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Low testosterone levels as an independent predictor of mortality in men with chronic liver disease
Objective To examine the prevalence and prognostic implications of low serum testosterone levels in men with chronic liver disease. Design We conducted an observational study at a tertiary referral centre. Patients and measurements Baseline serum testosterone was measured in 171 men presenting to th...
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| Published in: | Clinical endocrinology (Oxford) 2012-08, Vol.77 (2), p.323-328 |
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| Main Authors: | , , , , , , , , |
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| container_end_page | 328 |
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| container_title | Clinical endocrinology (Oxford) |
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| creator | Grossmann, Mathis Hoermann, Rudolf Gani, Linsey Chan, Irene Cheung, Ada Gow, Paul J Li, Angela Zajac, Jeffrey D. Angus, Peter |
| description | Objective
To examine the prevalence and prognostic implications of low serum testosterone levels in men with chronic liver disease.
Design
We conducted an observational study at a tertiary referral centre.
Patients and measurements
Baseline serum testosterone was measured in 171 men presenting to the Victorian Liver Transplant Unit for liver transplant evaluation. Patients were followed up to liver transplant or death.
Results
Sixty‐one per cent of men had a low total testosterone level (TT, |
| doi_str_mv | 10.1111/j.1365-2265.2012.04347.x |
| format | article |
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To examine the prevalence and prognostic implications of low serum testosterone levels in men with chronic liver disease.
Design
We conducted an observational study at a tertiary referral centre.
Patients and measurements
Baseline serum testosterone was measured in 171 men presenting to the Victorian Liver Transplant Unit for liver transplant evaluation. Patients were followed up to liver transplant or death.
Results
Sixty‐one per cent of men had a low total testosterone level (TT, <10 nm), and 90% of men had a low calculated free testosterone level (cFT, <230 pm). During the available observation time (median 8 months, interquartile range 4–14 months), 56 men (33%) died and 63 (37%) received a liver transplant. Fifty‐two (30%) survived without a transplant. Median time to death was 8 months (range 2–13) and to liver transplant was 8 months (4–14). Baseline low TT and cFT levels both (P < 0·0001) predicted mortality. Moreover, in a Cox proportional hazard model, both low total (P = 0·02) and free testosterone (P = 0·007) levels remained predictive of death independently of established prognostic factors, such as the model for end‐stage liver disease (MELD) score and serum sodium levels. A decrease in TT by 1 nm and in cFT by 10 pm was associated with an 8% increase in mortality.
Conclusions
Low testosterone levels are common in men with severe liver disease and predict mortality independent of MELD, the standard score used to prioritize the allocation of liver transplants.</description><identifier>ISSN: 0300-0664</identifier><identifier>EISSN: 1365-2265</identifier><identifier>DOI: 10.1111/j.1365-2265.2012.04347.x</identifier><identifier>PMID: 22280063</identifier><identifier>CODEN: CLECAP</identifier><language>eng</language><publisher>Oxford: Blackwell Publishing Ltd</publisher><subject>Biological and medical sciences ; Chronic Disease - mortality ; Endocrinopathies ; Epidemiology ; Fundamental and applied biological sciences. Psychology ; General aspects ; Humans ; Liver Diseases - blood ; Liver Diseases - mortality ; Male ; Medical sciences ; Middle Aged ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Testosterone - blood ; Vertebrates: endocrinology</subject><ispartof>Clinical endocrinology (Oxford), 2012-08, Vol.77 (2), p.323-328</ispartof><rights>2012 Blackwell Publishing Ltd</rights><rights>2015 INIST-CNRS</rights><rights>2012 Blackwell Publishing Ltd.</rights><rights>Copyright © 2012 Blackwell Publishing Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4657-2169ec215da79d00ddf6ceef924ba63c4a1e81e1a650a37e72c7f5b5a2c46c013</citedby><cites>FETCH-LOGICAL-c4657-2169ec215da79d00ddf6ceef924ba63c4a1e81e1a650a37e72c7f5b5a2c46c013</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26107332$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22280063$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grossmann, Mathis</creatorcontrib><creatorcontrib>Hoermann, Rudolf</creatorcontrib><creatorcontrib>Gani, Linsey</creatorcontrib><creatorcontrib>Chan, Irene</creatorcontrib><creatorcontrib>Cheung, Ada</creatorcontrib><creatorcontrib>Gow, Paul J</creatorcontrib><creatorcontrib>Li, Angela</creatorcontrib><creatorcontrib>Zajac, Jeffrey D.</creatorcontrib><creatorcontrib>Angus, Peter</creatorcontrib><title>Low testosterone levels as an independent predictor of mortality in men with chronic liver disease</title><title>Clinical endocrinology (Oxford)</title><addtitle>Clin Endocrinol</addtitle><description>Objective
To examine the prevalence and prognostic implications of low serum testosterone levels in men with chronic liver disease.
Design
We conducted an observational study at a tertiary referral centre.
Patients and measurements
Baseline serum testosterone was measured in 171 men presenting to the Victorian Liver Transplant Unit for liver transplant evaluation. Patients were followed up to liver transplant or death.
Results
Sixty‐one per cent of men had a low total testosterone level (TT, <10 nm), and 90% of men had a low calculated free testosterone level (cFT, <230 pm). During the available observation time (median 8 months, interquartile range 4–14 months), 56 men (33%) died and 63 (37%) received a liver transplant. Fifty‐two (30%) survived without a transplant. Median time to death was 8 months (range 2–13) and to liver transplant was 8 months (4–14). Baseline low TT and cFT levels both (P < 0·0001) predicted mortality. Moreover, in a Cox proportional hazard model, both low total (P = 0·02) and free testosterone (P = 0·007) levels remained predictive of death independently of established prognostic factors, such as the model for end‐stage liver disease (MELD) score and serum sodium levels. A decrease in TT by 1 nm and in cFT by 10 pm was associated with an 8% increase in mortality.
Conclusions
Low testosterone levels are common in men with severe liver disease and predict mortality independent of MELD, the standard score used to prioritize the allocation of liver transplants.</description><subject>Biological and medical sciences</subject><subject>Chronic Disease - mortality</subject><subject>Endocrinopathies</subject><subject>Epidemiology</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>General aspects</subject><subject>Humans</subject><subject>Liver Diseases - blood</subject><subject>Liver Diseases - mortality</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Testosterone - blood</subject><subject>Vertebrates: endocrinology</subject><issn>0300-0664</issn><issn>1365-2265</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNqNkVGPEyEUhYnRuHX1LxgSY-LLjBcYYPrgg5ldV5PumhiNj4Qyd7LU6VBhum3_vYytNfFJQoCE7xwu9xBCGZQsj7erkgklC86VLDkwXkIlKl3uH5HZ-eIxmYEAKECp6oI8S2kFALIG_ZRccM5rACVmZLkIOzpiGkMaMYYBaY8P2Cdq8xyoH1rcYF6GkW4itt6NIdLQ0XWIo-39eMgIXeNAd368p-4-W3hHe_-AkbY-oU34nDzpbJ_wxWm_JN8-XH9tPhaLzzefmveLwlVK6oIzNUfHmWytnrcAbdsph9jNebW0SrjKMqwZMqskWKFRc6c7uZSWZ70DJi7Jm6PvJoaf2_wls_bJYd_bAcM2GQa8qrSWnGf01T_oKmzjkKszTFaynjOpJ8P6SLkYUorYmU30axsP2cpMOZiVmdptpnabKQfzOwezz9KXpwe2yzW2Z-Gfxmfg9Qmwydm-i3ZwPv3lFAMtxFTpuyO38z0e_rsA01zfTaesL456n_Pdn_U2_jBKCy3N97sbc3vFr5pb2Zgv4hezebJ-</recordid><startdate>201208</startdate><enddate>201208</enddate><creator>Grossmann, Mathis</creator><creator>Hoermann, Rudolf</creator><creator>Gani, Linsey</creator><creator>Chan, Irene</creator><creator>Cheung, Ada</creator><creator>Gow, Paul J</creator><creator>Li, Angela</creator><creator>Zajac, Jeffrey D.</creator><creator>Angus, Peter</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201208</creationdate><title>Low testosterone levels as an independent predictor of mortality in men with chronic liver disease</title><author>Grossmann, Mathis ; Hoermann, Rudolf ; Gani, Linsey ; Chan, Irene ; Cheung, Ada ; Gow, Paul J ; Li, Angela ; Zajac, Jeffrey D. ; Angus, Peter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4657-2169ec215da79d00ddf6ceef924ba63c4a1e81e1a650a37e72c7f5b5a2c46c013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Biological and medical sciences</topic><topic>Chronic Disease - mortality</topic><topic>Endocrinopathies</topic><topic>Epidemiology</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>General aspects</topic><topic>Humans</topic><topic>Liver Diseases - blood</topic><topic>Liver Diseases - mortality</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Testosterone - blood</topic><topic>Vertebrates: endocrinology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grossmann, Mathis</creatorcontrib><creatorcontrib>Hoermann, Rudolf</creatorcontrib><creatorcontrib>Gani, Linsey</creatorcontrib><creatorcontrib>Chan, Irene</creatorcontrib><creatorcontrib>Cheung, Ada</creatorcontrib><creatorcontrib>Gow, Paul J</creatorcontrib><creatorcontrib>Li, Angela</creatorcontrib><creatorcontrib>Zajac, Jeffrey D.</creatorcontrib><creatorcontrib>Angus, Peter</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical endocrinology (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grossmann, Mathis</au><au>Hoermann, Rudolf</au><au>Gani, Linsey</au><au>Chan, Irene</au><au>Cheung, Ada</au><au>Gow, Paul J</au><au>Li, Angela</au><au>Zajac, Jeffrey D.</au><au>Angus, Peter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Low testosterone levels as an independent predictor of mortality in men with chronic liver disease</atitle><jtitle>Clinical endocrinology (Oxford)</jtitle><addtitle>Clin Endocrinol</addtitle><date>2012-08</date><risdate>2012</risdate><volume>77</volume><issue>2</issue><spage>323</spage><epage>328</epage><pages>323-328</pages><issn>0300-0664</issn><eissn>1365-2265</eissn><coden>CLECAP</coden><abstract>Objective
To examine the prevalence and prognostic implications of low serum testosterone levels in men with chronic liver disease.
Design
We conducted an observational study at a tertiary referral centre.
Patients and measurements
Baseline serum testosterone was measured in 171 men presenting to the Victorian Liver Transplant Unit for liver transplant evaluation. Patients were followed up to liver transplant or death.
Results
Sixty‐one per cent of men had a low total testosterone level (TT, <10 nm), and 90% of men had a low calculated free testosterone level (cFT, <230 pm). During the available observation time (median 8 months, interquartile range 4–14 months), 56 men (33%) died and 63 (37%) received a liver transplant. Fifty‐two (30%) survived without a transplant. Median time to death was 8 months (range 2–13) and to liver transplant was 8 months (4–14). Baseline low TT and cFT levels both (P < 0·0001) predicted mortality. Moreover, in a Cox proportional hazard model, both low total (P = 0·02) and free testosterone (P = 0·007) levels remained predictive of death independently of established prognostic factors, such as the model for end‐stage liver disease (MELD) score and serum sodium levels. A decrease in TT by 1 nm and in cFT by 10 pm was associated with an 8% increase in mortality.
Conclusions
Low testosterone levels are common in men with severe liver disease and predict mortality independent of MELD, the standard score used to prioritize the allocation of liver transplants.</abstract><cop>Oxford</cop><pub>Blackwell Publishing Ltd</pub><pmid>22280063</pmid><doi>10.1111/j.1365-2265.2012.04347.x</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Clinical endocrinology (Oxford), 2012-08, Vol.77 (2), p.323-328 |
| issn | 0300-0664 1365-2265 |
| language | eng |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Biological and medical sciences Chronic Disease - mortality Endocrinopathies Epidemiology Fundamental and applied biological sciences. Psychology General aspects Humans Liver Diseases - blood Liver Diseases - mortality Male Medical sciences Middle Aged Public health. Hygiene Public health. Hygiene-occupational medicine Testosterone - blood Vertebrates: endocrinology |
| title | Low testosterone levels as an independent predictor of mortality in men with chronic liver disease |
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