Serum concentrations of 17beta-E2 and 25-hydroxycholecalciferol (25OHD) in relation to all-cause mortality in older men--the MINOS study.

OBJECTIVE: To examine the association of serum hormone levels with all-cause mortality in older community-dwelling men.

DESIGN: Single centre cohort study.

SUBJECTS: Men aged 50 and older, insured by Société de Secours Minière de Bourgogne (Montceau les Mines, France). Among 3400 men invited to participate, 782 volunteers had serum hormone measurements and were followed up for 10 years. No exclusion criteria were used.

RESULTS: Nonsurvivors (n = 182) were older, had more comorbidities and lower physical performance. The lowest quartile of 25-hydroxycholecalciferol (25OHD) level predicted mortality [HR = 1.44, 95% confidence interval (CI): 1.03-2.03, P < 0.05] regardless of age, BMI, smoking, physical activity, vitamin D supplementation, and health status; mainly for the first 3 years. The 17beta-E(2) level predicted mortality independent of confounders after the third year (HR = 1.21 per 1 SD increase, 95% CI: 1.09-1.35, P < 0.001). In the fully adjusted models, risk of death increased per quartiles of 17beta-E(2) (trend -P < 0.001) and was higher in the third and the fourth quartiles compared with the lowest quartile (HR = 1.80, 95% CI: 1.09-2.98, P < 0.05 and HR = 2.83, 95% CI: 1.71-4.67, P < 0.001). Concentrations of testosterone and PTH did not predict mortality independent of the model.

CONCLUSIONS: In older men, increased 17beta-E(2) level predicted mortality after 3 years of follow-up. Thus, high 17beta-E(2) level may reflect presence of risk factors precipitating development of diseases. Low 25OHD level predicted mortality more weakly, mainly for the first 3 years of the follow-up, and was strongly influenced by the confounding variables. Thus, low 25OHD level may reflect poor current health status and unhealthy lifestyle.