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Cited by 155Hormonal and reproductive studiesSperm and Testicular FunctionAdrenal Hormones and Disorders

Reference Ranges and Determinants of Testosterone, Dihydrotestosterone, and Estradiol Levels Measured using Liquid Chromatography-Tandem Mass Spectrometry in a Population-Based Cohort of Older Men

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Yeap, Bu B., Alfonso, Helman, Chubb, S. A. Paul, Handelsman, David J., Hankey, Graeme J., Norman, Paul E., Flicker, Leon·2012·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2012-2265
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Abstract

Context: Testosterone (T) levels decline with increasing age. Controversy exists over the threshold for classifying T as low vs. normal in older men. The relevance of assessing dihydrotestosterone (DHT) and estradiol (E2) remains unclear. Objective: We assessed the associations of T, DHT, and E2 in men aged 70 yr or older and established reference ranges for these in healthy older men. Participants: Community-dwelling men aged 70–89 yr residing in Perth, Western Australia, Australia, participated in the study. Main Outcome Measures: Plasma T, DHT, and E2 were assayed using liquid chromatography-tandem mass spectrometry in early morning samples from 3690 men. Results: Increasing age, higher body mass index and waist to hip ratio, dyslipidemia, diabetes, and higher LH were independently associated with lower levels of T and DHT. Increasing age, diabetes, and higher LH were associated with lower E2. In a reference group of 394 men aged 76.1 ± 3.2 yr reporting excellent or very good health with no history of smoking, diabetes, cardiovascular disease, cancer, depression, or dementia, the 2.5th percentile for T was 6.4 nmol/liter (184 ng/dl); DHT, 0.49 nmol/liter; and E2, 28 pmol/liter. Applying these cutoffs to all 3690 men, those with low T or DHT had an increased odds ratio for frailty, diabetes, and cardiovascular disease. Men with both low T and DHT had a higher odds ratio for these outcomes. Conclusions: The 2.5th percentile in a reference group of healthy older men provides age-appropriate thresholds for defining low T, DHT, and E2. Additional studies are needed to test their potential applicability and clinical utility in older men.

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Authors
Yeap, B. B., Alfonso, H., Chubb, S. A. P., Handelsman, D. J., Hankey, G. J., Norman, P. E., & Flicker, L.
Affiliations
  • The University of Western Australia (AU)
  • Western Australian Centre for Health and Ageing (H.A., L.F.), Western Australia 6009, Australia
  • The University of Sydney (AU)
Corresponding author
Yeap, Bu B.
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2012-11-01
Volume
97
Issue
11
Pages
4030-4039
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2012-2265
OpenAlex
W2145924182
Cited by
155
References
45
Citations by year
2026: 2 · 2025: 6 · 2024: 7 · 2023: 7 · 2022: 10 · 2021: 8 · 2020: 11 · 2019: 7 · 2018: 16 · 2017: 12 · 2016: 14 · 2015: 16 · 2014: 29 · 2013: 10
FWCI
14.09
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
  • eSpace (Curtin University) (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
testosterone, dihydrotestosterone, estradiol, reference values, older men, frailty, diabetes mellitus, cardiovascular disease, luteinizing hormone, body mass index, waist-to-hip ratio, dyslipidemia
MeSH terms
Aged, Aged, 80 and over, Chromatography, Liquid, Estradiol, Health Status, Humans, Male, Reference Values, Dihydrotestosterone, Testosterone, Western Australia, Cohort Studies, Tandem Mass Spectrometry

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