Noriaki Kurita1, Shigeo Horie2, Shin Yamazaki3, Koji Otani4, Miho Sekiguchi4, Yoshihiro Onishi5, Misa Takegami6, Rei Ono7, Shin-ichi Konno4, Shin-ichi Kikuchi4, Shunichi Fukuhara8. 1. Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan; Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan. 2. Department of Urology, Juntendo University School of Medicine, Tokyo, Japan. 3. Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan. 4. Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan. 5. Institute for Health Outcomes and Process Evaluation Research (i-Hope International), Kyoto, Japan. 6. Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan. 7. Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan. 8. Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan; Center for Innovative Research for Communities and Clinical Excellence (CIRC(2)LE), Fukushima Medical University, Fukushima, Japan. Electronic address: fukuhara.shunichi.6m@kyoto-u.ac.jp.
Abstract
OBJECTIVES: Findings from several experimental studies in animals have suggested a protective action of testosterone on kidney function, but hard evidence for such an association in humans is scarce. We examined the association between testosterone levels and kidney function among adult men living in super-aged communities. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: We conducted cross-sectional study involving residents aged 40-80 years who participated in annual health check-ups in 2 communities. A total of 1031 men were recruited in 2010. Main exposure was salivary testosterone (sT) levels measured using an enzyme-linked immunosorbent assay. Main outcome was estimated glomerular filtration rate (eGFR) determined by age, gender, and serum creatinine levels. RESULTS: For the 848 participants analyzed, median age and eGFR were 69 years and 69.1 mL/min/1.73 m(2), respectively. On comparison of 90th-percentile sT levels with lower levels, our general linear model with restricted cubic splines showed that lower sT levels were associated with decreased eGFR after adjustment for sociodemographic characteristics, comorbidities, and blood pressure. For example, fifth percentile sT was associated with decreased eGFR, with a difference in eGFR [-3.43 mL/min/1.73 m(2) (95% confidence interval, CI -6.02 to -0.84)] comparable in magnitude to the reduction in eGFR observed for a 6-year increase in age in our population. The association between low testosterone levels and decreased eGFR remained similar even when analyses were restricted to participants aged over 60 years (734 participants, median age 71 years). CONCLUSIONS: Results from our study indicated that having low testosterone levels was independently associated with reduced eGFR in adult men. Our finding of this association between low testosterone levels and reduced kidney function needs to be corroborated among persons with chronic kidney disease or in a longitudinal study.
OBJECTIVES: Findings from several experimental studies in animals have suggested a protective action of testosterone on kidney function, but hard evidence for such an association in humans is scarce. We examined the association between testosterone levels and kidney function among adult men living in super-aged communities. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: We conducted cross-sectional study involving residents aged 40-80 years who participated in annual health check-ups in 2 communities. A total of 1031 men were recruited in 2010. Main exposure was salivary testosterone (sT) levels measured using an enzyme-linked immunosorbent assay. Main outcome was estimated glomerular filtration rate (eGFR) determined by age, gender, and serum creatinine levels. RESULTS: For the 848 participants analyzed, median age and eGFR were 69 years and 69.1 mL/min/1.73 m(2), respectively. On comparison of 90th-percentile sT levels with lower levels, our general linear model with restricted cubic splines showed that lower sT levels were associated with decreased eGFR after adjustment for sociodemographic characteristics, comorbidities, and blood pressure. For example, fifth percentile sT was associated with decreased eGFR, with a difference in eGFR [-3.43 mL/min/1.73 m(2) (95% confidence interval, CI -6.02 to -0.84)] comparable in magnitude to the reduction in eGFR observed for a 6-year increase in age in our population. The association between low testosterone levels and decreased eGFR remained similar even when analyses were restricted to participants aged over 60 years (734 participants, median age 71 years). CONCLUSIONS: Results from our study indicated that having low testosterone levels was independently associated with reduced eGFR in adult men. Our finding of this association between low testosterone levels and reduced kidney function needs to be corroborated among persons with chronic kidney disease or in a longitudinal study.
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