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Serum estradiol associates with blood hemoglobin in elderly men; The MrOS Sweden Study

Journal article
Authors Catharina Lewerin
Herman Nilsson-Ehle
Stefan Jacobsson
Helena Johansson
Valter Sundh
M. K. Karlsson
Mattias Lorentzon
E. Barrett-Connor
Liesbeth Vandenput
Claes Ohlsson
Dan Mellström
Published in Journal of Clinical Endocrinology and Metabolism
Volume 99
Issue 7
Pages 2549-56
ISSN 0021-972X
Publication year 2014
Published at Institute of Biomedicine, Department of Clinical Chemistry and Transfusion Medicine
Centre for Bone and Arthritis Research
Institute of Medicine
Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages 2549-56
Language en
Links dx.doi.org/10.1210/jc.2013-4111
Subject categories Clinical Medicine

Abstract

Context: Blood hemoglobin (Hb) declines with age in healthy elderly men, in whom decreasing testosterone has been regarded as part of normal ageing. However, the association between Hb and serum estradiol is incompletely known. Objective: To determine whether estradiol is associated with anemia/Hb and established determinants of Hb in elderly men without prostate cancer. Design, Setting and Participants: The MrOS (Osteoporotic Fractures in Men) is a population-based study (n=918, median age 75.3 years, range 70-81 years). Main Outcome Measures: We evaluated total estradiol in relation to Hb and adjusted for potential confounders (i.e. age, body mass index (BMI), erythropoietin (EPO), total testosterone, cystatin C, iron- and B-vitamin status). Results: Estradiol correlated negatively with age (r=-0.14, p<0.001). Hb correlated (age adjusted) positively with estradiol (r=0.21, p<0.001) and testosterone (r=0.10, p<0.01). Independent predictors for Hb in multivariate analyses were estradiol, EPO, BMI, transferrin saturation, cystatin C and free T4 but not testosterone. After exclusion of subjects with Hb <130g/L and/or testosterone <8 nmol/L (n=99), the correlation between Hb and testosterone was no longer significant, whereas the associations between Hb and estradiol remained. After adjusting for age, BMI and EPO, men with lower estradiol levels were more likely to have Hb in the lowest quartile of values [OR per SD decrease in estradiol = 1.61 (95% CI 1.34-1.93)]. Anemic subjects (Hb <130 g/L) had lower mean estradiol than non-anemic (67.4 vs 79.4 pmol/L, p<0.001). Conclusions: Estradiol correlated, positively and independently, with Hb. Decreased estradiol might partly explain the age-related Hb decline observed in healthy elderly men.

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