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The Journal of Clinical Endocrinology & Metabolism Vol. 86, No. 2 724-731
Copyright © 2001 by The Endocrine Society

Original Studies

Longitudinal Effects of Aging on Serum Total and Free Testosterone Levels in Healthy Men

S. Mitchell Harman, E. Jeffrey Metter, Jordan D. Tobin, Jay Pearson and Marc R. Blackman

The Intramural Research Program, National Institute on Aging, National Institutes of Health (S.M.H., E.J.M., J.D.T., J.P.) and Department of Medicine (M.R.B.), The Johns Hopkins University School of Medicine, Baltimore, Maryland 21224

Address all correspondence and requests for reprints to: S. Mitchell Harman, M.D., Ph.D., Director, Kronos Research Foundation, 4455 East Camelback Road, Suite B135, Phoenix, Arizona 85018. E-mail: harman{at}kronofoundation.org

Many studies have shown cross-sectional (and two small studies, longitudinal) declines in total and/or free testosterone (T) levels, with age, in men. The extent to which decline in T is the result of the aging process per se, as opposed to chronic illness, medication use, and other age-related factors, remains controversial. The frequency with which aging leads to T levels consistent with hypogonadism has also not been defined. These issues bear on the potential use of T replacement in aging men, because aging and hypogonadism have, in common, reduced bone and lean body mass and muscle strength and increased total and abdominal fat. We measured T and sex hormone-binding globulin (SHBG), by RIA, in stored samples from 890 men in the Baltimore Longitudinal Study on Aging. Using a mixed-effects model, we found independent effects of age and date of sampling to reduce T levels. After compensating for date effects, which investigation suggested was artifactual, we observed significant, independent, age-invariant, longitudinal effects of age on both T and free T index (free T index = T/SHBG), with an average change of -0.124 nmol/L·yr and -0.0049 nmol T/nmol SHBG·yr. T, but not free T index, also decreased with increasing body mass index. Use of ß-blocking drugs was associated with higher T and higher free T index levels. Using total T criteria, incidence of hypogonadal T levels increased to about 20% of men over 60, 30% over 70 and 50% over 80 yr of age, and even greater percentages when free T index criteria were employed. Our observations of health factor independent, age-related longitudinal decreases in T and free T, resulting in a high frequency of hypogonadal values, suggest that further investigation of T replacement in aged men, perhaps targeted to those with the lowest serum T concentrations, are justified.




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