Gretchen R. Esche

Lean mass and not fat mass is associated with male proximal femur strength.

Obesity is suspected to confer protection against fracture, but evidence is mixed. We examined proximal femur geometry and body composition measures in a diverse group of 1171 men (30–79 yr of age). Analyses showed that nonbone lean mass, but not fat mass, is independently associated with measures of proximal femur density, axial and bending strength, and resistance to buckling.

Correlates of low testosterone and symptomatic androgen deficiency in a population-based sample.

CONTEXT Risk factors for low testosterone and symptomatic androgen deficiency (AD) may be modifiable. OBJECTIVE Our objective was to examine demographic, anthropometric, and medical correlates of low testosterone and symptomatic AD. DESIGN Data were used from the Boston Area Community Health Survey, an epidemiological study conducted from 2002-2005. SETTING Data were obtained from a community-based random sample of racially and ethnically diverse men. PATIENTS OR OTHER PARTICIPANTS Data were available for 1822 men. MAIN OUTCOME MEASURES Multivariate logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for associations of covariates with 1) low testosterone and 2) symptomatic AD. The operational definition of low testosterone was serum total testosterone less than 300 ng/dl and free testosterone less than 5 ng/dl; symptomatic AD was defined as the additional presence of symptoms: any of low libido, erectile dysfunction, or osteoporosis or two or more of sleep disturbance, depressed mood, lethargy, or diminished physical performance. RESULTS Factors associated with low testosterone included age (OR = 1.36; 95% CI= 1.11-1.66, per decade), low per-capita income (

Association Between Testosterone and Estradiol and Age-Related Decline in Physical Function in a Diverse Sample of Men

6000 or less per household member vs. more than

Treatment of Symptomatic Androgen Deficiency: Results From the Boston Area Community Health Survey

30,000; OR = 2.86; 95% CI = 1.39-5.87), and waist circumference (per 10-cm increase; OR = 1.75; 95% CI = 1.45-2.12). Only age (OR = 1.36; 95% CI = 1.04-1.77), waist circumference (OR = 1.88; 95% CI = 1.44-2.47), and health status (OR = 0.21; 95% CI = 0.05-0.92, excellent vs. fair/poor) were associated with our construct of symptomatic AD. Of all variables, waist circumference was the most important contributor in both models. CONCLUSIONS Waist circumference is a potentially modifiable risk factor for low testosterone and symptomatic AD. Manifestation of symptoms may be a consequence of generally poor health status.

Association Between Testosterone and Estradiol and Age-Related Decline in Physical Function in a Diverse Sample of Men: AGING, HORMONES, AND PHYSICAL FUNCTION IN MEN

OBJECTIVES: To examine the association between aging and physical function in men by testing a theoretically based model of aging, hormones, body composition, strength, and physical function with data obtained from men enrolled in the Boston Area Community Health/Bone (BACH/Bone) Survey.

ASSOCIATION OF TESTOSTERONE AND ESTRADIOL WITH AGE-RELATED DECLINES IN PHYSICAL FUNCTION IN A DIVERSE SAMPLE OF MEN

BACKGROUND Despite the aging of the US population and increasing sales of prescription testosterone, treatment patterns for androgen deficiency (AD) are poorly understood. We describe patterns and correlates of testosterone treatment in community-dwelling men. METHODS The Boston Area Community Health Survey is an observational study of a population-based random sample of racially and ethnically diverse men representative of Boston, Massachusetts. Data collected by in-person interview from April 2002 to June 2005 included health status, socioeconomic status, access to medical care, and use of prescription medications. A venous blood sample was collected. The operational definition of untreated AD was serum total testosterone level less than 300 ng/dL (to convert to nanomoles per liter, multiply by 0.0347) and free testosterone level less than 5 ng/dL, and the presence of at least 1 specific symptom (low libido, erectile dysfunction, or osteoporosis) or 2 or more less-specific symptoms (sleep disturbance, depressed mood, lethargy, or diminished physical performance) and not using prescription testosterone. Any man who was using testosterone was considered to have treated AD. RESULTS Data were available for 1486 Boston Area Community Health Survey participants (mean age, 46.4 years; age range, 30-79 years). A total of 5.5% (95% confidence interval, 3.5-8.5) men met the criteria for having untreated, symptomatic AD, and 0.8% (95% confidence interval, 0.4-1.4) met the criteria for having treated AD. Considering all cases, the proportion treated was 12.2%. Men with untreated AD seemed to have adequate access to care. CONCLUSIONS Under our assumptions, a large majority (87.8%) of 97 men in our groups with AD were not receiving treatment despite adequate access to care. The reasons for this are unknown but could be due to unrecognized AD or unwillingness to prescribe testosterone therapy.

Prevalence of symptomatic androgen deficiency in men.

OBJECTIVES: To examine the association between aging and physical function in men by testing a theoretically based model of aging, hormones, body composition, strength, and physical function with data obtained from men enrolled in the Boston Area Community Health/Bone (BACH/Bone) Survey.

Age trends in proximal femur geometry in men: variation by race and ethnicity

OBJECTIVES: To examine the association between aging and physical function in men by testing a theoretically based model of aging, hormones, body composition, strength, and physical function with data obtained from men enrolled in the Boston Area Community Health/Bone (BACH/Bone) Survey.