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Submitted on August 23, 2006
Accepted on November 28, 2006
New England Research Institutes, Watertown, MA, USA
* To whom correspondence should be addressed. E-mail: ttravison{at}neriscience.com.
Context. Though it is known that serum testosterone (T) concentrations decline with age, the relative contributions of changes in health and lifestyle to that decline have not been adequately assessed.
Objective. To establish the relative importance of aging, health and lifestyle in contributing to male testosterone decline.
Design. A prospective cohort study of health and endocrine functioning in randomly selected men, with a baseline (T1: 1987-89) and two follow-up (T2: 1995-97, T3: 2002-04) visits.
Setting. An observational study of men residing in greater Boston, MA, USA.
Participants. 1667 men aged 40-70 at baseline; follow-up on 947 (57%) and 584 (35%) at T2 and T3, respectively.
Main outcome measures. Total serum testosterone (TT), calculated free testosterone (FT), sex hormone-binding globulin (SHBG).
Results. There were substantial declines in TT and FT levels associated with aging alone. However, many health and lifestyle changes were associated with accelerated decline. A 4-5 kg/m2 increase in BMI, or loss of spouse, was associated with declines in TT comparable to that associated with approximately 10 years of aging. Results were similar for FT, but fewer factors were associated with SHBG after age was taken into account.
Conclusions. Both chronologic aging and changes in health and lifestyle factors are associated with declines in serum T. Comorbidities and lifestyle influences may be as strongly associated with declining T levels as is aging itself over the short- to mid-term. These results suggest the possibility that age-related hormone decline may be decelerated through the management of health and lifestyle factors.
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