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Oestradiol level, oestrogen receptors, and mortality in elderly men: The three‐city cohort study
Author(s) -
Laouali Nasser,
BraillyTabard Sylvie,
Helmer Catherine,
Ancelin MarieLaure,
Tzourio Christophe,
Elbaz Alexis,
GuiochonMantel Anne,
Caico Marianne
Publication year - 2018
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13797
Subject(s) - medicine , cohort , proportional hazards model , demography , endocrinology , disease , cohort study , cancer , cause of death , oncology , physiology , sociology
Context Although endogenous oestradiol, generally considered as the female hormone, has been little investigated in men, it could play a role in men's health, mortality in particular. The influence of oestrogen receptors ( ER ) genetic polymorphisms on this relationship has never been studied. Design and Participants The Three‐City cohort study included (1999‐2001) 3650 men ≥65 years who were followed for mortality over 12 years. At baseline, total oestradiol ( tE 2) was measured and ER genotyped in a random subsample of 472 men without hormonal treatment. Free oestradiol ( fE 2) was estimated using Vermeulen and Södergard algorithms. Main Outcome Mortality data were obtained from death certificates. We used inverse probability weighted Cox models to examine the association of oestradiol with all‐cause and cause‐specific mortality and its interaction with ER genetic polymorphisms. Results A total of 183 men died over the follow‐up (cardiovascular disease ( CVD ), n = 44; cancer, n = 57; other causes, n = 82). After adjustment, there was a quadratic relationship of all‐cause mortality with tE 2 and fE 2 ( P ‐quadratic = 0.04 and 0.05, respectively), with higher mortality for the top and bottom tertiles compared to the middle one. These associations were stronger for CVD mortality ( P ‐quadratic = 0.01 and 0.02 for tE 2 and fE 2, respectively) and disappeared for cancer mortality. There was no evidence of an interaction of oestradiol with any ER polymorphisms on all‐cause mortality. Conclusion In elderly men, we showed a nonlinear association of tE 2 and fE 2 with all‐cause mortality. These quadratic relationships were stronger for CVD mortality and did not exist for cancer mortality. ER genetic polymorphisms did not modify this association.