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Estradiol drop could explain blood hemoglobin decreases in older men
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Decreased estradiol levels could be partially responsible for reduced blood hemoglobin in healthy elderly men, according to research published in The Journal of Clinical Endocrinology & Metabolism.
In the population-based Osteoporotic Fractures in Men (MrOS) study, involving 918 men without prostate cancer aged 70 to 81 years, Swedish researchers found serum estradiol correlated positively and independently with blood hemoglobin.
Catharina Lewerin, MD, PhD, of the Institute of Medicine at the University of Gothenburg, Sweden, and colleagues evaluated the relationship between the hormone and hemoglobin, adjusting for age, BMI, erythropoietin (EPO), total testosterone, cystatin C and status of iron and vitamin B.
Estradiol showed a negative association with age (r=–0.14; P<.0001). Hemoglobin showed a positive association with both estradiol (r=0.21; P<.001) and testosterone (r=0.1; P<.01), with adjustments for age.
In multivariate analysis, estradiol, EPO, BMI, transferrin saturation, cystatin C and free thyroxine were independent predictors for hemoglobin; testosterone was not. Upon excluding participants with hemoglobin <130 g/L, testosterone <8 nmol/L (n=99), or both, the association between hemoglobin and testosterone was no longer significant, but the associations between hemoglobin and estradiol remained.
With adjustments made for age, BMI and EPO, men with lower estradiol levels were more likely to have hemoglobin in the lowest quartile of values (OR per standard deviation decrease in estradiol=1.61; 95% CI, 1.34-1.93). Patients with anemia (hemoglobin <130 g/L) had a lower average estradiol level than those without anemia (67.4 pmol/L vs. 79.4 pmol/L; P<.001).
“Taken together, our data indicate that estradiol might be an independent regulator of [hemoglobin] in elderly men,” the researchers wrote.
Disclosure: This work was supported by the Swedish Research Council, the Swedish Foundation for Strategic Research, the ALF/LUA research grant in Gothenburg and the Gustav V and Queen Victoria Freemason Foundation.
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