.24 ± 0.09	5.42 ± 1.87	15.16 ± 16.23	9.06 ± 6.42	0.41 ± 0.16
1	242	28.61 ± 8.69	51.51 ± 21.66	0.64 ± 0.00	4.89 ± 1.92	0.10 ± 0.03	0.18 ± 0.00	0.64 ± 0.36	0.21 ± 0.09	4.84 ± 1.90	17.58 ± 17.18	9.58 ± 6.26	0.42 ± 0.19
Model 1		0.99	0.67	0.80	<0.01	<0.01	0.03	<0.01	<0.01	0.01	0.18	0.51	0.50
Model 2		0.87	0.81	0.43	0.03	0.16	0.03	0.02	0.01	0.02	0.89	0.90	0.14
Model 3		0.89	0.69	0.59	0.46	0.09	0.46	0.10	<0.01	<0.01	0.86	0.94	0.04
Model 4		0.72	0.68	0.69	0.53	0.13	0.45	0.12	0.66	0.52	0.76	0.9	0.03
Hyperlipidemia
0	85	28.36 ± 8.30	52.64 ± 20.70	0.61 ± 0.00	5.17 ± 2.18	0.10 ± 0.04	0.19 ± 0.00	0.68 ± 0.42	0.22 ± 0.09	5.19 ± 2.17	18.37 ± 18.95	10.12 ± 7.00	0.43 ± 0.20
1	252	28.79 ± 8.36	51.51 ± 21.66	0.66 ± 0.00	5.00 ± 1.84	0.11 ± 0.03	0.18 ± 0.00	0.69 ± 0.38	0.22 ± 0.08	4.99 ± 1.80	16.40 ± 16.16	9.19 ± 6.03	0.41 ± 0.17
Model 1		0.68	0.04	0.26	0.46	0.34	0.49	0.71	0.37	0.49	0.32	0.19	0.29
Model 2		0.72	0.07	0.37	0.40	0.63	0.49	0.40	0.35	0.44	0.54	0.34	0.18
Model 3		0.73	0.561	0.87	0.74	0.71	0.64	0.58	0.52	0.72	0.36	0.32	0.30
Model 4		0.70	0.63	0.85	0.76	0.74	0.63	0.62	<0.01	<0.01	0.41	0.42	0.32
Hyperuricemia
0	261	29.01 ± 8.65	53.63 ± 22.22	0.63 ± 0.00	5.13 ± 1.98	0.10 ± 0.03	0.19 ± 0.00	0.70 ± 0.41	0.22 ± 0.09	5.08 ± 1.96	17.11 ± 16.37	9.68 ± 6.53	0.42 ± 0.17
1	76	27.34 ± 6.98	45.63 ± 17.15	0.69 ± 0.00	4.73 ± 1.73	0.11 ± 0.04	0.18 ± 0.00	0.66 ± 0.34	0.20 ± 0.07	4.69 ± 1.72	16.15 ± 18.65	8.54 ± 5.32	0.41 ± 0.21
Model 1		0.12	<0.01	0.13	0.09	0.07	0.71	0.48	0.08	0.11	0.70	0.18	0.87
Model 2		0.12	<0.01	0.15	0.09	0.06	0.71	0.39	0.08	0.10	0.79	0.19	0.81
Model 3		0.13	0.03	0.31	0.31	0.08	0.68	0.76	0.33	0.37	0.6	0.12	0.97
Model 4		0.13	0.03	0.32	0.06	0.35	0.68	0.81	0.32	0.36	0.59	0.13	0.93

Model 1: p with no adjustment; Model 2: p adjusted by age; Model 3: p adjusted by age + BMI; Model 4: p adjusted by age + BMI + Macrovascular disease; Model 5: p adjusted by age + Macrovascular disease.

*Abnormal metabolic result including overweight/obesity, hyperglycemia, hypertension, hyperlipidemia and hyperuricemia.

†Hyperglycemia category, 0 = normal glucose test result, 1 = IGR, 2 = DM; abnormal metabolic test result category, 0 = normal metabolic test result, 1–5 represent the number of abnormal metabolic test results; for other category, 0 = normal metabolic test result, 1 abnormal metabolic test result.

Table 4. Sex hormone test results analyzed using stepwise regression.

	SHBG			TT				BT
	Model 1	Model 3	FTI	Model 1	Model 2	TSI	FT	Model 1	Model 2	FSH	LH	T/E2	E2/SHBG
R^2	0.36	0.48	0.18	0.14	0.47	0.17	0.18	0.12	0.41	0.16	0.15	0.22	0.15
F	29.12	29.77	58.72	14.05	73.48	16.63	26.73	18.55	58.77	48.59	46.09	18.47	12.17
Age	0.35	0.21	−0.43		−0.26	−0.35	−0.309			0.40	0.39		0.35
BMI	−0.32	−0.24		−0.31		−0.13		−0.31				−4.3	0.20
TC	0.16	0.19		0.16		0.18		0.15				0.19	−0.22
PBG	−0.17	−0.16		−0.12									0.18
FBG												−0.16
HDL	0.14	0.11										0.15	−0.15
SHBG					0.74				0.61
LH		0.23

Model 1: Age, BMI, BP (SBP, DBP), plasma glucose (FBG, PBG), plasma lipid (TC, LDL, HDL and TG), plasma urine acid, macrovascular disease, metabolic integrated indices (MS, number of abnormal metabolic test results) were inserted into the sex hormone stepwise regression.

Model 2: dependent variables in Model 1 + SHBG were inserted into the sex hormones stepwise regression.

Model 3: dependent variables in Model 1 + LH, FSH, ALT, AST, BUN, Cr were inserted into the sex hormones stepwise regression.

Figure 2. Interrelationship between age, abnormal metabolism and sex hormones. The effect of age and age-related chronic diseases includes the effect of abnormal metabolism on the androgen levels in elderly men. Serum FT and testosterone levels in elderly men significantly decreased with increasing age, and with the increase in incidence of MetS and chronic diseases, SHBG and TT levels decreased. However, age directly or indirectly promoted SHBG levels, which in turn compensated for the decrease in androgens in elderly men to some extend. + positive effect, − opposite effect. The yellow square means bidirectional effect on androgens; the red square means opposite effect on androgens; and the green square means positive effect on androgens.